Explorer
About this plan
🥇 Best suited for individuals and families seeking affordable network hospital cover with essential day-to-day benefits. Income based plan.
Principal Member
From
R1,839
per month
Adult Dependant
From
R1,781
per month
Child Dependant
From
R930
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
Explorer
Suremed Health Explorer Plan (🇿🇦 2026*)
Overall, the Suremed Health Explorer Medical Aid Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and gap cover for its Family Members. The Suremed Health Explorer Medical Aid Plan starts from R2,010 ZAR.| 👤 Main Member Contribution | R2,010 – R5,020 |
| 👥 Adult Dependent Contribution | R1,781 – R5,020 |
| 🍼 Child Dependent Contribution | R930 – R1,560 |
| 🔁 Gap Cover | ✅ Yes |
| 🦾 Internal Prosthesis | Only PMBs are covered |
| 🦿 External Prosthesis | Only PMBs are covered |
| 💙 Hospital Cover | Unlimited |
| 💶 Prescribed Minimum Benefits | ✅ Yes |
| 📉 Screening and Prevention | ✅ Yes |
| ➡️ Medical Savings Account | None |
Suremed Health Explorer Plan - 7 Key Point Quick Overview
- ✅ Suremed Health Explorer Plan Overview
- ✅ Suremed Health Explorer Plan Contributions
- ✅ Suremed Health Explorer Student Plan Overview
- ✅ Suremed Health Explorer Plan Benefits and Cover Comprehensive Breakdown
- ✅ Suremed Health Explorer Plan Exclusions and Waiting Periods
- ✅ Suremed Health Explorer Plan vs Similar Plans from Other Medical Schemes
- ✅ Our Verdict on the Suremed Health Explorer Plan
- ✅ Suremed Health Explorer Plan Frequently Asked Questions
Suremed Health Explorer Plan Overview
The Suremed Health Explorer Medical Aid Plan is one of 4, starting from R2,010 and includes unlimited hospitalization in Netcare hospitals, a comprehensive network of GPs, Dentists, Optometrists, and Pharmacies, extended day-to-day benefits, and more.
Gap Cover is available on the Suremed Health Explorer Plan, along with 24/7 medical emergency assistance. According to the Trust Index, Suremed Health has a trust rating of 2.1.
👉🏾 Suremed Health Medical Aid Scheme has the following plans:
- ✅ Suremed Health Challenger
- ✅ Suremed Health Explorer
- ✅ Suremed Health Navigator
- ✅ Suremed Health Shuttle
Suremed Health Explorer Student Plan Overview (2025)
The Suremed Health Explorer Student Plan for 2025 offers comprehensive and affordable health coverage tailored to meet the unique needs of students for only R625 per month but your income must only be between 0-R500 to be eligible to qualify for this plan. This plan provides access to a wide network of healthcare providers, ensuring quality care for routine checkups, preventive services, and emergencies. Designed with flexibility in mind, it includes customizable options such as mental health support, telemedicine services, and prescription benefits. With competitive premiums and easy enrollment, the plan empowers students to focus on their education while staying healthy and protected. 👉🏿 Download the EXPLORER 2025 STUDENT PLANSuremed Health Explorer Plan Contributions 2026
| 💴 Income Bracket | 👤 Main Member | 👥 Adult Dependent | 🍼 Child Dependent |
| 💵 R501 – R8,500 | R2,010 | R1,781 | R930 |
| 💶 R8,501 – R13,000 | R2,535 | R2,245 | R1,130 |
| 💷 R13,001 – R17,000 | R4,025 | R4,025 | R1,175 |
| 💴 R17,001> | R5,020 | R5,020 | R1,560 |
👉🏾 Discover the 5 Best Medical Aids under R1000
Suremed Health Explorer Plan Benefits and Cover Comprehensive Breakdown
| 📌 Prescribed Minimum Benefits (PMB) | A Preferred Provider provides unlimited coverage. PMBs are unlimited when using a scheme DSP. |
| 📍 Emergency Stabilisation and Transportation | Emergency transport only. Pre-authorisation required by phoning ER24 on 084 124. Unlimited cover provided. |
| ☑️ Hospitalisation Alternatives | Limited to R13,125 per member family (PMF). Pre-authorization is required. |
| ✅ GP and Specialist Consultation | The unlimited cover is provided by a Preferred Provider. Specialists are limited to R21,000 PMF unless it involves a PMB. |
| 🅰️ Maternity | Unlimited only when using a Preferred Provider. Pre-approval is required. |
| 🅱️ Basic Radiology and Pathology | Unlimited only when using a Preferred Provider. Pathology is limited to R22,575PMF unless PMBs apply. |
| 📉 Physiotherapy | Members must use a Preferred Provider. Limited to R3,728 PMF unless PMBs apply. Only covers in-hospital treatment. |
| 📈 Prostheses | Limited to PMBs. Pre-approval is required before admission. Unlimited when using a DSP, but scheme protocols will apply. |
| 📊 Take-home Medication | Limited to R300 per beneficiary per event. Subject to the formulary. |
| ❤️ Compassionate Care | Limited to R21,000 PMF only for clinically appropriate medical care. PMBs are unlimited when using a DSP. Pre-approval is required. A doctor’s letter is required to confirm end-of-life treatment. |
| 🩺 Medical Equipment | Limited to R4,200 PMF when using a Preferred Provider. Includes wheelchairs, oxygen, and cylinders. Pre-approval is required. |
| 💊 Chronic Medication | Unlimited when using a Preferred Provider. Pre-authorization is required via the Prime Cure formulary. Subject to preferred provider-managed care protocols. |
| ➡️ Dialysis | Unlimited when using a Preferred Provider and only for PMBs. Pre-approval is required. Subject to case and treatment management. |
| 🎗️ HIV/AIDS | Unlimited cover but subject to managed care protocols. |
| ↪️ Oncology | Unlimited when using a Preferred Provider and for PMBs. Pre-approval and registration with the necessary program are required. |
| 🤕 Acute Medicine | Unlimited acute (prescribed) medicine from a nominated provider. Limited to R368 per beneficiary per year and up to R446 PMF. Maximum R120 per event via Prime Cure. |
| 🟥 Contraceptives | R2 340 PMF. Limited to R180 script limit PMF |
| 🤧 Chronic Medicine | Unlimited coverage is provided if prescribed by a nominated provider. Subject to registration through Prime Cure. Subject to the Prime Cure medication formulary. |
| 🪥 Basic Dentistry | Unlimited when treatment is obtained from a Primary care network provider. Only covers approved dental codes. Limited to one preventative consultation per beneficiary per year. |
| 🦷 Dentures | Covers one set of acrylic dentures PMF per 2 years, with a limit of R4,505 per family. Covered up to 80% at cost. Pre-authorization required. The benefit is only covered for beneficiaries older than 21 years. |
| 👩⚕️ GP Consultations | Limited to 12 consultations per beneficiary. Authorization is required for the twelfth consultation to activate the PMB benefit. Members may only change doctors twice a year. |
| 👨⚕️ Out-of-Network and After-Hour GP Consultations | Limited to one visit per beneficiary or two per family. Limited to R1,260 per event. Authorization is required within 72 hours of the visit. |
| 💉 Immunizations | Limited to one per beneficiary per year and only for high-risk patients. This only covers flu injections. |
| 🤓 Optometry | Unlimited at any Primary Care Network Optometrist 1 Eye test PB per year. Frame from selected range. 1 Pair of spectacles PB per 24 month cycle. Lenses limited to R2 500 PB. Contact Lenses - no benefit. Frames range up to the value of R840. Any frames selected. |
| ⚠️ Radiology and Pathology | Unlimited cover when referred by a nominated doctor. Subject to the approved Radiology and Pathology codes. |
| 🍼 Maternity | Subject to registration on maternity programme through Momentum TYB 0860 08 08 88 or (041) 395 4545. 2 x 2D scans per pregnancy. Limited to 2 visits (GP or Gynae) and 1 paediatrician visit / Ante-natal Vitamins: R120 per month for 9 months. |
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Suremed Health Explorer Plan Exclusions and Waiting Periods
Explorer Plan Exclusions
The Suremed Health Explorer Plan Exclusions include, but are not limited to, the following:- ☑️ Costs exceeding the annual or biennial maximums.
- ☑️ Medical, surgical, and orthopedic appliances, devices, and products not specifically provided for.
- ☑️ Operations, medicines, treatments, and procedures for cosmetic purposes or personal reasons.
- ☑️ Medicines not included in a prescription from a legally entitled medical practitioner or healthcare professional (except schedule 0, 1, and 2 medicines supplied by a registered pharmacist).
- ☑️ Healthcare services are not appropriate or necessary for symptoms, diagnosis, or treatment of a medical condition.
- ☑️ Medicines not registered and approved by SAHPRA for clinical treatment of a condition.
- ☑️ Treatment where efficacy and safety cannot be scientifically proven.
- ☑️ MRI scans are ordered by a general practitioner (except in emergencies).
- ☑️ Specialist referral for second opinions unless authorized by the scheme.
- ☑️ Injuries sustained while participating voluntarily in certain activities or any injuries arising from professional sports or speed contests.
- ☑️ Organ and tissue donations to anyone other than a member or dependent of a member.
- ☑️ Treatment of a sickness condition directly attributable to the failure to carry out medical practitioner instructions (except if the sickness condition is a PMB).
- ☑️ Medical examinations for employers, insurance, school readiness, or legal purposes.
- ☑️ Non-disclosure of conditions.
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Explorer Plan Waiting Periods
Waiting periods prevent members from anti-selecting or joining a program solely when ill. There are two types of wait times:- ☑️ A 3-month General Waiting Period – The scheme will not fund any claims during this general waiting period.
- ☑️ A 12-month Condition-Specific Waiting Period – A member is ineligible to claim benefits for a condition for which medical advice, diagnosis, care, or treatment was recommended or received within the 12 months ending on the date of the membership application.
Suremed Health Explorer Plan vs Similar Plans from Other Medical Schemes
| 🔎 Medical Aid Plan | 🥇 Suremed Health Explorer (2026) | 🥈 Medimed Alpha (2026) | 🥉 Discovery Health Essential Delta Core (2026) |
| 👤 Main Member Contribution | R2,010 – R5,020 | R1,820 | R2,507 |
| 👥 Adult Dependent Contribution | R1,781 – R5,020 | R1,820 | R1,887 |
| 🍼 Child Dependent Contribution | R930 – R1,560 | R700 | R1,006 |
| ➡️ Hospital Cover | Unlimited | Unlimited | Unlimited |
| ↪️ Oncology Cover | Unlimited for PMBs at a Preferred Provider | R200,000 | R250,000 |
Our Verdict on the Suremed Health Explorer Plan
💙 The Suremed Explorer plan offers comprehensive medical aid coverage at an affordable price. With this plan, members can access a wide range of benefits, including unlimited hospitalization, chronic medication coverage, and maternity benefits.
💙 The plan also covers out-of-hospital treatments such as consultations, diagnostic tests, and procedures. One of the main advantages of this plan is access to a large network of hospitals and medical practitioners, ensuring that members receive quality healthcare services.
💙 However, the plan has some drawbacks, such as limitations on certain treatments and procedures, co-payments, and waiting periods for certain benefits. Despite these limitations, the Suremed Explorer plan offers an attractive option for those looking for comprehensive medical aid coverage at an affordable price.
👉🏾 You might also like: Suremed Health Challenger
👉🏾 You might also like: Suremed Health Navigator
👉🏾 You might also like: Suremed Health ShuttleSuremed Health Explorer Plan Frequently Asked Questions
What is the Suremed Explorer medical aid plan?
The Suremed Explorer is a medical aid plan offered by Suremed Health that provides comprehensive healthcare coverage at an affordable price.What are the benefits of the Suremed Explorer plan?
The Suremed Explorer plan offers unlimited hospitalization, chronic medication coverage, maternity benefits, and coverage for out-of-hospital treatments such as consultations, diagnostic tests, and procedures.Which hospitals and medical practitioners are included in the Suremed Explorer network?
The Suremed Explorer plan provides access to a large network of hospitals within the Netcare Group and medical practitioners to ensure that members receive quality healthcare services.Is there a waiting period for benefits under the Suremed Explorer plan?
Yes, there is a waiting period for certain benefits under the Suremed Explorer plan. The waiting period may vary depending on the benefit.Does the Suremed Explorer plan cover chronic medication?
Yes, the Suremed Explorer plan provides coverage for chronic medication.Are maternity benefits included in the Suremed Explorer plan?
Yes, the Suremed Explorer plan provides maternity benefits.Ladies can make use of our free Ovulation Calculator
