Medihelp MedAdd Elect Medical Aid Plan
Overall, the Medihelp MedAdd Elect Medical Aid Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and in-hospital procedures to up to 3 Family Members. The Medihelp MedAdd Elect Medical Aid Plan starts from R2,676 ZAR.
| 👤 Main Member Contribution | R2,676 |
| 👥 Adult Dependent Contribution | R2,100 |
| 🍼 Child Dependent Contribution | R930 |
| 📌 Annual Limit | Unlimited Hospital Cover |
| 🏥 Hospital Cover | Unlimited |
| 💶 Prescribed Minimum Benefits (PMB) | ☑️ Yes |
| 💻 Screening and Prevention | ☑️ Yes |
| 📍 Medical Savings Account | ☑️ Yes |
| 👶 Maternity Benefits | ☑️ Yes |
| 🅰️ Chronic Conditions | ☑️ Yes |
Medihelp MedAdd Elect Plan – 11 Key Point Quick Overview
- ☑️ Medihelp MedAdd Elect Plan Overview
- ☑️ Medihelp MedAdd Elect Plan Contributions and Medical Savings
- ☑️ MedAdd Elect Plan Benefits and Cover Comprehensive Breakdown
- ☑️ MedAdd Elect Day-to-Day Benefits
- ☑️ MedAdd Elect Benefit Table
- ☑️ MedAdd Elect Emergency Benefits
- ☑️ MedAdd Elect Added Insured Benefits
- ☑️ Medihelp MedAdd Elect Plan Exclusions and Waiting Periods
- ☑️ Medihelp MedAdd Elect Plan vs. Similar Plans from other Medical Schemes
- ☑️ Our Verdict on The MedAdd Elect Plan
- ☑️ MedAdd Elect Plan Frequently Asked Questions
Medihelp MedAdd Elect Plan Overview
The Medihelp MedAdd Elect medical aid plan is one of 11, starting from R2,676 and includes a medical savings account, chronic medicine, out-of-hospital benefits and cover, care extender, extended maternity benefits, and more. Gap Cover is not available on the Medihelp MedAdd Elect Plan. However, Medihelp offers 24/7 medical emergency assistance. According to the Trust Index, Medihelp has a trust rating of 4.2.
MediHelp has the following 11 plans to choose from:
Medihelp MedAdd Elect Plan Contributions and Medical Savings
Contributions
| 🔎 Main Member | 👤 +1 Adult Dependent | 💙 +1 Child Dependent |
| R2,676 | R2,100 | R930 |
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Medical Savings Account
| 👤 Main Member | 👥 +1 Adult Dependent | 💙 +1 Child Dependent |
| R402 per month / R4,824 per year | R312 per month / R3,744 per year | R138 per month / R1,656 per year |
MedAdd Elect Plan Benefits and Cover Comprehensive Breakdown
MedAdd Elect Accumulative Unused Savings Contributions
Each month, a portion of your contributions equal to 15% is allocated to a savings account.
- This amounts to R402 per month or R4 824 per year for the principal member.
- Adult dependents receive R312 per month or R3 744 per year.
- Child dependents receive R138 per month or R1 656 per year.
These savings are intended to cover daily medical expenses. At the start of each year, the entire year’s contributions to the savings account become available as a credit facility. Any funds that are not used are carried forward to the following year. The remaining portion of your monthly contributions is used to fund your comprehensive core and insured benefits.
How Medihelp pays claims on MedAdd Elect
- Except for services relating to prescribed minimum benefits (PMB), qualifying claims are paid from the savings account first until the account is empty.
- Claims are then reimbursed until the insured’s daily benefits are exhausted. PMB services are paid from day-to-day benefits until they are depleted, then from core benefits without limitation.
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MedAdd Elect Day-to-Day Benefits
Benefits are first paid from the available Medical Savings Account. Once funds are depleted, the following limits apply to day-to-day benefits:
- All claims are paid up to 100% of the Medihelp Tariff (MT).
- Main Members – limited to R1,400 per year.
- Main Member and Dependents – limited to R2,700 per year.
MedAdd Elect Consultations
- GP appointments and follow-up appointments
- Specialists (35% co-payment if not referred by a network primary care physician or not pre-authorized)
- Telemedicine, virtual consultations, and visits from nurses at network pharmacies.
- Pharmacies providing primary care and emergency units, including primary care drug therapists, in terms of consultations and follow-ups.
- Physiotherapy, including material and treatment.
MedAdd Elect Medication
- The medication is obtained through the Medihelp Preferred Pharmacy Network and prescribed or given by a physician.
- Acute and non-PMB chronic medication and self-medication, including emergency room drugs and immunizations.
- Generic medicine – 100% of the MMAP Original medicine if no generic equivalent – 80% of the MT.
- 70% of the MMAP comprises original medication taken willingly when a generic alternative is available.
- Homeopathy, naturopathy, and osteopathy account for 25% of the possible daily benefit.
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MedAdd Elect Benefit Table
MedAdd Elect Care Extender
| 🔎 Additional GP Consultation | A beneficiary’s Pap smear, mammography, prostate test, FOBT, or bone mineral density test activates a family consultation benefit. |
| 📌 R475 for Self-Medication | After a beneficiary claims the combo health screening (blood glucose, cholesterol, BMI, and blood pressure measurement) at a preferred pharmacy clinic, the family will receive R475 for non-prescribed medicine. |
| 📍 PMB Chronic Medicine | Pre-approval and registration on Medihelp’s PMB drug management program are required.
Covered up to 100% of the MHRP.
There is a 60% co-payment for non-compliance with the formulary and DSP.
The unlimited cover is provided. |
☑️ DSPs
Medipost and Elect chronic collection points for PMB chronic medicine.
Dis-Chem/Medipost for Oncology medicine.
Dis-Chem/Medipost for HIV/AIDS medication. | Covered up to 100% of the MHRP.
There is a 60% co-payment for non-compliance with the formulary and DSP.
The unlimited cover is provided. |
| ✅ Clinical Psychology and Psychiatric Nursing in and out-of-hospital | Covered up to 100% of the MT.
Claims for services and treatment are paid from the medical savings account. |
Allied Medical Services (Out-of-Hospital)
Allied Medical Services (Out-of-Hospital), include the following:
- Occupational and speech therapy
- Dietitian services
- Audiometry
- Podiatry
- Massage
- Orthoptic
- Chiropractic
- Homeopathic
- Herbal and naturopathic
- Osteopathic
- Biokinetic services
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MedAdd Elect Standard Radiology
Pathology and Medical Technologist Services (via Ampath as the contracted DSP)
| 💙 Oxygen | Covered out-of-hospital.
Subject to pre-approval and clinical protocols and must be prescribed by a medical doctor.
Covered up to 100% of the MT.
Unlimited cover.
20% co-payment if this benefit is not pre-approved before treatment. |
| 🤓 Optometry | Subject to pre-authorization by a PPN.
Services must be via a PPN provider.
There is a limit of 1 composite consultation, including refraction test, tonometry, and visual field test per 2-year cycle.
Covered up to 100% of the MT. |
| 👓 Spectacles or Contact Lenses | Spectacles – Frames or lens enhancement
Limited to R285 per beneficiary/2 years.
Lenses (1 x clear pair)
Limited to single-vision or bifocal lenses per beneficiary/2 years.
Multifocal lenses are covered at the cost of bifocal lenses.
Contact lenses
Limited to R670 per beneficiary/2 years. |
MedAdd Elect Dentistry
| 🔎 Conservative Dental Services | Benefits are subject to Dental Risk Company (DRC) protocols, contracted to Medihelp as a DSP.
Benefits are subject to protocols and are limited to certain item codes. |
| ✅ Routine Check-ups | Covered up to 100% of the MT.
Limited to once every six months for beneficiaries <18.
Only available to two beneficiaries per year.
The benefit is paid from the savings account for beneficiaries 18>. |
| ☑️ Oral Hygiene | Scale and Polish Treatments:
Covered up to 100% of the MT.
Limited to once every six months for beneficiaries <18.
Only available to two beneficiaries per year.
The benefit is paid from the savings account for beneficiaries 18>.
Fluoride Treatment for children between 5 and 13:
Covered up to 100% of the MT.
Paid from the medical savings account.
Fissure sealants for children between 5 and 16 (permanent teeth):
Covered up to 100% of the MT.
Paid from the medical savings account. |
| 📌 Fillings | Treatment plans and x-rays might be requested where multiple fillings are necessary.
Pre-approval is required for 4> fillings per year and 2 fillings on front teeth per visit.
Covered up to 100% of the MT.
Limited to 1 filling per tooth per year for beneficiaries <18.
Fillings for beneficiaries 18> are paid from the available medical savings. |
| 📍 Tooth Extractions and Root Canals on permanent teeth in the Dentist’s chair | Pre-authorization for 4> extractions in a single visit.
Covered up to 100% of the MT.
Beneficiaries under 18 have unlimited coverage.
Treatment for beneficiaries 18> is paid from the available medical savings. |
| ✔️ Laughing Gas (Dentist’s Chair) | Covered up to 100% of the MT.
Paid from the medical savings account. |
| ✳️ Dentistry under conscious sedation (Dentist’s chair) | The benefit is only available for removing impacted teeth (3rd molars)
Covered up to 100% of the MT
20% co-payment for no authorization. |
| 💤 Dentistry under general anesthesia in a day procedure facility, including the removal of impacted teeth and extensive dental treatment for children <7 (only once per beneficiary yearly) | Covered up to 100% of the MT
Member must pay the first R3,700 per admission.
35% co-payment for procedures not performed in a day procedure network.
20% co-payment for no authorization. |
| 🔎 Special Needs Patients – dentistry under general anesthesia in a day procedure | Covered up to 100% of the MT
35% co-payment for procedures not performed in a day procedure network.
20% co-payment for no authorization. |
| 🦷 Plastic Dentures | Covered up to 100% of the MT.
Paid from the medical savings account.
Limited to one set per beneficiary/4 years. |
| ❌ X-Rays | Intra-Oral X-Rays
Covered up to 100% of the MT.
Beneficiaries under 18 have unlimited coverage.
Treatment for beneficiaries 18> is paid from the available medical savings.
Extra-Oral X-Rays
Covered up to 100% of the MT.
Beneficiaries under 18 have unlimited coverage.
Treatment for beneficiaries 18> is paid from the available medical savings. |
| 🪥 Specialized Dentistry | Subject to pre-authorization and DRC protocols. |
| ☑️ Partial Metal Frame Dentures | Covered up to 100% of the MT.
Paid from the savings account.
20% co-payment for no authorization. |
| 😊 Maxillofacial Surgery and Oral Pathology | Benefits for temporomandibular joint (TMJ) benefit limited to non-surgical treatment or interventions.
Covered up to 100% of the MT.
Paid from the savings account.
20% co-payment for no authorization. |
| 👑 Crowns and Bridges | Covered up to 100% of the MT.
Paid from the savings account.
20% co-payment for no authorization. |
| 📈 Implants | Covered up to 100% of the MT.
Paid from the savings account.
20% co-payment for no authorization. |
| 📉 Orthodontic Treatment | Covered up to 100% of the MT.
Paid from the savings account.
Limited to once per beneficiary <18.
Payment is made from the authorization date until the patient turns 18. |
| 📊 Periodontal Treatment | Covered up to 100% of the MT.
Paid from the savings account.
20% co-payment for no authorization. |
External Prostheses and Medical Appliances
🔎 Services in and out of the hospital, including fitting, cost of repairs, maintenance, spares, accessories, and adjustments on the following:
Artificial Eyes
Speech and Hearing Aids
Artificial Limbs
Wheelchairs
External Breath Prostheses
Medical Appliances
CPAP Apparatus | Covered up to 100% of the MT.
Paid from the savings account. |
| 📌 Hyperbaric Oxygen Treatment (In and Out-of-Hospital) | Covered up to 100% of the MT.
Limited to R800 per family per year. |
📍 Stoma Components
Incontinence Products or Supplies | Covered up to 100% of the MT.
The unlimited cover is available. |
MedAdd Elect Hospitalization and Advanced Treatment
| 1️⃣ Chronic Illness and PMB | Subject to protocols, pre-authorization, DSPs, and the specialist network.
Covered up to 100% of the cost or the contracted tariff.
Unlimited cover provided.
Co-payments can apply if not using a DSP or deviating from the code. |
2️⃣ Trauma Benefits
This applies to major trauma requiring hospitalization, for example:
Motor Vehicle Accidents
Stab Wounds
Gunshot Wounds
Head Trauma
Burns
Near-drowning | Subject to authorization, PMB protocols, and case management.
Covered up to 100% of the cost or the contracted tariff. |
| 3️⃣ Post-Exposure Prophylaxis (HIV/AIDS) | Subject to authorization, PMB protocols, and case management.
Covered up to 100% of the cost or the contracted tariff. |
Emergency Transport Services via Netcare 911
| 🔎 In the Beneficiary’s Country of Residence (RSA, Lesotho, Eswatini, Mozambique, Namibia, Zimbabwe, Botswana), including road and air transport. | Unlimited Cover.
Covered up to 100% of the MT.
If not pre-approved, a 50% co-payment applies. |
| ☑️ Outside the beneficiary’s Country of Residence | Road Transport
Covered up to 100% of the MT.
If not pre-approved, a 50% co-payment applies.
Limited to R2,320 per case.
Air Transport
Covered up to 100% of the MT.
If not pre-approved, a 50% co-payment applies.
Limited to R15,400 per case. |
MedAdd Elect Hospitalization
(Only MedAdd Elect hospital and day procedure network can be used)
🅰️ Intensive Care and high-care wards
Ward Accommodation
Theatre fees
Treatment and medicine in the ward
In-hospital consultation with GPs and specialists
Surgery
Anesthesia | Unlimited Cover.
Covered up to 100% of the MT.
If not pre-approved, a 20% co-payment applies.
If not admitted to a hospital/day procedure facility in the network, a 35% co-payment applies.
Additional co-payments on certain procedures may apply. |
🅱️ Day Procedures
(Including Ophthalmological, endoscopic, ear, nose, and throat procedures, dental procedures, removal of skin lesions, circumcisions, and procedures as pre-authorized) | Unlimited Cover.
Covered up to 100% of the MT.
If not admitted to a hospital/day procedure facility in the network, a 35% co-payment applies.
Additional co-payments on certain procedures may apply. |
| 📌 Hospital Medicine upon Discharge | Covered up to 100% of the MT.
There is an R390 limit per admission. |
MedAdd Elect Childbirth
Subject to pre-authorization, protocols, and case management
• Unlimited Cover.
• Covered up to 100% of the MT.
• If not pre-approved, a 20% co-payment applies.
Home Delivery Includes the following:
- Professional Nursing Fee
- Equipment
- Material and Medicine
- Covered up to 100% of the MT
- Limited to R14,900 per event
- If not pre-approved, a 20% co-payment applies
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Radiology, Pathology, and Medical Technologist Services
· In-Hospital cover only.
· Subject to clinical protocols and approved hospital admission.
· Members must use Ampath as the contracted Pathology DSP.
| 📌 Radiography | Covered up to 100% of the MT.
Limited to R1,210 per family yearly. |
| 📍 Specialized Radiography | MRI and CT scans
Subject to pre-authorization.
Covered up to 100% of the MT.
Unlimited Cover.
Member pays the first R3,200 per examination and R2,700 out of the hospital.
Angiography
Covered up to 100% of the MT.
Unlimited Cover. |
| ☑️ Clinical Technologist Services | Covered up to 100% of the MT.
Unlimited Cover. |
| ❤️ Organ Transplants | Covered up to 100% of the MT.
Unlimited Cover.
Subject to pre-authorization and clinical protocols.
Cornea implants
Covered up to 100% of the MT.
Limited to R32,600 per implant yearly. |
| 🏥 In-hospital Oxygen | Covered up to 100% of the MT.
Unlimited Cover. |
➡️ Renal Dialysis
Acute Renal Dialysis
Chronic/Peritoneal Renal Dialysis | Covered up to 100% of the MT.
Unlimited Cover.
Subject to pre-authorization and clinical protocols.
20% co-payment if not pre-approved. |
🚑 Post-Hospital Care
Speech therapy, occupational therapy, and physiotherapy 30 days after discharge | Accessible day-to-day benefits cover prescription medication and medical equipment.
Covered up to 100% of the MT.
Limited to the following:
Main Member – R2,100 per year.
Main Member + Dependents – R3,000 per year. |
✳️ Other Medical Services
Dietitian services, physiotherapy, and occupational therapy
Speech therapy
Audiometry and orthoptic services
Podiatry | Must be pre-approved and requested by the treating physician
Covered up to 100% of the MT.
Unlimited Cover. |
🩺 Psychiatry
Psychiatrist-provided hospital and outpatient treatments
General ward accommodations
Institution-supplied medication
Outpatient consultations | Covered up to 100% of the MT.
Limited to R27,600 per beneficiary per year, with a limit of R38,000 per family per year.
If not pre-approved, a 20% co-payment applies. |
MedAdd Elect Oncology
PMB Cases
- Pre-authorization and Medihelp Oncology Program registration are required.
- Protocols, a DSP, and the MORP apply.
- Covered up to 100% of the MT.
- Unlimited Cover.
- 10% co-payment on non-DSP treatment.
- 20% co-payment for deviating from protocol.
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Non-PMB Cases
- Covered up to 100% of the MT.
- Limited to R242,000 per family per year.
- 10% co-payment on non-DSP treatment.
- 20% co-payment for deviating from protocol.
MedAdd Elect Alternative Hospitalization Services
| 1️⃣ Hospice Services and Subacute Care Facilities | Covered up to 100% of the MT.
20% co-payment if not pre-authorized
Unlimited cover. |
| 2️⃣ Palliative Care | Covered up to 100% of the MT.
20% co-payment if not pre-authorized
Limited to R21,800 per family per year. |
| 3️⃣ Private Nursing | Covered up to 100% of the MT.
20% co-payment if not pre-authorized
Unlimited cover. |
| 4️⃣ Appendectomy: Conventional or Laparoscopic Procedure | Unlimited cover.
Covered up to 100% of the MT. |
| 5️⃣ Prostatectomy: Conventional or Laparoscopic Procedure | Member pays the first R6,600 per admission.
Covered up to 100% of the MT. |
MedAdd Elect Emergency Benefits
A medical emergency is a sudden and unexpected occurrence that necessitates quick medical or surgical treatment to safeguard a patient’s health. Failure to offer medical or surgical treatment would result in severe impairment of bodily functioning or severe dysfunction of a bodily organ or portion or jeopardize the individual’s life. Netcare 911 is the designated service provider for Medihelp’s emergency transport services, and you must contact them in an emergency. Phone 082 911. Furthermore, you may also seek assistance at the nearby hospital’s emergency room. However, the following conditions apply:
- Emergency admissions must be reported to Medihelp on the following business day by calling 086 0200 678.
- If you visit an emergency facility but are not hospitalized, the care you receive will be covered by your regular plans.
- Facilities costs are not included.
Emergency Transport Services via Netcare 911
| ☑️ In the Beneficiary’s Country of Residence (RSA, Lesotho, Eswatini, Mozambique, Namibia, Zimbabwe, Botswana), including road and air transport. | Unlimited Cover.
Covered up to 100% of the MT.
If not pre-approved, a 50% co-payment applies. |
| ☑️ Outside the beneficiary’s Country of Residence | Road Transport
Covered up to 100% of the MT.
If not pre-approved, a 50% co-payment applies.
Limited to R2,320 per case.
Air Transport
Covered up to 100% of the MT.
If not pre-approved, a 50% co-payment applies.
Limited to R15,400 per case. |
MedAdd Elect Added Insured Benefits
- With a strong emphasis on preventative care, early diagnosis of potential health problems, and maternity benefits and childcare, these benefits are offered annually in addition to your insured benefits unless otherwise specified.
- Protocols and item codes may be applicable.
- Members can look for network provider information on Medihelp’s website or app using the provider search option.
- You can also sign up for HealthPrint, a free online health and fitness program offered by Medihelp, to activate the specified benefits.
Women’s Health
Mammogram
- For women 40 – 75 years old.
- Every two years.
- A medical doctor must request it.
Pap Smear
- For women 21 – 65 years old.
- Every three years.
- A medical doctor must request it.
Flu Vaccines
- Once yearly.
- It must be done at network pharmacy clinics.
Contraceptives
- Oral, injectable, or implantable contraceptives
- Female beneficiaries up to 50 years.
- Covered up to R155 per month and up to R2,015 per beneficiary.
- Intra-uterine devices for women up to 50 years
- Every 60 months.
- Covered up to R2,420 per beneficiary.
Enhanced Maternity Benefits
HealthPrint’s Maternity and Infant program registration will activate these additional benefits per family per year.
- Ten prenatal and postnatal consultations with a midwife, general practitioner, or gynecologist. However, a recommendation from a network GP to the gynecologist is not required.
- Two prenatal and postnatal visits to a lactation consultant, dietician, or antenatal classes.
- Two 2D ultrasound imaging.
Child Benefits
- Babies <2 years receive two additional visits to a general practitioner, pediatrician, or ear, nose, and throat specialist. However, a network Physician reference is not required to see these specialists.
- In network pharmacy clinics, the full series of regular child immunizations are covered for up to seven years.
- Vaccination of children against influenza at network pharmacy clinics.
Routine Screening and Immunization
- A combo test, including blood glucose, cholesterol, BMI & blood pressure measurement.
- Individual tests, including blood glucose or cholesterol.
- HIV testing, counseling & support
- A tetanus vaccine
- A flu vaccination
- Two HPV vaccinations for girls and boys between 10 – 14 years or three between 15 – 26 years
Men’s Health
- A prostate test (PSA level) was requested by a physician for men aged 40 to 75.
- Flu vaccination is administered at network pharmacies.
Screening and Immunization for beneficiaries 45>
- An FOBT test for recipients 45-75 years
- Women aged 65 and older can access one bone mineral density test every two years if requested by a physician.
- A Pneumovax vaccine on a 5-year cycle for each 55-year-old with asthma or COPD who is registered.
Wellness Support
- Back Treatment – this benefit covers back therapy at a DBC facility as an alternative to surgery for eligible patients. Moreover, treatment is a precondition for spinal surgery.
- One dietitian consultation with each registered HealthPrint member whose BMI is greater than 30 and whose BMI was determined by a BMI test.
- An oncology schedule is provided in conjunction with Independent Clinical Oncology Network oncologists (ICON)
- HIV program
- Presented in partnership with LifeSense Disease Management
Care Extender Benefit
Additional GP visit
- Once your increased insured benefits pay for a Pap smear, mammography, prostate test, FOBT, or bone mineral density test, the family will receive a one-time GP visit benefit.
- Test protocols will apply to this benefit.
Self-Medication (R475)
- Once your enhanced insured benefits pay for a combo health screening (blood glucose, cholesterol, BMI, and blood pressure), the family will receive a one-time R475 for self-medication.
Medihelp MedAdd Elect Plan Exclusions and Waiting Periods
Medihelp MedAdd Elect Exclusions
As medical research advances, new medical services are introduced each year. However, Medihelp covers life-saving medical treatment first. The Medical Schemes Act requires medical schemes to cover the diagnostic, treatment, and care costs of the mandated minimum benefits (PMB) without co-payments or limits. Furthermore, services must follow legislation’s PMB treatment algorithms and Medihelp’s managed healthcare guidelines, which may include pharmaceutical formularies. Medihelp will cover the cost of a substitute treatment if a protocol or formulary drug is ineffective or hazardous. However, the Medihelp MedAdd Elect plan excludes several items, including but not limited to the following:
- Restorative fillings for teeth injured by toothbrush abrasion, attrition, erosion, and fluorosis
- Resin bonding for restorations is billed separately from the restoration.
- The polishing of restorations
- Gold foil embellishments
- Ozone therapy Diagnostic dentures and laboratory fees
- Snoring aids and accompanying laboratory expenses
- Provisional dentures and corresponding laboratory fees
- Implants for third molars
- Dolder bars and accompanying implant abutments, including laboratory costs
- Fees for laboratory delivery
- Cosmetic orthodontic treatment and accompanying laboratory expenses
- Orthodontic treatment for those aged 18 and older
- Surgical periodontics, including gingivectomies, periodontal flap surgery, tissue grafting, and tooth hemisection.
- Placement of perio-chip
- Appointments missed
- The plan of treatment finished
- Electrognathographic recordings, pantographic recordings, and similar electronic examinations
- Tests for caries susceptibility and microbiology
- Pulp tests
- The price of mineral trioxide
- Enamel micro-abrasion
- All biological, biosimilar, and other drugs excluded by Medihelp’s drug exclusion list
- Advanced medical techniques, surgical instruments, and medications
- Blood-derived pharmaceuticals, including autologous blood serum eye drops, and more.
Medihelp MedAdd Elect Waiting Periods
During waiting periods, members are eligible for membership but not for benefits. For example, Medihelp could implement either a general or condition-specific waiting period as follows:
- The general waiting period is up to three months from the date of membership. During this time, you will not be eligible for benefits other than the minimum prescribed benefits (PMB). During this waiting period, the Scheme will not pay any claims you file.
- From the day you join, a condition-specific waiting period of up to 12 months applies. During this period, you will not be eligible for benefits related to a specific ailment for which you get medical advice, a diagnosis, care, or treatment (this excludes PMB).
Medihelp MedAdd Elect Plan vs. Similar Plans from other Medical Schemes
| 🔎 Medical Aid Plan | 🥇 Medihelp MedAdd Elect | 🥈 Bestmed Beat 2 | 🥉 Discovery Health KeyCare Plus |
| 🌎 International Cover | None | R500,000 – R3 million | None |
| 👤 Main Member Contribution | R2,676 | R2,545 | R1,652 – R3,354 |
| 👥 Adult Dependent Contribution | R2,100 | R1,976 | R1,652 – R3,354 |
| 💙 Child Dependent Contribution | R930 | R1,071 | R601 – R897 |
| 📉 Annual Limit | Unlimited Hospital Cover | Several limits and sub-limits | Unlimited Hospital Cover |
| 🏥 Hospital Cover | Unlimited | Subject to scheme rules | KeyCare Hospital Network – Unlimited |
| 💶 Prescribed Minimum Benefits | ☑️ Yes | ✅ Yes | ☑️ Yes |
| 💻 Screening and Prevention | ✅ Yes | ☑️ Yes | ✅ Yes |
| 💳 Medical Savings Account | ☑️ Yes | ✅ Yes | ☑️ Yes |
| 🔁 Gap Cover | None | None | ✅ Yes |
Our Verdict on The MedAdd Elect Plan
Medihelp MedAdd Elect is a medical aid plan offered by Medihelp, a South African medical scheme. The plan complements Medihelp’s core medical aid plans by providing additional cover for day-to-day medical expenses. Members of the plan pay a monthly contribution, with 15% of that amount being allocated to a savings account that can be used to cover daily medical expenses. At the start of each year, the entire year’s contributions to the savings account become available as a credit facility.
Any unused funds are carried forward to the following year. In addition to the savings account, Medihelp MedAdd Elect also provides comprehensive cover for various medical services, including chronic medication, dentistry, optometry, and hospitalization. Overall, Medihelp MedAdd Elect appears to be a comprehensive medical aid plan that offers a good balance of cover for day-to-day medical expenses and more serious medical events. However, the specific suitability of the plan will depend on an individual’s unique medical needs and budget. Therefore, potential members should carefully review the plan’s terms and conditions and compare it to other available medical aid plans before deciding.
You might also consider the following options of MediHelp:
MedAdd Elect Plan Frequently Asked Questions
What is Medihelp MedAdd Elect?
Medihelp MedAdd Elect is a medical aid plan offered by Medihelp, designed to provide additional cover for day-to-day medical expenses that Medihelp’s core medical aid plans may not cover.
What types of medical expenses are covered by Medihelp MedAdd Elect?
Medihelp MedAdd Elect covers a range of medical expenses, including chronic medication, dentistry, optometry, and hospitalization. The plan also includes a savings account that can be used to cover day-to-day medical expenses.
How does the savings account work?
Members of Medihelp MedAdd Elect pay a monthly contribution, with 15% of that amount allocated to a savings account. At the start of each year, the full year’s contributions to the savings account become available as a credit facility that can be used to cover day-to-day medical expenses. Furthermore, any unused funds are carried forward to the following year.
Is Medihelp MedAdd Elect suitable for everyone?
The suitability of Medihelp MedAdd Elect will depend on an individual’s unique medical needs and budget. Furthermore, some might find that the co-payments involved with MedAdd do not suit their budget or that the savings account is insufficient to cover day-to-day expenses.
How do I join Medihelp MedAdd Elect?
To join Medihelp MedAdd Elect, you will need to become a member of Medihelp and select the MedAdd Elect plan as an add-on to your core medical aid plan. Then, you can visit the Medihelp website or contact their customer service team.
What happens if I don’t use all the funds in my savings account?
Any unused funds in the savings account are carried forward to the following year. The full year’s contributions to the savings account become available as a credit facility at the start of each year. This means that you will have access to the unused funds and the new contributions.
