Overall, Profmed offers 10 medical aid plans (ProSelect, ProSelect Savvy, ProActive Plus, ProActive Plus Savvy, etc.) starting from R956 per month. Additionally, Profmed offers 24/7 emergency support and offers a comprehensive gap cover on every policy.
| 🔎 Medical Aid | 🥇 Profmed |
| 👥 Number of Employees | 100+ |
| 📈 GCR Rating | AA |
| 💙 Average Customer Rating | 3.5 |
| 👤 Average Number of Reviews | 100+ |
| 📊 Market Share | <5% |
| 🔟 The number of plans | 10 |
| 🚑 Number of Hospitals in Network | 200+ |
| 🏠 Home care provided | ☑️ Yes |
| 🤝 Sponsorships | None |
| 🔎 Medical Aid | 🥇 Profmed |
| 📌 Date Established | 1959 |
| 📍 Headquartered | Gauteng, South Africa |
| ✔️ Registration Number | FSP 43918 |
| 👥 The average number of members | Unknown |
| 📈 Number of Markets | South Africa |
| 👤 Number of Employees | 100+ |
| 📉 GCR Rating | AA |
| 📊 Listed on the JSE | No |
| 📎 JSE Stock Symbol | None |
| ✳️ The most recent Market Cap reported | None |
| 💙 Average Customer Rating | 3.5 |
| ➡️ Average Number of Reviews | 100+ |
| 📍 Market Share | <5% |
| 🔟 The number of plans | 10 |
| 🚑 Number of Hospitals in Network | 200+ |
| 🏠 Home care provided | ✅ Yes |
| 🤝 Sponsorships | None |
| 📱 Mobile App | ✅ Yes |
| 📖 Profmed Magazine for clients | No |
| 💻 Medical Claims Portal | ✅ Yes |
| 😷 Information Hub for COVID-19 | ✅ Yes |
| ⚕️ Chronic Illness Benefits | ✅ Yes |
| 🔍 Number of PMB Diagnoses | 271 |
| 🔎 Number of PMB Chronic Conditions | 58 |
| 🖥️ Screening and Prevention offered | ✅ Yes |
| 👶 Maternity Benefit | ✅ Yes |
| 💵 Medical Aid Contribution Range (ZAR) | 956 – 11.883 ZAR |
| ⛔ Average Waiting Period | Up to 12 months |
| 💵 Late-joiner penalties charged | ✅ Yes |
| 🌎 Is International Medical Cover offered | ✅ Yes |
| 💴 International Travel Benefit (ZAR) | Up to R8 million per beneficiary per journey. |
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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:
Furthermore, if a medical scheme is found to violate the law, the CMS has the authority to issue administrative fines and penalties.
| 🔎 Plan | 💶 Contribution (Main) | 💶 Contributions (+Adult) | 💶 Contributions (+Child) | 💶 CDL Covered |
| 1️⃣ ProSelect Savvy | R956 | R1,201 | R731 | 27 |
| 2️⃣ ProSelect | R2,442 | R2,394 | R1,009 | 27 |
| 3️⃣ ProActive Plus Savvy | R2,723 | R2,531 | R1,063 | 27 |
| 4️⃣ ProActive Plus | R3,026 | R2,814 | R1,179 | 27 |
| 5️⃣ ProSecure Savvy | R3,464 | R3,464 | R1,570 | 40 |
| 6️⃣ ProSecure | R5,349 | R4,953 | R2,091 | 40 |
| 7️⃣ ProSecure Plus Savvy | R5,877 | R5,439 | R2,291 | 40 |
| 8️⃣ ProSecure Plus | R6,531 | R6,041 | R2,545 | 40 |
| 9️⃣ ProPinnacle Savvy | R10,695 | R9,921 | R3,209 | 58 |
| 🔟 ProPinnacle | R11,883 | R11,023 | R3,565 | 58 |
Ladies can make use of our free Ovulation Calculator
| 🔎 Benefits¹ | 1️⃣ ProSelect Savvy / ProSelect | 2️⃣ ProActive Plus Savvy / ProActive Plus | 3️⃣ ProSecure Savvy / ProSecure | 4️⃣ ProSecure Plus Savvy / ProSecure Plus | 5️⃣ ProPinnacle Savvy / ProPinnacle |
| 💴 In-Hospital Doctor Fees | Specific Tariff² | 200% the Profmed Tariff | Specific Tariff² | 200% the Profmed Tariff | 300% the Profmed Tariff |
| 💵 Out-of-Hospital Doctor Fees | Specific Tariff² | Specific Tariff² | Specific Tariff² | Specific Tariff² | 300% the Profmed Tariff |
| 💶 In- and Out-of-Hospital Dentistry Fees | 135% the Profmed Tariff | 135% the Profmed Tariff | 135% the Profmed Tariff | 135% the Profmed Tariff | 135% the Profmed Tariff |
| 🚑 Unlimited Hospitalization | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes |
| 📌 Day-Procedure Network | No | Only ProActive Plus | Only ProSecure | Only ProSecure Plus | No |
| 📍 Comprehensive Oncology Cover | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes |
| ❤️ Transplants, Dialysis, Donor Costs | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes |
| ®️ Rehabilitation | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes |
| ⚙️ Internal Surgical Devices | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes |
| 📈 Trauma and HIV Assistance | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes |
| 📉 Preventative Care and Screening | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes |
| 📊 Gender-Based Violence (GBV) Support Program | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes |
| 👶 Child Immunization and Pneumococcal Vaccine | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes |
| 💊 Chronic Medication | ❎ No | ❎ No | ADHD | ADHD | ADHD |
| 🏥 Additional Chronic Medication | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes |
| 💉 Contraceptives | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes |
| ☀️ Day-to-Day Cover General | ❎ No | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes |
| 🦷 Day-to-Day Cover for Dentistry | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes |
| 🍼 Maternity Benefits³ | ❎ No | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes |
| 🚼 Maternity Program⁴ | ❎ No | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes |
| 👶 Tums2Tots Baby and Toddler Program | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes |
| 🧭 International Travel Medical Assistance | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes |
| 📌 PPS Gap Cover | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes |
| 👛 PPS Wallet – Independent Medical Savings Account | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes |
| 🤒 Healing@Home Program | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes | ☑️ Yes |
Conditions and Notes:
READ more about the 5 Best Hospital Plans under R500
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:
Discover the 5 Best Gap Cover Options for Under R200
Once you have an active membership with Profmed, you can apply for PPS Gap Cover by following these steps:
To apply for Medical Aid through Profmed, you must:
Get a Profmed Medical Aid quote from our Dedicated Medical Aid Specialists Broker
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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.
To submit a compliment or complaint with Profmed, you can contact the company’s Client Services team in several ways:
READ: 10 Things to Consider Before Cancelling your Medical
| 🔎 Medical Aid | 🥇 Profmed | 🥈 Platinum Health | 🥉 Fedhealth |
| 📌 Years in Operation | 64 Years | 22 Years | 87 Years |
| 📍 Average # Members | Unknown | <55,000 | 150,000+ |
| 📈 GCR Rating | AA | A+ | AA- |
| 📉 Number of Employees | 100+ | 100+ | 500+ |
| 📊 Market Share | <5% | <5% | <5% |
| ✔️ Market Coverage | South Africa | South Africa | South Africa |
| 💙 Customer Rating | 3.5/5 | 3/5 | 3.5 |
| 🔍 Number of reviews | 100+ | 3,000+ | 2,800+ |
| 📱 Mobile App | ✅ Yes | ❎ No | ✅ Yes |
| 💶 Contribution Range (ZAR) | 956 – 11,883 ZAR | ZAR | 1,590 – 14,289 ZAR |
| 🌎 International Travel Benefit (ZAR) | Up to R8 million | – | – |
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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 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.
| ✅ Pros | ❎ Cons |
| There are several comprehensive benefits offered to members | There is a limited network, which means that members might pay more for services |
| The claims process is straightforward, and members can use the app | The claims processing time can be longer than the average times of other schemes |
If you possess a postsecondary degree and relevant professional experience, Profmed will provide you with medical coverage.
Profmed manages medical costs by negotiating with healthcare providers and service providers to secure the best prices for its members.
Yes, Profmed covers pre-existing conditions, but waiting periods and exclusions may apply.
Yes, Profmed covers the chronic medication, but there may be limits on the amount and type of medication covered.
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.
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.
Yes, you can change your Profmed plan anytime, subject to certain conditions and restrictions.
You can contact Profmed customer support by calling 0860 679 200 or by sending an email to [email protected].
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.
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.
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.
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