Overall, the Medihelp MedPlus Medical Aid Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and Specialist consultations to its members. The Medihelp MedPlus Medical Aid Plan starts from R14 184 ZAR.
| 👤 Main Member Contribution | R14 184 |
| 👥 Adult Dependent Contribution | R14 184 |
| 💙 Child Dependent Contribution | R3 540 |
| 📉 Annual Limit | Unlimited Hospital Cover |
| 🏥 Hospital Cover | Unlimited |
| 💶 Prescribed Minimum Benefits | ✅ Yes |
| 📌 Screening and Prevention | ☑️ Yes |
| ⚕️ Medical Savings Account | ✅ Yes |
| 🍼 Maternity Benefits | ☑️ Yes |
| 🏠 Home Care | ✅ Yes |
The Medihelp MedPlus medical aid plan is one of 12, starting from R14 184. It includes extensive coverage in and out-of-hospital for GP and Specialist consultations, radiology, pregnancy, chronic medication, dentistry, prostheses, and fewer co-payments on treatment. Gap Cover is not available on the Medihelp MedPlus 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 12 plans to choose from:
👉 Download the MedPlus Summary for 2025
| 👤 Main Member | 👥 +1 Adult Dependent | 💙 +1 Child Dependent |
| R14 184 | R14 184 | R3,540 |
| 📌 Consultations: Treatment | Covered up to 100% of the MT. Unlimited cover provided. |
| 📍 GP Consultations, Specialists, Telemedicine and Virtual Consults, Nurse Visits at Network Pharmacies Pharmacists who offer primary care and emergency units | Covered up to 100% of the MT. Limited to R4,500 per beneficiary per year and pooled per family. |
| ☑️ Physiotherapy (Out-of-hospital, treatment and material included) | Covered up to 100% of the MT. Limited to R4,500 per beneficiary per year and pooled per family. |
| ✅ Clinical Psychology and Psychiatric Nursing in and out-of-hospital | Covered up to 100% of the MT. Limited to R4,500 per beneficiary per year and pooled per family. |
| 🅰️ Other Medical Services Out-of-Hospital (Including Occupational and speech therapy, dietician services, audiometry, podiatry, massage, orthoptic, chiropractic, homoeopathic, herbal, naturopathic, osteopathic and biokinetic services) | Covered up to 100% of the MT. Limited to R4,500 per beneficiary per year and pooled per family. |
| 🅱️ Care Extender: Additional GP Consultation | When a beneficiary claims for a Pap smear, mammography, prostate exam, faecal occult blood test (FOBT), or bone mineral density test, an additional consultation benefit is activated for the family. |
| 🩺 Care Extender: R510 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 R510 for non-prescribed medicine. |
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Includes medicine obtained in the Preferred Pharmacy Network (PPN) and prescribed or dispensed by a medical doctor. Homeopathic, naturopathic, and osteopathic medicine – 25% of the available acute medicine benefit.
| ☑️ Acute and self-medication | R8 200 per person (pooled per family) |
| ☑️ Non-PMB Chronic Medicine | Covered up to 100% of the MMAP Limited to R23,100 per beneficiary yearly. Pre-authorisation & registration on Medihelp’s chronic medicine management programme. |
| ☑️ PMB Chronic Medicine (Out-of-Hospital) | Covered up to 100% of the MHRP. Unlimited cover is provided. |
| 🧪 Basic Radiology (Out-of-Hospital) | Covered up to 100% of the MT. Subject to clinical protocols. A medical doctor must request it. Only black and white X-rays will be covered if a chiropractor requests it. |
| 💙 Pathology and Medical Technologist Services (Out-of-Hospital) | Subject to clinical protocols. A medical doctor must request it. Subject to using the Pathology DSP – Ampath, Lancet, and PathCare Vermaak Covered up to 100% of the MT. |
| ⚕️ Oxygen | Day to day benefits: Hyperbaric oxygen treatment – R2 300 per person. Covered in hospital. Subject to pre-approval and clinical protocols and must be prescribed by a medical doctor. Covered up to 100% of the MT. 20% co-payment if not pre-approved before treatment. |
| 🤓 Optometry | Per person per 24-month cycle. Eye examination at a non-network optometrist – R400 per beneficiary per 24-month cycle. R1 135 for a frame/lens enhancements. (R851 for a frame/lens enhancements at non-network optometrist). Single vision and bifocal per beneficiary per 24-month cycle. R810 for multifocal lenses per beneficiary per 24-month cycle. Non-Network: R215 for single vision lenses. R460 for bifocal lenses. R810 for multifocal lenses per beneficiary per 24-month cycle. R1 835 for contact lenses per beneficiary per 24-month cycle. |
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| 👩⚕️ 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 specific item codes. |
| ✅ Dentistry: Routine Check-ups | Covered up to 100% of the MT. Limited to one in six months per beneficiary from date of service. |
| 🦷 Oral Hygiene | – Scale and Polish Treatments: Covered up to 100% of the MT. Limited to one in six months per beneficiary from date of service. – Fluoride Treatment for children between 5 and 13: Covered up to 100% of the MT. Limited to one in six months per beneficiary from date of service. – Fissure sealants for children between 5 and 16 (permanent teeth): Covered up to 100% of the MT. First and second permanent molars once per tooth. |
| ➡️ Fillings | Treatment plans and x-rays might be requested where multiple fillings are necessary. Pre-authorisation required for more than 4 fillings per year, 2 fillings on front teeth per visit and 4 extractions per visit Covered up to 100% of the MT. Limited to one filling per tooth yearly. |
| 🦷 Tooth Extractions and Root Canals on permanent teeth in the Dentist’s chair | Unlimited You might need Pre-authorization for 4> extractions in a single visit. Covered up to 100% of the MT. Benefits for the retreatment of a tooth subject to managed care protocols. Specific pre-authorisation apply to certain dental services. |
| 😊 Laughing Gas (Dentist’s Chair) | Covered up to 100% of the MT. |
| 😴 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. Extensive dental treatment is only offered for children <12 years. Subject to 20% co-payment |
| 💤 Dentistry under general anaesthesia in a day procedure facility, including the removal of impacted teeth | Covered up to 100% of the MT Removal of impacted teeth (3rd molars) Extensive dental treatment for children <7 (only once per beneficiary yearly) 35% co-payment for procedures not performed in a day procedure network. Co-payment of R1 120 per admission. |
| 💙 Special Needs Patients – dentistry under general anaesthesia in a day procedure | Covered up to 100% of the MT Unlimited cover provided. 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. Limited to one set per beneficiary/4 years. |
| 📌 X-Rays | Intra-Oral X-Rays: Covered up to 100% of the MT & Unlimited. Pre-authorisation for more than six per year. Extra-Oral X-Rays: Covered up to 100% of the MT. One per beneficiary every three years. |
| 📍 Specialized Dentistry | Subject to pre-authorization and DRC protocols. Covered 100% of the MT. |
| ☑️ Partial Metal Frame Dentures | Covered up to 100% of the MT. Two partial frames (upper or lower) per beneficiary every 5 years. 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 & Unlimited. A 20% co-payment applies if not authorized. |
| 👑 Crowns and Bridges | Covered up to 100% of the MT. Three crowns per family per year, once per tooth in a five-year period 20% co-payment for no authorization. |
| ✔️ Implants | Implants are subject to pre-approval. Covered up to 100% of the MT. Two implants per beneficiary in five-year period. R3 090 for implant components per implant. A 20% co-payment applies if the treatment is not pre-authorized. |
| 🅰️ Orthodontic Treatment | Covered up to 100% of the MT. R18 200 per beneficiary per lifetime. Limited to once per beneficiary <18. Payment is made from the authorization date until the patient turns 18. Subject to pre-authorisation and orthodontic needs analysis. |
| 🅱️ Periodontal Treatment | Covered up to 100% of the MT. Cover Unlimited (conservative non-surgical therapy only). Subject to pre-authorisation and treatment plan. 20% co-payment for no authorization. |
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| ☑️ 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, External Breath Prostheses, Medical Appliances, CPAP Apparatus | Consultations and follow-up consultations subject to available day-to-day benefits/savings. Covered up to 100% of the MT. – Artificial Eyes: Limited to R19,800 per beneficiary every three years. – Speech & hearing aids: Limited to R19,800 per beneficiary every three years. – Artificial Limbs: Limited to R10,700 per beneficiary every three years. |
| ✅ Wheelchairs | Covered up to 100% of the MT. Limited to R10,700 per beneficiary every 3 years. |
| 🅰️ Medical Appliances (back, leg, neck, and arm supports, crutches, orthopaedic footwear, nebulizers, etc. Hyperbaric oxygen treatment (as prescribed by a doctor) Insulin Pumps Glucometers (every 5 years) | Covered up to 100% of the MT. Limited to R2,300 per beneficiary per year. |
| 🅱️ Stoma Components Incontinence Products or Supplies | Covered up to 100% of the MT. Unlimited cover provided. |
| ✳️ Wigs (only for alopecia totalis or cancer) | Subject to pre-approval. Covered up to 100% of the MT. Limited to R2,300 per beneficiary every 3 years. |
| ☑️ CPAP Apparatus | A doctor must prescribe it. Covered up to 100% of the MT. Limited to R11,900 per beneficiary every 2 years. |
| 🅰️ 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. |
| 🅱️ Trauma Benefits This applies to major trauma requiring hospitalization, for example: Motor Vehicle Accidents, Stab Wounds, Gunshot Wounds, Head Trauma & Burns. | Subject to authorization, PMB protocols, and case management. Covered up to 100% of the cost or the contracted tariff. Unlimited cover provided. |
| 📌 Post-Exposure Prophylaxis (HIV/AIDS) | Subject to authorization, PMB protocols, and case management. Covered up to 100% of the cost or the contracted tariff. Unlimited cover provided. |
The Beneficiary’s Country of Residence (RSA, Lesotho, Eswatini, Mozambique, Namibia, Zimbabwe, Botswana) includes road and air transport.
Outside the beneficiary’s Country of Residence
Road Transport
Air Transport
(Only MedPlus hospital and day procedure network can be used)
| 1️⃣ 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 | Apply to state/private hospitals and day procedure facilities. Subject to pre-authorisation, protocols, and case management. Unlimited Cover. Covered up to 100% of the MT. If not pre-approved, a 20% co-payment applies per admission. |
| 2️⃣ Day Procedures (Including Ophthalmological, endoscopic, ear, nose, and throat procedures, dental procedures, removal of skin lesions, circumcisions) | Subject to pre-authorisation, clinical protocols, and services rendered in day procedure facility. Unlimited Cover. Covered up to 100% of the MT. Procedure-specific co-payments may also apply. Network plans: 35% co-payment applies to procedures performed outside the day procedure network. Non-network plans: 35% co-payment applies to procedures not performed in day procedure facility. |
| 3️⃣ Hospital Medicine upon Discharge | Covered up to 100% of the MT. There is a R720 limit per admission. Excludes PMB/chronic medicines. |
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Childbirth
💙Subject to pre-authorization, protocols, and case management:
Home Delivery
💙Includes the following:
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| 📈 Radiography | Covered up to 100% of the MT. Limited to R1,300 per family yearly. Subject to clinical protocols and on request of medical doctor. |
| 📉 Specialized Radiography | MRI and CT scans: Subject to pre-authorisation, clinical protocols & on request of a specialist. Covered up to 100% of the MT. Unlimited Cover. Angiography: Subject to pre-authorisation, clinical protocols & on request of a specialist. Covered up to 100% of the MT. Unlimited Cover. |
| 📊 PET (non-PMB) | Covered up to 100% of the MT & subject to pre-authorisation. Limited to R27,500 per case. |
| 📌 Clinical Technologist Services | In hospital – services must be prescribed by medical doctor/dentist. 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 R35,900 per implant yearly. |
| 🏥 In-hospital Oxygen | Covered up to 100% of the MT. Unlimited Cover. Out of hospital oxygen are subject to pre-authorisation, clinical protocols & prescription by medical doctor. |
| 🚑 Neurostimulators (Includes device and components) | Covered up to 100% of the MT. Limited to R144,600 per beneficiary. |
| ✳️ Renal Dialysis (In & Out of Hospital) Acute Renal Dialysis Chronic/Peritoneal Renal Dialysis | Covered up to 100% of the MT. Unlimited Cover. Subject to pre-authorisation, clinical protocols, preferred provider rates. 20% co-payment per admission if not pre-authorised. 30% co-payment if not obtained from a DSP. |
| 🏠 Post-Hospital Care Speech therapy, occupational therapy, and physiotherapy 30 days after discharge | Covered 100% of the MT. M = R2 300 per year M+ = R3 300 per year Including after a procedure in a day procedure facility. |
| ➡️ Other Medical Services – Dietician services, biokenitics, audiometry & orthoptic services. – Podiatry, speech therapy, massage, chiropractic services, homeopathic services, herbal and naturopathic services & osteopathic services. – Physiotherapy & occupational therapy. | In-hospital & protocols might apply. Covered up to 100% of the MT. Unlimited Cover. Must be pre-authorised & requested by the attending medical doctor. |
| 🧠 Psychiatry Psychiatrist-provided hospital and outpatient treatments General ward accommodations Institution-supplied medication Outpatient consultations | Covered up to 100% of the MT. Subject to pre-authorisation, protocols & services rendered in approved or network hospital/facility & prescribed by medical doctor. 20% co-payment per admission if not pre-authorised. 35% co-payment for voluntary admission to non-network hospital (network plans only). – Hospitalisation and professional psychiatric services: Limited to R53,900 per beneficiary per year, with a limit of R73,300 per family. – Treatment of depression out of hospital, subject registration on Mental Health programme: Limited to R6 000 per beneficiary per year. – Medicine: R160 per beneficiary per month, subject to the in-hospital limit & annual mental health limit. – Treatment of autism by an educational psychologist: Limited to one consultation per beneficiary per year, subject to in hospital benefit. |
| 🔎 Oncology PMB and non-PMB cases | All services relating to treatment & care In and out of hospital. Subject to pre-authorisation & registration on Medihelp Cancer Programme protocols, a DSP, and MORP apply. 20% co-payment if not pre-authorised. Covered 100% of MT. R650 000 per family per year. Deviation from protocols may result in co-payment. Voluntary use of non-network services – additional 10% co-payment. |
| 📌 Hospice Services and Subacute Care Facilities | Covered up to 100% of the MT. Unlimited Cover. Subject to pre-authorisation, programmes & protocols. Services rendered in approved facility & prescribed by medical doctor. 20% co-payment per admission if not pre-authorised. |
| 📍 Palliative Care | Covered up to 100% of the MT. 20% co-payment if not pre-authorized Limited to R33 800 per family per year. Subject to pre-authorisation, clinical protocols, services prescribed by medical doctor, treatment plan, programmes, protocols & formularies. |
| ☑️ Private Nursing | Covered up to 100% of the MT. Unlimited Cover. Subject to pre-authorisation, programmes & protocols. General day-to-day care excluded from benefits. 20% co-payment per case if not pre-authorised. |
| ✅ Conventional or Laparoscopic Procedure | Unlimited cover. Covered up to 100% of the MT. Subject to pre-authorisation. |
| ➡️ Robotic-assisted Laparoscopy | Covered up to 100% of the MT. Hospitalization is covered up to R139,000 per beneficiary. Subject to pre-authorisation. |
| ✳️ Refractive Surgery | Subject to pre-authorization and clinical protocols. Covered up to 100% of the MT. 20% co-payment per admission if not pre-authorised. 35% co-payment for voluntary admission to non-network hospital/day procedure facility (for network plans only). |
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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:
💙In the Beneficiary’s Country of Residence (RSA, Lesotho, Eswatini, Mozambique, Namibia, Zimbabwe, Botswana), including road and air transport:
💙Outside the beneficiary’s Country of Residence:
Road Transport
Air Transport
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| 📌 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 R180 per month and up to R2,400 per beneficiary. – Intra-uterine devices: Covered every 60 months. Covered up to R2,800 per beneficiary. |
| 🍼 Enhanced Maternity Benefits | – Ten prenatal & postnatal consultations with midwife, general practitioner, or gynecologist. Recommendation from a network GP to the gynecologist is not required. – Two prenatal & postnatal visits to lactation consultant, dietician, or antenatal classes. – Two 2D ultrasound imaging. – Antenatal supplements: Nine months iron & folic acid supplements. HealthPrint’s Maternity and Infant program registration will activate these additional benefits per family per year. |
| 👶 Child Benefits | Babies <2 years receive two additional visits to general practitioner, pediatrician, or ear, nose, and throat specialist. However, network Physician reference is not required to see these specialists. Regular child immunizations in-network pharmacy clinics covered for up to seven years. Vaccination of children against child flu at network pharmacy clinics. |
| 📉 Routine Screening and Immunization (Available at network pharmacy clinics per person) | 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 children 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 | – One back treatment: this benefit covers back therapy at a DBC facility as alternative to surgery for eligible patients. Moreover, treatment is a pre-condition for spinal surgery. – One dietitian consultation with each registered HealthPrint member if BMI measurement indicates BMI higher than 30. Oncology programme is provided in conjunction with Independent Clinical Oncology Network oncologists (ICON). – HIV program: Presented in partnership with LifeSense Disease Management. |
| 🔁 Care Extender Benefit | – One additional GP consultation – first of either a Pap smear, mammogram, prostate test, faecal occult blood test (FOBT) or bone mineral density test activates a one-off GP consultation for the family yearly. – Self-medication dispensed at network pharmacy – additional R510 will be activated for the family to use for non-prescribed medicine once a combo health screening has been claimed from the added insured benefits. |
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 MedPlus plan excludes several items, including but not limited to the following:
💙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:
💙Read more about the MediHelp Late Joiner fee
| 🔎 Medical Aid Plan | 🥇 Medihelp MedPlus (2025) | 🥈 Profmed ProPinnacle (2025) | 🥉 Discovery Health Executive Plan (2025) |
| 🌎 International Cover | None | Up to R8 million | Up to US$1 million |
| 👤 Main Member Contribution | R14 184 | R12,192 | R11,430 |
| 👥 Adult Dependent Contribution | R14 184 | R11,310 | R11,430 |
| 🍼 Child Dependent Contribution | R3,540 | R3,658 | R2,185 |
| 📈 Annual Limit | Unlimited Hospital Cover | ✅ Yes | Unlimited |
| 📉 Hospital Cover | Unlimited | Unlimited | Unlimited |
| ⚕️ Home Care | ☑️ Yes | ☑️ Yes | ☑️ Yes |
| 💙 Maternity Benefits | ✅ Yes | ✅ Yes | ✅ Yes |
| 💳 Medical Savings Account | ☑️ Yes | ☑️ Yes | ☑️ Yes |
👉 The Medihelp MedPlus plan is the top-tier health insurance plan offered by Medihelp in South Africa. It provides the most comprehensive cover for medical expenses, including unlimited hospitalization and chronic medication benefits, among others.
👉 The Medihelp MedPlus plan includes full cover for in-hospital and day-to-day medical expenses, international travel insurance, and access to advanced medical technology and treatments. Additionally, the plan offers wellness benefits such as a health risk assessment, screening tests, and a personal health report. However, one drawback of the Medihelp MedPlus plan is its relatively high cost compared to other Medihelp plans. Therefore, it may not be suitable for individuals on a tight budget or those with low healthcare needs.
👉 Overall, the Medihelp MedPlus plan offers significant advantages over other Medihelp plans regarding its comprehensive cover, advanced medical technology and treatments, and wellness benefits. Therefore, it is an excellent choice for individuals seeking high-quality healthcare and willing to invest in a top-tier health insurance plan.
💙You might also consider the following options of MediHelp:
The Medihelp MedPlus plan is the top-tier health insurance plan offered by Medihelp in South Africa, providing comprehensive medical cover, including unlimited hospitalization and chronic medication benefits.
The cost of the Medihelp MedPlus plan varies depending on factors such as age, location, and healthcare needs. However, it is generally more expensive than other Medihelp plans due to its comprehensive medical cover and advanced medical technology. For the primary member of MedPlus, the monthly contribution is R14,184.
The Medihelp MedPlus plan offers comprehensive medical cover, access to advanced medical technology and treatments, international travel insurance, and wellness benefits such as a health risk assessment, screening tests, and a personal health report.
One of the main drawbacks of the Medihelp MedPlus plan is its relatively high cost compared to other Medihelp plans, which may not be suitable for individuals on a tight healthcare budget or those with low healthcare needs.
The Medihelp MedPlus plan is an excellent choice for individuals seeking high-quality healthcare and willing to invest in a top-tier health insurance plan. However, it may not be the best option for individuals with low healthcare needs or a tight budget.
The Medihelp MedPlus plan offers more comprehensive medical cover and advanced medical technology than other Medihelp plans. Compared to other health insurance plans in South Africa, the Medihelp MedPlus plan is a top-tier one providing high-quality healthcare.
A hospital plan is a type of medical aid plan that covers only in-hospital treatment, including accommodation, nursing care, and medical procedures. Typically hospital plans have lower monthly premiums than comprehensive plans but provide limited cover for out-of-hospital expenses such as doctor’s visits and medication.
No, there is no waiting period for Prescribed Minimum Benefit (PMB) conditions with South African medical aids. PMBs are a set of medical conditions that all medical aids must cover in full, regardless of the type of plan or the member’s waiting period.
Yes, most South African medical aids cover pregnancy and childbirth, including prenatal care, hospitalization, and postnatal care. However, some plans may have waiting periods for pregnancy-related benefits or may require additional premiums for maternity benefits.
Yes, foreigners living and working in South Africa can access medical aid plans. However, some medical aids may require proof of residency or work permit before enrolling, and premiums may be higher for non-residents.
Yes, many South African medical aids offer unique plans for students, including discounted rates and benefits tailored to their needs. In addition, these plans cover essential healthcare services, such as doctor’s visits, emergency treatment, and prescription medication.
Yes, some medical aid plans in South Africa offer immediate cover, depending on the type of plan and the member’s health status.
Adriaan holds an MBA and specializes in medical aid research. With his commitment to perfection, he ensures the accuracy of all data presented on medicalaid.com every three months. When he is not conducting research, Adriaan can be found indulging in his passion for trout fishing amidst nature.
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