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Medihelp MedVital Elect Medical Aid Plan ( 🇿🇦 2025)

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 its members. The Medihelp MedVital Elect Medical Aid Plan starts from R2,244 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 12, starting from R2,2,44, 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 12 plans to choose from:

👉 Download the MedVital Summary for 2025 from Medihelp.

Medihelp MedVital Elect Plan Contributions

👤 Main Member	👥 +1 Adult Dependent	🍼 +1 Child Dependent
R2,244	R1,632	R942

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 R1,500 dedicated to day-to-day for the main member and R2,900 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.

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MedVital Elect Benefit Table

📌 Care Extender: Additional GP Consultation	One additional GP consultation – the 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.
📍 Care Extender: R510 for Self-Medication (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 added insured benefits.
💊 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 in & 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 R4,100 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 R2,500 per case.

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Air Transport

✅ Covered up to 100% of the MT.
✅ If not pre-approved, a 50% co-payment applies.
✅ Limited to R16,900 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. Usage of Network Hospitals only.
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 R420 limit per admission. Excluding PMB/chronic medicine.

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 R16,300 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 R1,300 per family yearly in hospital. Subject to clinical protocols and on request of medical doctor.
📍 Specialized Radiology	Covered 100% of the MT. In and out-of-hospital. Subject to pre-authorisation, clinical protocols & on request of a specialist. Prescribed by specialist on referral by a network GP. R15 000 per family per year Member pays first R2 500 per examination in hospital and R2 300 out of hospital.
☑️ Clinical Technologist Services	Covered up to 100% of the MT. Unlimited Cover. In hospital – services must be prescribed by medical doctor/dentist.
❤️ 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.
✅ Oxygen (In and out of hospital)	Covered up to 100% of the MT. Unlimited Cover. Benefits for oxygen out of hospital are subject to pre-authorisation, clinical protocols, and a prescription by medical doctor.
✔️ 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. 30% co-payment if not obtained from DSP.
🚑 Post-Hospital Care Speech therapy, occupational therapy, and physiotherapy 30 days after discharge	Covered at 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 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. Hospitalisation and professional psychiatric services: Limited to R23,900 per beneficiary per year, with a limit of R36,400 per family per year. Treatment of depression out of hospital, subject to registration on Mental Health programme: R3 000 per beneficiary per year. Medicine: R95 per beneficiary per month, subject to the in-hospital limit & annual mental health limit. 20% co-payment per admission if not pre-authorised. 35% co-payment for voluntary admission to non-network hospital (network plans only).

MedVital Elect Oncology

🅰️ Oncology: PMB and non-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.

Limited to R250,000 per family per year.

20% co-payment if not pre-authorised.

Deviation from protocols may result in a co-payment.

30% co-payment for voluntary use of non-network services.

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. Subject to pre-authorisation, programmes, and protocols, Services rendered in an approved facility and prescribed by medical doctor.
📍 Palliative Care	Covered up to 100% of the MT. 20% co-payment if not pre-authorized Limited to R23,900 per family per year. Subject to pre-authorisation, clinical protocols, services prescribed by medical doctor, a treatment plan, programmes, protocols & formularies.
👩‍⚕️ Private Nursing	Covered up to 100% of the MT. 20% co-payment if not pre-authorized Unlimited cover. Subject to pre-authorisation, programmes & protocols. General day-to-day care excluded from benefits.
✅ Prostatectomy: Conventional or Laparoscopic Procedure	Unlimited cover. Covered up to 100% of the MT. Subject to pre-authorisation. Member pays first, R8 000 per procedure.

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 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 R2,500 per case.

Air Transport

✅Covered up to 100% of the MT.
✅If not pre-approved, a 50% co-payment applies.
✅Limited to R16,900 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 R2100 per beneficiary. Intra-uterine devices for women up to 50 years. Covered up to R2350- Every 60 months.

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 (R510)

▶️ 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 R510 for self-medication.

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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 (2025)	Discovery KeyCare (2025) (Depending on Income Scale)	Bonitas BonStart (2025)
👤 Main Member Contribution	R2,244	R1,184	R1,498
👥 Adult Dependent Contribution	R1,632	R1,184	R1,498
💙 Child Dependent Contribution	R942	R713	R1,498
📉 Annual Limit	Unlimited	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

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.

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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.