Navigator
About this plan
🥇 Best suited for professionals and families seeking comprehensive hospital and day-to-day cover with a Medical Savings Account.
Principal Member
From
R4,881
per month
Adult Dependant
From
R4,175
per month
Child Dependant
From
R1,580
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
Navigator
Suremed Health Navigator Plan (🇿🇦 2026*)
Overall, the Suremed Health Navigator Medical Aid Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and a medical savings account for its family Members. The Suremed Health Navigator Medical Aid Plan starts from R5,335 ZAR.| 👤 Main Member Contribution | R5,335 |
| 👥 Adult Dependent Contribution | R4,175 |
| 🍼 Child Dependent Contribution | R1,580 |
| 🔁 Gap Cover | ✅ Yes |
| ↪️ Hospital Cover | Unlimited |
| ➡️ Oncology Cover | R262,500 |
| 💶 Prescribed Minimum Benefits | ✅ Yes |
| 📉 Screening and Prevention | ✅ Yes |
| 💙 Medical Savings Account | ✅ Yes |
| 🟦 Maternity Benefits | ✅ Yes |
Suremed Health Navigator Plan - 7 Key Point Quick Overview
- ✅ Suremed Health Navigator Plan Overview
- ✅ Suremed Health Navigator Plan Contributions and Medical Savings Account
- ✅ Suremed Health Navigator Plan Benefits and Cover Comprehensive Breakdown
- ✅ Suremed Health Navigator Plan Exclusions and Waiting Periods
- ✅ Suremed Health Navigator Plan vs Similar Plans from Other Medical Schemes
- ✅ Our Verdict on the Suremed Health Navigator Plan
- ✅ Suremed Health Navigator Plan Frequently Asked Questions
Suremed Health Navigator Plan Overview
The Suremed Health Navigator Medical Aid Plan is one of 4, starting from R5,335 and includes additional out-of-hospital benefits, a medical savings account, advanced dentistry, internal and external prostheses, and more.
Gap Cover is available on the Suremed Health Navigator 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 Navigator Plan Contributions and Medical Savings Account
| 💶 Amount | 👤 Main Member | 👥 Adult Dependent | 🍼 Child Dependent |
| 💵 Monthly Risk Contribution | R4,760 | R3,730 | R1,390 |
| 💴 Savings per Month Contribution | R575 | R445 | R190 |
| 💷 Total Contribution | R5,335 | R4,175 | R1,580 |
👉🏾 Discover the 5 Best Medical Aids under R1500
Suremed Health Navigator Plan Benefits and Cover Comprehensive Breakdown
| 📌 Prescribed Minimum Benefits (PMB) | Unlimited cover provided. Covered up to 100% of the Suremed Scheme Tariff. Pre-authorization is required before admission, or an R1,000 co-payment is required. Medication on discharge (TTO’s) R500 PB per event. |
| 📍 Emergency Stabilisation and Transportation | Emergency transport only. Pre-authorisation required by phoning ER24 on 084 124. |
| ☑️ Hospitalisation Alternatives | Limited to R21,000 per member family (PMF). Pre-authorization is required. |
| ✅ GP and Specialist Consultation | Unlimited cover provided. Covered up to 125% of the Suremed Scheme Tariff. |
| 🅰️ Maternity | Unlimited cover provided. Pre-approval is required. Cesarean Section is only covered if clinically necessary or will be paid up to natural delivery rates. The benefit includes the following: Accommodation Medication Materials Anaesthetist Gynaecologist Paediatrician |
| 🅱️ Mental Health | Limited to R16,800 PMF. This benefit includes all costs relating to hospitalization and doctors. |
| 💖 Organ Transplants | Limited to R157,500 PMF. Covered up to 100% of PMBs treated at a DSP. Pre-authorization required. All services are covered, including anti-rejection medication, and harvesting. |
| 🦾 Internal/Surgical Prostheses | Limited to R36,750 per beneficiary. Spinal fusion limited to 2 levels per year to a maximum of R26 250 PB. Intra-occular lenses limited to R2 625 per lens. Mesh limited to R8 400 PB. Subject to Scheme protocols |
| 🦿 Physiotherapy while in the hospital | Limited to R5,933 per beneficiary unless it is a PMB. |
| 📉 Basic Radiology and Pathology | Unlimited cover. |
| 📈 Dentistry | Subject to available PMSA from the Day-to-Day limit. |
| 📊 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. |
| ➡️ Chronic Medication | Unlimited when using a Preferred Provider. Pre-authorization is required. Subject to preferred provider-managed care protocols. |
| ↪️ Dialysis | Unlimited PMF. PMBs are covered up to 100% when using a DSP. Pre-approval is required. Subject to case and treatment management. |
| 🎗️ HIV/AIDS | Unlimited cover but subject to LifeSense protocols. |
| 🟥 Oncology | Limited to R262,500 PMF. Benefits must be pre-approved via ICON. PMBs are covered up to 100% when using a DSP. Pre-authorization is required, and the benefit includes medication and chemicals used during active treatment periods. |
| 🟧 Specialized Radiology and Pathology | Limited to R17,745 PMF. Pre-approval is required, or cover is only up to 80%. |
| 🟨 Acute Medicine | Paid from available funds in the PMSA. Once funds are depleted, there is a sub-limit of R3,323 within the overall day-to-day limit. OTC medication is limited to R168 per prescription per month, up to a maximum of R1,496 per year. |
| 🟩 Alcoholism and Drug Dependency. | Paid from available funds in the PMSA. Once funds are depleted, there is a sub-limit of R1,628 within the overall day-to-day limit. Pre-approval is required before treatment. Treatment includes accommodation, medication, materials, and visits. |
| 🟦 Paramedical, Auxiliary, and Mental Health | Paid from available funds in the PMSA. Once funds are depleted, the benefit is subject to the day-to-day limit. This benefit includes the following: Audiology Dietetics Hearing Aid Acoustics Homoeopathy Podiatry Speech Therapy Social Workers Clinical and Counselling Psychology |
| 🟪 Ambulance Services | Unlimited cover if ER24 is used. |
| 🩺 Appliances | Paid from available funds in the PMSA. Once funds are depleted, there is a sub-limit of R2,625 within the overall day-to-day limit. There is a limit of R4,200 paid to PMF for Oxygen. The benefit is subject to Suremed protocols and must be pre-approved. The following additional limits apply: Hearing aids are limited to R5,250 per 3-year cycle. Nebulizers/Humidifiers are limited to R525. CPAP Machines are limited to R5,250 per 3-year cycle. Glucometers are limited to R525 per 3-year cycle. Back support/braces are limited to R2,625. Orthotics are limited to R1,050. |
| 🪥 Basic Dentistry | Paid from available funds in the PMSA. Once depleted, the benefit will be subject to the day-to-day limit. Basic dentistry includes fillings, extractions, etc. |
| 🦷 Advanced Dentistry | Paid from available funds in the PMSA. Once depleted, the benefit will be subject to a sub-limit of R5,040 per beneficiary within the day-to-day limit. This benefit includes crowns, bridges, orthodontics, inlays, dental technician fees, and Osseo-integrated implants. |
| 👩⚕️ GP Consultations | Paid from available funds in the PMSA. Once depleted, the benefit will be subject to the day-to-day limit. This benefit includes casualty or emergency room visits. |
| 🍼 Maternity | Included in benefit parameters. Subject to early registration on Maternity Programme. 2 x 2D scans per pregnancy, includes 9 Ante-natal consultations and R390 for Ante-natal classes. 1 Postnatal consultation with GP / Specialist / Mid-wife / Ante-natal Vitamins: R68 per month for 9 months. |
| 🤓 Optometry | Paid from available funds in the PMSA. Subject to available PMSA thereafter a sub limit of R1 418 PB. Limited to R3 549 PMF within the overall Day-to-Day limit. Benefit for 1 pair of spectacles per beneficiary every two years or contact lenses every year. |
| ⚽ Physiotherapy | Paid from available funds in the PMSA. Once depleted, the benefit will be subject to the day-to-day limit. This benefit includes physiotherapy, chiropractics, and biokinetics. |
| 🧪 Pathology and Basic Radiology | Paid from available funds in the PMSA. Once depleted, the benefit will be subject to the day-to-day limit. This benefit includes X-rays, blood tests, etc. |
| 💜 Preventative Care and Wellness | Paid from available funds in the PMSA. Once depleted, the benefit will be subject to a sub-limit of R1,166 per beneficiary and up to R2,205 PMF within the day-to-day limit. This benefit covers the following: Mammograms Pap Smears Prostate Check-ups (PSA) Tonometry |
👉🏾 Discover the 5 Best Hospital Plans for Babies
Suremed Health Navigator Plan Exclusions and Waiting Periods
Navigator Plan Exclusions
The Suremed Health Navigator 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).
Navigator 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 Navigator Plan vs Similar Plans from Other Medical Schemes
| 🔎 Medical Aid Plans | 🥇 Suremed Health Navigator (2026) | 🥈 Fedhealth FlexiFED 3 Hospital plan (2026) | 🥉 Medimed Medisave Max (2026) |
| 👤 Main Member Contribution | R5,335 | R3,705 – R4,946 | R4,200 – R4,920 |
| 👥 Adult Dependent Contribution | R4,175 | R3,398 – R4,531 | R4,200 – R4,920 |
| 🍼 Child Dependent Contribution | R1,580 | R1,314 – R1,753 | R770 – R860 |
| ☑️ Hospital Cover | Unlimited | Unlimited | Unlimited |
| ✅ Oncology Cover | R262,500 | R360,850 | R400,000 |
👉🏾 You might like the 5 Best Gap Cover Options for Under R500
Our Verdict on the Suremed Health Navigator Plan
💙 Suremed Navigator is a comprehensive medical aid plan designed to provide its members with access to quality healthcare services at an affordable cost. The plan offers a range of features and benefits catering to individuals’ and families’ diverse healthcare needs.
💙 One of the key benefits of the Suremed Navigator plan is that it provides members with unlimited private hospital coverage. This means that members can receive medical treatment in a private hospital of their choice without worrying about the cost of treatment. The plan also covers the chronic medication, an essential benefit for individuals with chronic conditions.
💙 Another advantage of the Suremed Navigator plan is that it offers a wellness program that gives members access to various health and wellness services, such as preventative care, health assessments, and disease management programs.
💙 Furthermore, this program helps members stay healthy and manage their health conditions effectively. However, there are also some drawbacks to the Suremed Navigator plan.
💙 One of the drawbacks is that it does not cover certain medical procedures and treatments, such as cosmetic surgery and infertility treatments. Additionally, the plan has waiting periods for some benefits, which can disadvantage individuals needing immediate medical treatment.
👉🏾 You might also like: Suremed Health Challenger
👉🏾 You might also like: Suremed Health Explorer
👉🏾 You might also like: Suremed Health Shuttle
