Medisave Essential
About this plan
🥇 Best suited for families in the Nelson Mandela Metropolitan seeking affordable network healthcare.
Principal Member
From
R1,860
per month
Adult Dependant
From
R1,860
per month
Child Dependant
From
R580
per month
What's covered
Hospital cover
Savings account
Day-to-day
Chronic cover
Dental
Optical
Maternity
Mental health
Waiting periods
- General
- 3 months
- Pre-existing conditions
- 12 months
Medisave Essential
Medimed Medisave Essential Medical Aid Plan (🇿🇦 2026)
Overall, the Medimed Medisave Essential 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 Medisave Essential Medical Aid Plan starts from R1,860 ZAR.| 👤 Main Member Contribution | R1,860 – R3,110 |
| 👥 Adult Dependent Contribution | R1,860 – R3,110 |
| 🍼 Child Dependent Contribution | R580 – R730 |
| 🔁 Gap Cover | No |
| 📉 Annual Limit | None |
| 💙 Mental Healthcare Program | Only hospitalization |
| 🟦 Hospital Cover | Unlimited |
| 🔵 Optometry Benefit | Only consultations |
| ➡️ Oncology Cover | R50,000 |
| ↪️ Pre and Postnatal Care | Only Prenatal |
Medimed Medisave Essential Plan - 7 Key Point Quick Overview
- ✅ Medimed Medisave Essential Plan Overview
- ✅ Medimed Medisave Essential Plan Contributions and Medical Savings Account 2023
- ✅ Medimed Medisave Essential Plan Benefits and Cover Comprehensive Breakdown
- ✅ Medimed Medisave Essential Plan Exclusions and Waiting Periods
- ✅ Medimed Medisave Essential Plan vs Similar Plans from Other Medical Schemes
- ✅ Our Verdict on the Medimed Medisave Essential Plan
- ✅ Medimed Medisave Essential Plan Frequently Asked Questions
Medimed Medisave Essential Plan Overview
The Medimed Medisave Essential medical aid plan is one of 4, starting from R1,860, and includes cover for private hospitalization, maternity care, chronic medication, and emergency medical services. Gap Cover is available on the Medimed Medisave Essential 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 Medisave Essential Plan Contributions and Medical Savings Account 2026
Medisave Essential Contributions
| 💴 Income Bracket | 👤 Main Member | 👥 Adult Dependent | 🍼 Child Dependent |
| R0 to R11,000 | R1,860 | R1,860 | R580 |
| R11,001 to R17,000 | R2,160 | R2,160 | R640 |
| R17,001 to R23,000 | R2,630 | R2,630 | R690 |
| R23,001 plus | R3,110 | R3,110 | R730 |
Medisave Essential Medical Savings Account (MSA)
| 💴 Income Bracket | 👤 Main | 👥 Main + Spouse | 🍼 Main + S + 1C | ☑️ Main + S + 2C |
| R0 to R11,000 | R2,232 | R4,464 | R5,160 | R5,856 |
| R11,001 to R17,000 | R2,592 | R5,184 | R5,952 | R6,720 |
| R17,001 to R23,000 | R3,156 | R6,312 | R7,140 | R7,968 |
| R23,001 plus | R3,732 | R7,464 | R8,340 | R9,216 |
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Medimed Medisave Essential Plan Benefits and Cover Comprehensive Breakdown
Medimed Medisave Essential In-Hospital Benefits and Major Medical Expenses
| ☑️ Hospitalization | - |
| 🟥 Hospital Limit | Unlimited cover provided. Covered up to 100% when using preferred providers. Covered up to 80% when using non-preferred providers. |
| 🟧 Hospitalisation Alternatives | Limited to R6,000 per beneficiary. |
| 🟨 Auxiliary Services | Limited to R2,000 per beneficiary. |
| 🟩 In-Hospital Dentistry | Limited to R10,000 per family per year. Limited to impacted wisdom teeth and treatment for children <12. |
| 🟦 Emergencies and Ambulance Services | Unlimited cover. ER24 is the preferred provider. |
| 🟪 GP and Specialist Services | Unlimited cover provided. |
| 🟥 Pathology | Unlimited cover provided. |
| 🟧 Internal Prostheses | Limited to R20,000 per family. Pre-approval is required. |
| 🟨 External Prostheses | Limited to R3,000 per family. Pre-approval is required. |
| 🟩 Prescribed Minimum Benefits (PMB) | Unlimited when obtained from a DSP and subject to protocols. |
| 🟦 Psychiatric Hospitalisation | Limited to R4,000 per beneficiary. Pre-approval is required. |
| 🟪 Basic Radiology | Unlimited cover provided. |
| 🟥 Specialized Radiology | Overall maximum of R10,000 per beneficiary and R15,000 per family. Pre-approval is required. |
| ☑️ 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 | Limited to R50,000 per family. Covered up to 100% of the Medimed Scheme Tariff. Pre-authorization is required. |
| 🟪 Organ Transplants | Combine limit with Dialysis. Pre-authorization is required. |
| 🟥 Oncology | Combine limit with Dialysis. 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. |
Medimed Medisave Essential Day-to-Day Benefits
| 🅰️ Out-of-Hospital Expenses | - |
| 🅱️ Acute Medication | Unlimited - prescribed or dispensed by a specific GP Medication is reimbursed based on a medication formulary. This is to help your chosen GP manage your condition more cost-effectively. |
| 📌 Acute Medication not on the formulary | If a generic equivalent is available on the formulary, the Scheme will pay the maximum of the generic formulary alternative, with the member responsible for the difference. The member will be liable for the entire amount if no generic equivalent exists. |
| 📍 Basic and Specialised Dentistry | Limited to R3,200 per beneficiary and up to R5,500 per family per year plus R1000 for dentures. Members can receive one set of plastic dentures every two years. |
| 👩⚕️ GP Consultations | Unlimited cover from a selected GP. There is an additional R500 benefit for a family per casualty. |
| 🍼 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) |
| 🥰 Optometry | 2-year benefit for contact lenses or glasses per beneficiary. The benefit is available via a PPN. |
| 😎 Optometrist Consultation/Examination | Covered up to 100% of the cost with a network provider or R380 with a non-network provider. Frames and Lenses R330 for frames and R215 for single vision lenses and R460 for Bifocal and for Base Multifocal. |
| 👁️ Contact Lenses | Limited to R845 per beneficiary. Multifocal lenses are covered up to the same value as bifocal lenses. |
| 📉 Pathology and Basic Radiology | Unlimited cover. Requires a referral from the selected GP. |
| 📈 Second Opinion Benefit | Limited to two consultations per family from another doctor of the same group. Includes medicine per the formulary. |
| 📊 Specialist Consultations and Procedures | Limited to R3,000 per beneficiary and R6,000 per family. Subject to a referral from the preferred GP. |
Medimed Medisave Essential Benefits paid from the Medical Savings Account (MSA)
| 🔴 Casualty Consultations | Will be paid from the funds available in the MSA. |
| 🟠 Out-of-Town GP Consults and Acute Medicine | Limited to 6 consultations per beneficiary. |
| 🟡 Prescriptions from a Company Doctor | Limited to R300 per family. |
| 🟢 Over-the-Counter Medication | Limited to R150 per prescription up to a maximum of R500 per family. |
| 🟣 Appliances | Will be paid from the funds available in the MSA. Pre-approval is required. |
| 🔵 Auxiliary Benefits | Will be paid from the funds available in the MSA. |
Medimed Medisave Essential After-Hour Facilities at Private Hospitals (Casualty)
The Medisave Essential option does not include after-hours services at private hospitals (including preferred provider hospitals). Unless you have an emergency, you must always consult with your chosen GP. If you have an emergency, you may consult with any other GP in the relevant GP group. An emergency is defined as any life-threatening situation that necessitates immediate medical attention.POLL: 5 Best Hospital Plans under R200
Medimed Medisave Essential Plan Exclusions and Waiting Periods
Medisave Essential Plan Exclusions
Medimed Medisave Essential 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.
Medisave Essential Plan Waiting Periods
The following Waiting Periods might apply to the Medimed Medisave Essential 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.
- ✅If the previous medical scheme had imposed a waiting period that had not expired at the time of termination, 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.
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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.
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Medimed Medisave Essential Plan vs Similar Plans from Other Medical Schemes
| 🔎 Medical Aid Plan | 🥇 Medimed Medisave Essential | 🥈 Medshield MediCurve | 🥉 Bonitas BonStart |
| 👤 Main Member Contribution | R1,860 – R3,110 | R1,821 | R1 603 |
| 👥 Adult Dependent Contribution | R1,860 – R3,110 | R1,821 | R1 603 |
| 🍼 Child Dependent Contribution | R580 – R730 | R483 | R1 603 |
| 📉 Annual Limit | None | Unlimited Hospital Cover | Unlimited Hospital Cover |
| ➡️ Hospital Cover | Unlimited | Unlimited | Unlimited |
Our Verdict on the Medimed Medisave Essential Plan
Overall, Medimed Medisave Essential is an entry-level plan that provides some basic cover for medical treatment and procedures in hospitals. Furthermore, a medical savings account covers consultations, prescriptions, medicine, and appliances.
An advantage of the Medimed Medisave Essential option is that unlimited hospital coverage is provided within the DSP network. Furthermore, PMBs have unlimited coverage, and Medimed offers emergency services via ER24. However, because this is a basic medical aid plan, the drawback is that many treatments and procedures are not covered. Therefore, Medisave Essential is unsuitable for those needing extensive medical cover in and out of the hospital.
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