Home » Medical Insurance »

Medihelp MedVital Elect Medical Aid Plan

Overall, the Medihelp MedVital Elect Medical Aid Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and several core benefits to up to 3 Family Members. The Medihelp MedVital Elect Medical Aid Plan starts from R2,022 ZAR.

Medihelp MedVital Elect Plan – 11 Key Point Quick Overview

☑️ Medihelp MedVital Elect Plan Overview
☑️ Medihelp MedVital Elect Plan Contributions
☑️ MedVital Elect Plan Benefits and Cover Comprehensive Breakdown
☑️ MedVital Elect Benefit Table
☑️ MedVital Elect Hospitalization and Advanced Treatment
☑️ MedVital Elect Emergency Benefits
☑️ MedVital Elect Added Insured Benefits
☑️ Medihelp MedVital Elect Plan Exclusions and Waiting Periods
☑️ Medihelp MedVital Elect Plan vs. Similar Plans from other Medical Schemes
☑️ Our Verdict on The MedVital Elect Plan
☑️ MedVital Elect Plan Frequently Asked Questions

Medihelp MedVital Elect Plan Overview

The Medihelp MedVital Elect medical aid plan is one of 11, starting from R2,022 and includes several core benefits, day-to-day benefits, added insured benefits, unlimited PMB medicine, additional GP consultations, childbirth, and more. Gap Cover is not available on the Medihelp MedVital 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 MedVital Elect Plan Contributions

👤 Main Member	👥 +1 Adult Dependent	🍼 +1 Child Dependent
R2,022	R1,470	R852

MedVital Elect Plan Benefits and Cover Comprehensive Breakdown

MedVital Elect Day-to-Day Benefits

🏆 Covered up to 100% of the Medihelp Tariff (MT).
🏆 There is a limit of R1,400 dedicated to day-to-day for the main member and R2,700 for the main member plus dependents.

MedVital Elect Consultations

✅ GP appointments and follow-up appointments
✅ Specialists (35 percent 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.

MedVital 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.

You might like 5 Best Medical Aids under R200

MedVital Elect Benefit Table

📌 Care Extender: Additional GP Consultation	A beneficiary’s Pap smear, mammography, prostate test, FOBT, or bone mineral density test activates a family consultation benefit.
📍 Care Extender: 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 MT. Unlimited cover Formulary and DSPs apply, or a 60% co-payment will apply.
☑️ 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.
✅ Dentistry under conscious sedation in the dentist’s rooms	Impacted tooth extraction (3rd molars covered on the dentist’s account) Covered up to 100% of the MT. If not pre-approved, a 20% co-payment applies.
🩺 Dental procedures performed under general anesthesia in a MedVital Elect Network Day facility	Impacted tooth extraction (3rd molars covered on the dentist’s account) Covered up to 100% of the MT. Member is responsible for the first R3,700 per admission. If not pre-approved, a 20% co-payment applies. There is a 35% co-payment if the procedure is not performed in the Medihelp day procedure network.
😊 Services in and out of the hospital, including fitting, cost of repairs, maintenance, spares, accessories, and adjustments on the following: Stoma Components Incontinence Products/Supplies	Unlimited Cover. Covered up to 100% of the MT.

MedVital Elect Hospitalization and Advanced Treatment

📌 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 Near-drowning	Subject to authorization, PMB protocols, and case management. Covered up to 100% of the cost or the contracted tariff.
➡️ Post-Exposure Prophylaxis (HIV/AIDS)	Subject to authorization, PMB protocols, and case management. Covered up to 100% of the cost or the contracted tariff.

MedVital Elect 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.

Discover more about What is Road and Transport Cover?

Air Transport

✅ Covered up to 100% of the MT.
✅ If not pre-approved, a 50% co-payment applies.
✅ Limited to R15,400 per case.

MedVital Elect Hospitalization

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	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.
2️⃣ 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.
3️⃣ Hospital Medicine upon Discharge	Covered up to 100% of the MT. There is an R390 limit per admission.

MedVital Elect Child Birth and Home Delivery

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.

You might like Health Insurance for Pregnancy

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 R3,400 per examination and R2,900 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 R21,800 per beneficiary per year, with a limit of R33,100 per family per year. If not pre-approved, a 20% co-payment applies.

MedVital Elect Oncology

🅰️ 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.
🅱️ Oncology: 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.

Hospice Services and Subacute Care Facilities

📌 Hospice Services and Subacute Care Facilities	Covered up to 100% of the MT. 20% co-payment if not pre-authorized Unlimited cover.
📍 Palliative Care	Covered up to 100% of the MT. 20% co-payment if not pre-authorized Limited to R21,800 per family per year.
👩‍⚕️ Private Nursing	Covered up to 100% of the MT. 20% co-payment if not pre-authorized Unlimited cover.
☑️ Appendectomy: Conventional or Laparoscopic Procedure	Unlimited cover. Covered up to 100% of the MT.
✅ Prostatectomy: Conventional or Laparoscopic Procedure	Unlimited cover. Covered up to 100% of the MT.

MedVital 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.

MedVital 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.

MedVital Elect 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 R150 per month and up to R1,950 per beneficiary. Intra-uterine devices for women up to 50 years Every 60 months. Covered up to R2,150 per beneficiary.

MedVital Elect 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.
Dual 2D ultrasound imaging.

MedVital Elect 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.

MedVital Elect 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

MedVital Elect 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.

MedVital Elect 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.

MedVital Elect Wellness Support

▶️ 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

MedVital Elect 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.

Discover more about the 5 Best Hospital Plans Under R3000 in South Africa

Medihelp MedVital Elect Plan Exclusions and Waiting Periods

Medihelp MedVital 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 MedVital Elect plan excludes several items, including but not limited to the following.

✅ Infertility treatment was other than that specified in the Medical Schemes Act of 1998 Regulations.
✅ Treatment of alcoholism and drug abuse, as well as services rendered by institutions registered per the Prevention and Treatment for Substance Abuse Act 70 of 2008 or other institutions whose services are similar, unless otherwise specified in the Regulations to the Medical Schemes Act of 1998.
✅ Therapy for impotence
✅ The artificial insemination of a human, as defined in section 61 of the National Health Act of 2003.
✅ Immunizations (including immunization processes and materials) are required by an employer, excluding flu vaccinations and routine childhood immunizations.
✅ Workout, counseling, and rehabilitation regimens
✅ Services provided by social workers and counselors who are not qualified clinical psychologists Expenses of home visits and home programs
✅ When only housing and basic care services are provided.
✅ All operations and services are excluded except for removing impacted teeth (3rd molars – dentist’s account solely for certain item codes).
✅ Dentures made of plastic
✅ Snoring aids
✅ Mouthguards
✅ Blood pressure apparatus
✅ Commode
✅ Raised toilet seat
✅ Hospital beds for home usage
✅ Vision-improving devices
✅ Mattresses and cushions
✅ Bras without external breast prosthesis
✅ Where the reason for hospitalization is dental fear or anxiety; Where there are many hospitalizations; Where the sole reason for hospitalization is to acquire a sterile facility; The cost of dental materials for procedures conducted under general anesthesia.

Medihelp MedVital 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 MedVital Elect Plan vs. Similar Plans from other Medical Schemes

	MedVital Elect	Discovery KeyCare	Bonitas BonStart
👤 Main Member Contribution	R2,022	R1,102	R1,378
👥 Adult Dependent Contribution	R1,470	R1,102	R1,378
💙 Child Dependent Contribution	R852	R664	R1,378
📉 Annual Limit	None	Unlimited Hospital Cover	Unlimited
💶 Prescribed Minimum Benefits	☑️ Yes	☑️ Yes	☑️ Yes
📌 Screening and Prevention	✅ Yes	✅ Yes	✅ Yes
📊 Medical Savings Account	None	None	None
🍼 Maternity Benefits	☑️ Yes	☑️ Yes	☑️ Yes
➡️ Pre- and Postnatal Care	✅ Yes	✅ Yes	✅ Yes
🏠 Home Care	None	☑️ Yes	☑️ Yes

Our Verdict on The MedVital Elect Plan

The Medihelp MedVital Elect Plan is one of their medical plans that offers a comprehensive range of benefits at an affordable price. This plan includes in-hospital and out-of-hospital benefits such as general practitioner visits, specialist consultations, and chronic medication coverage. In addition, the Medihelp MedVital Elect Plan also offers emergency medical services, basic dentistry, and maternity benefits. One of the main advantages of this plan is that it offers members access to a wide network of healthcare providers, including hospitals and doctors. However, one drawback is that certain benefits are subject to limits and co-payments, which can increase out-of-pocket expenses for members. Overall, the Medihelp MedVital Elect Plan is a solid medical plan option for individuals and families looking for comprehensive healthcare coverage at an affordable price.

You might also consider the following options of MediHelp:

MedVital Elect Plan Frequently Asked Questions

What is Medihelp MedVital Elect Plan?

It is a medical plan offered by Medihelp, a South African medical scheme that provides comprehensive healthcare coverage to its members.

What benefits are covered under the Medihelp MedVital Elect Plan?

The plan covers a range of in-hospital and out-of-hospital benefits, including general practitioner visits, specialist consultations, chronic medication coverage, emergency medical services, basic dentistry, and maternity benefits.

Can I choose my own healthcare provider under this plan?

Yes, the Medihelp MedVital Elect Plan offers access to a wide network of healthcare providers, including hospitals and doctors. However, there are co-payments involved when you use non-DSP providers and facilities.

Is there a limit to the benefits covered under this plan?

Yes, certain benefits are subject to limits and co-payments, which can increase out-of-pocket expenses for members.

Can I add dependents to my Medihelp MedVital Elect Plan?

Yes, the plan allows members to add dependents such as spouses, children, and other family members.

How do I make a claim under this plan?

Members can submit claims online or through the Medihelp mobile app. Alternatively, claims can be submitted through a paper-based form on the Medihelp website.

Does this plan cover pre-existing medical conditions?

Yes, pre-existing medical conditions are covered after a waiting period of up to 12 months, subject to certain conditions.

Is emergency medical transportation covered under this plan?

Yes, the Medihelp MedVital Elect Plan covers emergency medical transportation, such as ambulance services, in and outside South Africa. However, certain limits and co-payments apply.

Can I use this plan for dental treatment?

Yes, dental treatment is covered, but it is limited to impacted tooth extractions.

Does the Medihelp MedVital Elect Plan cover alternative therapies?

Medihelp MedVital Elect covers limited alternative therapies.

Are prescription glasses covered under this plan?

No, prescription glasses and contact lenses are not covered under this plan.

Can I change my Medihelp MedVital Elect Plan during the year?

Yes, members can change their plans during the annual open enrollment period. Furthermore, members can change during certain life events such as marriage or childbirth.

Does this plan cover medical treatment received outside of South Africa?

Yes, the plan includes coverage for emergency medical treatment received outside of South Africa, subject to certain conditions.

Is there a waiting period before I can use my Medihelp MedVital Elect?

Yes, a waiting period of up to three months applies to certain benefits such as hospitalization and major medical procedures.

Adriaan Schoeman

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.

AFFORDABLE HEALTH PLANS FROM R850 PER MONTH

Free Medical Aid Quote

MEDICAL AID FROM R1870 P/M