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Medimed Alpha Plan (🇿🇦 2025)

Overall, the Medimed Alpha Medical Aid Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and private hospitalization to up to 3 Family Members. The Medimed Alpha Medical Aid Plan starts from R1,820 ZAR.

🔎 Medical Aid Plan	🥇 Medimed Alpha
👤 Main Member Contribution	R1,820
👥 Adult Dependent Contribution	R1,820
🍼 Child Dependent Contribution	R700
💙 Hospital Cover	Unlimited
🟦 Annual Limit	None

Medimed Alpha Plan – 7 Key Point Quick Overview

✅ Medimed Alpha Plan Overview
✅ Medimed Alpha Plan Contributions
✅ Medimed Alpha Plan Benefits and Cover Comprehensive Breakdown
✅ Medimed Alpha Plan Exclusions and Waiting Periods
✅ Medimed Alpha Plan vs Similar Plans from Other Medical Schemes
✅ Our Verdict on the Medimed Alpha Plan
✅ Medimed Alpha Plan Frequently Asked Questions

Medimed Alpha Plan Overview

The Medimed Alpha medical aid plan is one of 4, starting from R1,820, and includes cover for private hospitalization, maternity care, chronic medication, and emergency medical services. Gap Cover is available on the Medimed Alpha Plan, along with 24/7 medical emergency assistance. According to the Trust Index, Medimed has a trust rating of 3.0.

💙Medimed Medical Aid has a late joiner fee and also has the following plans to choose from:

Medimed Alpha Plan Contributions

👤 Main Member	👥 Adult Dependent	🍼 Child Dependent
R1,820	R1,820	R700

Medimed Alpha Plan Benefits and Cover Comprehensive Breakdown

Medimed Alpha In-Hospital Benefits and Major Medical Expenses

✅Subject to pre-authorization and managed care protocols, the hospital account is paid at 100% of the Medimed Scheme Tariff.
✅Members will be liable for the applicable member levy (25-40%) for providers who provided services related to non-PMB conditions during the hospital admission.
✅Specialist and GP levies will not apply if the member is admitted to treating a valid PMB condition per the Scheme’s managed care protocols.

🅰️ Hospital Limit	Unlimited cover provided.
🅱️ Hospitalisation Alternatives	Limited to R15,000 per beneficiary.
☑️ Auxiliary Services	PMBs only paid at 100% of MEDIMED scheme Tariff.
✅ In-Hospital Dentistry	Limited to R12,000 per family per year. Covered up to 60% of the Medimed Scheme Tariff. Limited to impacted wisdom teeth and treatment for children <12. Covered up to 75% for anesthetic and maxilla-facial surgeries.
📌 Emergencies and Ambulance Services	Unlimited cover. ER24 is the preferred provider.
📍 GP and Specialist Services	Unlimited cover provided. PMBs are covered up to 100%. Non-PMBs are covered up to 75% of the Medimed Scheme Tariff.
➡️ Pathology	Unlimited cover provided. PMBs are covered up to 100%. Non-PMBs are covered up to 75% of the Medimed Scheme Tariff.
🦾 Internal Prostheses	Limited to R40,000 per family. Covered up to 100% of the Medimed Scheme Tariff. Pre-approval is required. The following sub-limits apply: – Spinal Fusion is limited to R23,000 per family. – Intra-occular lenses are limited to R2,500 per lens. – Mesh is limited to R7,000 per family.
🦿 External Prostheses	Limited to R6,500 per family. Pre-approval is required. Covered up to 100% of the Medimed Scheme Tariff.
💴 Prescribed Minimum Benefits (PMB)	Unlimited when obtained from a DSP and subject to protocols.
🧠 Psychiatric Hospitalisation	Limited to R6,500 per family. Covered up to 100% of the Medimed Scheme Tariff; after that, covered up to 75%. Overall limit of R12,000 per family. Pre-approval is required.
📉 Basic Radiology	Unlimited cover provided. Paid up to 75% of the Medimed Scheme Tariff.
📈 Specialized Radiology	R10,000 per beneficiary up to a maximum of R15,000 per family. Paid at 75% of the MEDIMED Scheme Tariff
🍼 Birth/Delivery	–
🏥 In-Hospital	Gynecologists/Obstetricians paid up to 200% of the Medimed Scheme Tariff.
🏠 Home Delivery	Registered midwives are covered by up to 100% of the Medimed Scheme Tariff. Limited to R12,000 per pregnancy. Subject to non-admission/hospitalization protocols. (*R1,200 will be paid if there is admission / hospitalization).
💷 Major Medical Expenses	–
🩺 Dialysis	Unlimited for PMBs per family. Pre-authorization is required.
❤️ Organ Transplants	Combine limit with Dialysis. Pre-authorization is required.
🧪 Oncology	Limited to R200,000 per family. Pre-authorization is required from ICON.
🎗️ HIV/AIDS	Unlimited cover provided. Subject to managed care protocols. Pre-authorization is required.
💊 Chronic Medication	–
😣 Chronic Disease List	Covered up to 100% of the momTYB CDA. Pre-authorization is required.
🤧 Extended Chronic Conditions	Covered up to 75% of the momTYB CDA. Limited to R3,000 per beneficiary. There is an overall limit of R6,000 per family. Pre-authorization is required.

💙POLL: 5 Best Medical Aids under R3000

Medimed Alpha Day-to-Day Benefits

🟥 Out-of-Hospital Expenses	–
🟧 Acute Medication	Limited to R2,000 per beneficiary with a maximum of R6,000 per family. Covered up to 60% of the Medimed Medicine Price.
🟨 Over-the-Counter Medication	Limited to R120 per prescription, up to R1,200 per family. Subject to the Acute Medication benefit limit. Covered up to 60% of the Medimed Medicine Price.
🟩 Appliances	Limited to R4,000 per family per year. Nebulizers and glucometers are limited to R500 per device. Covered up to 60% of the Medimed Scheme Tariff. Pre-authorization is required.
🟦 Auxiliary Services	Limited to R2,000 per beneficiary and up to R4,000 per family per year. Covered up to 60% of the Medimed Scheme Tariff.
🟪 Basic and Specialised Dentistry	Limited to R5,000 per beneficiary and up to R10,000 per family per year. Covered up to 60% of the Medimed Scheme Tariff.
🟥 Maternity	Beneficiaries who register on the Medimed Maternity Program are covered up to 100% of the Scheme Tariff on the following: – Three prenatal visits. – Two 2D scans. – One Paediatrician visit. – One maternity bag per pregnancy. – Antenatal vitamins up to R100 for 9 months (payable from Acute benefit at 60%)
🟧 Optometry	Limited to one consultation/examination per beneficiary per year. Covered up to 100% of the Medimed Scheme Tariff.
🟨 Pathology and Basic Radiology	Unlimited cover. Paid up to 75% of the Medimed Scheme Tariff.
🟩 Preventative Care	The cover is provided for the following: – Flu vaccination – Pap Smear – Mammogram – Breast scan – Bone density scan – Prostate test – Cholesterol test – Dental Consultation – Blood Sugar Test – HIV Test Limited to R1,500 per beneficiary and R3,000 per family. Covered up to 100% of the Medimed Scheme Tariff.
🟦 Specialized Radiology	R10,000 per beneficiary up to a maximum of R15,000 per family. Covered up to 75% of the Medimed Scheme Tariff. Pre-approval is required.

Medimed Alpha Plan Exclusions and Waiting Periods

Alpha Plan Exclusions

💙Medimed Alpha has some of the following exclusions:

✅All costs incurred for treating sickness conditions or injuries sustained by a member or a Dependent, for which any other party is liable, can be recovered by that party.
✅Members are entitled to benefits provided per the rules, provided that they agree to sign a third-party claim and reimburse the Scheme upon receipt of payment.
✅Costs for treatment of self-inflicted sickness or injuries, excessive use of intoxicating substances or drugs, or material violation of the law are not covered unless according to the Prescribed Minimum Benefits.
✅Costs for injuries arising from professional sports, speed contests, and speed trials are not covered unless according to the Prescribed Minimum Benefits.
✅Costs for cosmetic procedures, treatment of obesity and its direct implications, and holidays for recuperative purposes are not covered unless according to the Prescribed Minimum Benefits.
✅Accommodation or treatment in headache and stress-relief clinics, spas, and resorts for health, slimming, recuperative, or other similar purposes, and traveling expenses incurred by practitioners, are not covered.
✅Any benefits not available under the Prescribed Minimum Benefits and not included in Annexure B are not covered.
✅Treatment of sexually transmitted diseases is not covered unless according to the Prescribed Minimum Benefits.
✅Treatment of alcoholism and drug addiction is not covered unless according to the Prescribed Minimum Benefits.
✅Accommodation in convalescent or nursing homes or similar institutions catering to the aged is not covered.

Infertility tests and treatments are not covered unless according to the Prescribed Minimum Benefits. Medical treatment necessitated due to non-compliance with prescribed therapy is not covered.

💙Discover more: 5 Best Hospital Plans for Pregnancy Coverage

Alpha Plan Waiting Periods

💙The following Waiting Periods might apply to the Medimed Alpha Plan:

✅Medimed may impose a waiting period on a person who applies for membership or admission as a dependent and was not a beneficiary of a medical scheme for at least 90 days before the application date.
✅This period could be a general waiting period of up to three months and a condition-specific waiting period of up to 12 months.
✅Medimed may impose a waiting period on a person who applies for membership or admission as a dependent and was previously a beneficiary of a medical scheme for a continuous period of up to 24 months, terminating less than 90 days immediately before the date of application.
✅This period may be a condition-specific waiting period of up to 12 months, except for any treatment or diagnostic procedures covered within the Prescribed Minimum Benefits.
✅Suppose the previous medical scheme had imposed a waiting period that had not expired at the time of termination. In that case, the Scheme might impose a waiting period for the unexpired duration of such a waiting period.
✅Medimed may impose a general waiting period of up to three months on a person who applied for membership or admission as a dependent and was previously a beneficiary of a medical scheme for a continuous period of more than 24 months, terminating less than 90 days immediately before the date of application.
✅This waiting period does not apply to any treatment or diagnostic procedures covered within the Prescribed Minimum Benefits.

💙Furthermore, no waiting periods may be imposed on a person who applies for membership or admission as a dependent and was previously a beneficiary of a medical scheme, terminating less than 90 days immediately before the date of application in the following cases:

✅If the transfer of membership is required as a result of a change of employment; or
✅If an employer changes or terminates the medical scheme of its employees, in which case the transfer must occur at the beginning of the financial year, or reasonable notice must have been furnished to the Scheme to which an application is made for such transfer to occur at the beginning of the financial year.
✅Suppose a waiting period was imposed by the former medical scheme and had not expired at the time of termination. In that case, the Scheme may impose such a waiting period for the unexpired duration.
✅No waiting periods may be imposed on a beneficiary who changes from one benefit option to another within the Scheme, except if the beneficiary is subject to a waiting period on the current benefit option, in which case the remaining period may be applied.

No waiting periods may be imposed on a child dependent born during the membership period.

Medimed Alpha Plan vs Similar Plans from Other Affordable Medical Aid Schemes

🔎 Medical Aid Plan	🥇 Medimed Alpha	🥈 Momentum Evolve Plan	🥉 Fedhealth MyFED (Income scale based)
👤 Main Member Contribution	R1,820	R1,847	R1,570 – R3 700
👥 Adult Dependent Contribution	R1,820	R1,847	R1,570 – R3 700
🍼 Child Dependent Contribution	R700	R1,847	R711 – R1,170
💙 Hospital Cover	Unlimited	Unlimited	Unlimited
🟦 Annual Limit	None	None	No Overall Annual Limit

💙READ more about Health Insurance

Our Verdict on the Medimed Alpha Plan

Medimed Alpha is a comprehensive medical aid plan that offers its members a wide range of benefits. The plan covers in-hospital and out-of-hospital medical expenses, chronic medication, and specialized maternity and mental health care treatments. In addition, the plan also provides emergency medical assistance, trauma counseling, and access to a range of wellness programs. One of the key features of the Medimed Alpha plan is its comprehensive cover.

In addition, the plan offers extensive benefits for both in-hospital and out-of-hospital treatments and chronic medication. This makes it an attractive option for individuals who require regular medical care and treatment. Another advantage of the Medimed Alpha plan is its flexibility. Members can choose from various benefits, allowing them to tailor their cover to their needs and budget.

Additionally, the plan offers various payment options, including monthly, quarterly, and annual payments. Despite its many benefits, the Medimed Alpha plan does have some drawbacks. Furthermore, the plan may not be suitable for individuals who require limited medical care, as it may offer more coverage than they need.

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Medimed Alpha Plan Frequently Asked Questions

What is the Medimed Alpha plan?

The Medimed Alpha is a medical aid plan offering comprehensive cover for in-hospital and out-of-hospital treatments, chronic medication, and specialized care.

What benefits does the Medimed Alpha plan offer?

The Medimed Alpha plan offers extensive benefits for in-hospital and out-of-hospital treatments, chronic medication, and specialized care such as maternity and mental health care. It also provides emergency medical assistance, trauma counseling, and access to wellness programs.

How much are Medimed Alpha plan premiums?

The premiums for the Medimed Alpha plan may vary depending on the chosen benefit option and payment plan. Contact Medimed for a quote.

Does the Medimed Alpha plan cover chronic medication?

Yes, the Medimed Alpha plan covers chronic medication.

What wellness programs are included in the Medimed Alpha plan?

The Medimed Alpha plan includes access to various wellness programs, including weight management, smoking cessation, and stress management.

Does the Medimed Alpha plan cover in-hospital treatments?

Yes, the Medimed Alpha plan covers in-hospital treatments. However, Alpha only covers a certain percentage of treatment.

Does the Medimed Alpha plan cover out-of-hospital treatments?

Yes, the Medimed Alpha plan covers out-of-hospital treatments. However, there are several limits and sub-limits to consider.

Does the Medimed Alpha plan provide emergency medical assistance?

Yes, the Medimed Alpha plan provides emergency medical assistance.

What is the waiting period for the Medimed Alpha plan?

The waiting period for the Medimed Alpha plan may vary depending on the chosen benefit option and individual circumstances. Waiting periods can range from 3 months up to 24 months.

How can I enroll in the Medimed Alpha plan?

To enroll in the Medimed Alpha plan, visit the Medimed website or contact their customer service for assistance.

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.