Profmed Medical Aid Scheme (🇿🇦 2025*)

  Overall, Profmed offers 10 medical aid plans (ProSelect, ProSelect Savvy, ProActive Plus, ProActive Plus Savvy, etc.) starting from R1,022 per month. Additionally, Profmed offers 24/7 emergency support and offers a comprehensive gap cover on every policy.        

Profmed Review - Analysis of Medical Aids' Main Features

 

1. ☑️ Profmed at a Glance
2. ☑️ Profmed Regulation
3. ☑️ Profmed Plan Overview
4. ☑️ Profmed Premium and Savvy Benefit Options Highlights 2025
5. ☑️ Profmed – Advantages over Competitors
6. ☑️ Profmed Medical Savings Account
7. ☑️ Overview of Profmed Gap Cover
8. ☑️ How to apply for Gap Cover with Profmed
9. ☑️ How to apply for Medical Aid with Profmed
10. ☑️ How to Submit a Claim with Profmed
11. ☑️ How to Submit a Compliment or Complaint with Profmed
12. ☑️ How to Switch my Medical Aid to Profmed
13. ☑️ Profmed Customer Support
14. ☑️ Profmed vs Platinum Health vs Fedhealth – A Comparison
15. ☑️ Profmed Member Reviews
16. ☑️ Profmed - Our Verdict 
17. ☑️ Profmed Pros and Cons
18. ☑️ Profmed Frequently Asked Questions

 

Medical Aid Profmed at a Glance

   

👉🏾 Discover the 5 Best Medical Aid Schemes for Employees

    https://youtu.be/K3smB-XfYB8  

Profmed Regulation

  💙 The Council for Medical Schemes regulates Profmed Medical Scheme.  The Council governs South Africa's medical plan business for Medical Schemes (CMS), a regulating body set up under the Medical Schemes Act, No. 131 of 1998 (the Act). The CMS is responsible for a range of tasks related to the oversight of medical insurance plans, such as:  

• ✅Responsible for registering medical insurance plans and ensuring they comply with the law and other laws.
• ✅ Making sure healthcare plans have the money to pay claims.
• ✅ Examining and authorizing proposed price hikes for medical plans.
• ✅ Accepting and examining member complaints and initiating disciplinary action against medical plans that violate the Act or other applicable rules.
• ✅Helping medical insurance plans follow the law and other laws.

  💙 Furthermore, if a medical scheme is found to violate the law, the CMS has the authority to issue administrative fines and penalties.    

Profmed Plan Overview

    👉🏾 Ladies can make use of our free Ovulation Calculator      

Profmed Premium and Savvy Benefit Options Highlights 2025

    Conditions and Notes:  

• ☑️ 1 – Subject to the Scheme's rules and protocols. Benefit restrictions are listed in the Schedule of Benefits, which is available on the Profmed website.
• ☑️ 2 – Procedures: 120% of Profmed Tariff; Consultations: R550 for GPs and R810 for specialists or paid at code-specific Rand rates.
• ☑️ 3 – Maternity benefits cover all possibilities for in- and out-of-hospital maternity therapy, medicine, or procedures.
• ☑️ 4 – Only the ProSecure Plus, ProSecure, and ProActive Plus choices and their Savvy equivalents provide specific out-of-hospital benefits.

 

Profmed – Advantages over Competitors

 

• ✅ Profmed offers a dedicated team of representatives to provide members with personalized support and assistance.
• ✅ Profmed is renowned for its efficient and prompt claims processing, which reduces the administrative burden for members and ensures they receive the benefits to which they are entitled.
• ✅ Profmed provides various medical aid options designed to meet members' diverse needs, ensuring that they have access to the necessary medical care.
• ✅ Profmed utilizes innovative technology to streamline processes and improve the member experience. This includes an online platform through which members can access their information, submit claims, and monitor the status of their claims.
• ✅ Profmed's proactive health management initiatives encourage members to take an active role in their health and well-being.
• ✅ Profmed has a robust network of healthcare providers, ensuring members have access to high-quality medical care whenever required.
• ✅ Profmed is constantly evolving and introducing innovative products and services to ensure its members access the most recent medical care advancements.

 

👉🏾 READ more about the 5 Best Hospital Plans under R500

   

Profmed Medical Savings Account

  💙 Profmed offers day-to-day benefits on several options. Furthermore, Profmed offers the PPS Wallet. The PPS Wallet is a flexible and intelligent savings account that empowers members to control their savings and expands their medical aid benefits.  The PPS Wallet offers the following benefits:  

• ☑️ Exclusive to Profmed subscribers.
• ☑️ PPS Healthcare Administrators (PPSHA) presents a novel and autonomous savings plan.
• ☑️ The PPS Wallet is an alternative to traditional medical savings accounts that can pay for a wider variety of healthcare costs not covered by Profmed.
• ☑️ In addition, PPS Wallet can be used to pay for certain deductibles and co-payments associated with medical care.
• ☑️ Starting from R300 per month, you can set your own savings goal.
• ☑️ R100 can increase your monthly savings up to a total of R2000.
• ☑️ All healthcare claims must be submitted through the standard Profmed procedures. Your PPS Wallet account will be charged for applicable expenses and co-payments on your behalf.

   

Overview of Profmed Gap Cover

 

• ☑️ Profmed has implemented PPS GAP cover to aid in the management of medical expense shortfalls and give you peace of mind.
• ☑️ A family of four under the age of 55 can get medical insurance with a premium as low as R504 per month.
• ☑️ The annual medical expense gap coverage for Profmed members is R192,000.
• ☑️ Protection for you and anyone else listed on your Profmed membership's beneficiary form.
•  Spouses covered by the same PPS Gap Cover policy but have their own Profmed medical aid membership are also covered.
• ☑️ There are no age limits for joining Profmed, and your coverage will remain in effect for as long as you remain a member.
• ☑️ You will have a smoother claims process because Profmed handles submitting payments on your behalf.

 

👉🏾 Discover the 5 Best Gap Cover Options for Under R200

   

How to apply for Gap Cover with Profmed

  💙 Once you have an active membership with Profmed, you can apply for PPS Gap Cover by following these steps:  

• ✅ Go to the Profmed website and hover over “Profmed Benefits.”
• ✅ Click on “PPS Gap Cover” at the bottom of the list on the right-hand side.
• ✅ Download the brochure to familiarize yourself with PPS Gap.
• ✅ Download the application form, complete it, and submit it to Profmed.

   

How to apply for Medical Aid with Profmed

 

Medical Aid Quote Profmed Medical Scheme process explained

  💙 To apply for Medical Aid through Profmed, you must:  

• ✅ Pick a Plan: Look at Profmed's selection of health insurance plans to find one that works for you.
• ✅ To expedite the processing of your application, you will need to gather all necessary information, including your personal and financial details.
• ✅ To apply to Profmed, either fill out the online application form provided or download an application form and send it to us via electronic mail, regular mail, or fax.
• ✅ Submit All Necessary Documentation With Your Application: Please submit all necessary documentation, including certified copies of your identification, proof of income, and bank statements.
• ✅ You must now wait for approval from the Profmed team after receiving your application. The decision regarding your application's acceptance or rejection will be communicated via email or regular mail.
•  ✅After accepting your application, you can immediately begin using your benefits by seeing a doctor and filing claims.
• ✅ If you want to ensure you get the care you need and that your claims are processed quickly, it is a good idea to track your benefits and claims regularly.

  💙 Get a Profmed Medical Aid quote from our Dedicated Medical Aid Specialists Broker   👉🏾 You might like 5 Best Medical Insurance for International Travel    

How to Submit a Claim with Profmed

  💙 Submit a claim to Profmed via email by scanning the invoice or sending a digital copy. Alternatively, use the Profmed App or post the claim to the Profmed Claims department.  When submitting a claim that has already been paid for by the member, it is important to provide a valid invoice and receipt or to indicate on the invoice that it has been paid and request reimbursement from the member.   💙 Failure to provide a valid invoice may result in the claim not being processed. It should be noted that claims not submitted within four months of service are considered stale and cannot be honored.  In most cases, the healthcare provider electronically submits claims. In such instances, the member is advised to review the Claims Advice to ensure that only services rendered to them are being claimed.   💙 If there are any discrepancies, the member should contact the service provider or Profmed Client Services for resolution.  Upon receipt of a claim, the member will receive an acknowledgment email from Profmed and a Claims Advice once the claim has been processed.   💙 If the member does not receive either or both, they should inquire about the receipt of the claim by contacting Client Services at 0860 679 200.    

How to Submit a Compliment or Complaint with Profmed

  💙 To submit a compliment or complaint with Profmed, you can contact the company's Client Services team in several ways:  

• ☑️ Phone: Call 0860 679 200 to speak with a representative.
• ☑️ Email: You can email the Client Services team at [email protected].
• ☑️ Online Form: You can complete the online Compliments and Complaints form on the Profmed website.
• ☑️ Postal Mail: You can send your complaint or compliment in writing to Profmed Medical Scheme, PO Box 1004, Houghton, 2041.

   

How to Switch my Medical Aid to Profmed

 

• ✅  Select a Plan: From the options provided by Profmed, select the medical aid plan that best meets your needs. Services.
• ✅ Complete plan available on the Profmed website or by contacting Client services.
• ✅  Include Supporting Documentation: Include any necessary supporting documentation with your application, such as proof of income and identification.
• ✅  Wait for Approval: Await approval of your application. Depending on the complexity of your application, this may take up to two to three weeks.
• ✅  Notify Your Former Health Plan: Once your application has been approved, you must notify your former health plan that you are switching to Profmed.
• ✅  Start Using Your Benefits: As soon as your Profmed medical aid coverage is activated, you can begin using your benefits.

  👉🏾 READ: 10 Things to Consider Before Cancelling your Medical    

Profmed Customer Support

 

• ☑️ You can call Profmed's Client Services team on 0860 679 200 from Monday to Friday between 8 am and 4h30 pm.
• ☑️ You can email [email protected] for general inquiries or [email protected] for service-related inquiries.
• ☑️ You can submit a query or complaint through the online contact form available on the Profmed website.
• ☑️ Postal Mail: You can send a letter to Profmed.
• ☑️ Profmed offers a live chat service on its website during business hours.

   

Profmed vs Platinum Health vs Fedhealth - A Comparison

   

Read more about Medical Aid Plans that cover Diabetes

   

Profmed Member Reviews

  Highly Recommended.  I am confident in recommending Profmed as a medical aid provider. I have been a member since 2008 and have consistently received excellent service and prompt and efficient claim payments. I have also encouraged family and friends to join; they have also expressed satisfaction with the service provided. I am grateful to be a part of such a reputable and reliable medical aid that has taken care of my needs in times of need. I wholeheartedly endorse this medical scheme and have peace of mind knowing that my healthcare is in good hands. - Nettie Hunt     Great Support. I was recently diagnosed with Major Depressive Disorder (MDD). I am appreciative of the support that I have received. Despite being enrolled in a Pro-Active Hospital Plan with an R15,000 limit for psychiatry, my psychiatrist recommended a clinic that would better address my needs. I was initially concerned about being referred to a potentially hazardous clinic in Michell's plain. However, I am grateful that my stay was approved at the Helderberg clinic, which exceeded the limit of R15,000. - Alastair McIntyre     Efficient and Effective. I recently transitioned to Profmed from another medical insurance provider. I am pleased to report that I have received efficient and effective assistance whenever I encounter any issues. In addition, the representatives I have spoken with have been helpful and able to resolve my concerns within 24 hours, which I find remarkable. I am highly impressed with the level of service I have received thus far. - Edwin Oliver    

Profmed - Our Verdict

  Profmed is a leading medical aid scheme in South Africa, offering a range of benefits and services to its members. The company has been in operation since 1959. It has a proven record of providing quality medical care to its members.  Profmed is restricted and only accepts professionals in South Africa with tertiary education. However, with its range of benefit options, easy claims process, personalized service, and innovative services, it is an excellent choice for those looking for a comprehensive and reliable medical aid scheme.  

Profmed Pros and Cons

   

Profmed Frequently Asked Questions

 

Can anyone join Profmed?

If you possess a postsecondary degree and relevant professional experience, Profmed will provide you with medical coverage.  

How does Profmed manage medical costs?

Profmed manages medical costs by negotiating with healthcare providers and service providers to secure the best prices for its members.  

Does Profmed cover pre-existing conditions?

Yes, Profmed covers pre-existing conditions, but waiting periods and exclusions may apply.  

Does Profmed cover chronic medication?

Yes, Profmed covers the chronic medication, but there may be limits on the amount and type of medication covered.  

How does Profmed handle claims?

Profmed manages claims through an electronic system, enabling healthcare providers to submit claims directly to medical aid.  Members can also submit claims manually by providing a valid invoice and receipt.  

What is the claims process for Profmed?

The claims process for Profmed involves submitting a valid invoice and receipt to the medical aid, which is then processed and paid within a specified timeframe.  

Can I change my Profmed plan?

Yes, you can change your Profmed plan anytime, subject to certain conditions and restrictions.  

How do I contact Profmed customer support?

You can contact Profmed customer support by calling 0860 679 200 or by sending an email to [email protected].  

How do I Downgrade my Plan with Profmed

To downgrade a plan, members can contact Profmed to receive the “Benefit Option Change Form” for 2023. This form must be completed and emailed to Profmed.  

How do I add a Beneficiary to Profmed?

If you want to add a child or adult dependent, you can log into your Profmed profile - Go to the Profmed website, and to “Members” from the homepage.  Click on “Download Important Documents” and click on “Adding a Dependent Form.”  Complete all the relevant sections, save the form as a PDF, and email it to Profmed Membership Department. Alternatively, you can print the form, complete it in black ink, scan and email or post it to Profmed.