5 Best Medical Aids for Fertility Treatment
The 5 Best Medical Aids for Fertility Treatment in South Africa revealed.
We tested them side by side and verified their medical aid plans.
This is a complete guide to the best medical aid for fertility treatment in South Africa.
In this in-depth guide you’ll learn:
- What is a Fertility Treatment?
- Which medical aids cover IVF in South Africa?
- How much of the IVF does medical aid pay for?
- How to compare medical aids against each other?
- Should you get IVF pre-approved by your medical aid?
- Do medical aids have waiting periods for IVF treatment?
So if you’re ready to go “all in” with the best medical aid for fertility treatment in South Africa, this guide is for you.
Let’s dive right in…
Best Medical Aids for Fertility Treatment (2023)
|🩺 Medical Aid||✔️ Fertility Treatments Offered?||⚕️ Plan Offered||👉 Sign Up|
|1. Discovery Medical Aid||Yes||Discovery KeyCare Plan||👉 Apply Now|
|2. Momentum Health||Yes||Ingwe Option||👉 Apply Now|
|3. BestMed Medical Aid||Yes||Beat1 Network Plan||👉 Apply Now|
|4. Medihelp Medical Aid||Yes||MedVital||👉 Apply Now|
|5. Bonitas Medical Aid||Yes||BonStart||👉 Apply Now|
5 Best Medical Aids for Fertility Treatment Summary
- Discovery Medical Aid – Overall, Best Medical Aids for Fertility Treatment in South Africa
- Momentum Health – Most Affordable and Accessible Medical Aid Coverage
- BestMed Medical Aid – Best Advantages for Preventative Care
- Medihelp Medical Aid – Top-of-the-Range Plans Offered to Members
- Bonitas Medical Aid – Best Day-to-Day Coverage in South Africa
What is Fertility Treatment
👉 Most cases of infertility are caused by blockages in the fallopian tubes, fibrous growths in the uterus, or less sperm or eggs being made. Endometriosis and hormonal imbalances have both been linked to not being able to have children.
👉 There are a number of specialised techniques and procedures that can make it easier to get pregnant. The type of treatment that is suggested to a couple depends on what is causing the problem and how old both people are.
👉 Common fertility treatments include laparoscopic surgery, medication, and hormone injections.
👉 In South Africa, the majority of medical aids provide financial assistance for diagnostic tests and procedures that are carried out with the goal of determining the reason for infertility but the costs of drugs and specialised medical treatments related to infertility are not covered by open medical aid plans.
👉 Because infertility is listed as one of 270 prescribed medical benefits (PMB) diagnostic treatment pairs recognised by the Medical Schemes Act under the female reproductive system category, they are legally obligated to cover the costs of certain surgeries and techniques aimed at creating the optimal conditions for a natural pregnancy.
Medical Aids in South Africa
👉 Even though infertility is a recommended minimum benefit illness in South Africa, medical aids do not cover treatments for it.
👉 Members of medical aids think that you should be able to get treatment for infertility no matter what medical aid plan you are enrolled in because it is considered a disease that needs a minimum benefit.
👉 Medical Aid companies, however, say that infertility does not put the patient’s life at risk. Unlike life-threatening conditions like heart disease, this is a treatment option that you can choose to go through.
👉 If the infertility is caused by a medical condition that can be treated, some medical assistance programmes may pay for procedures like surgery to unblock the fallopian tubes or blood tests.
👉 Since 2021, fertility treatments have been covered by the Discovery Medical Scheme, which is the biggest medical plan in South Africa. This coverage, however, comes with strict rules and is only available to a small number of the scheme’s customers.
1. Discovery Medical Aid
👉 Discovery Health Medical Scheme (DHMS) is probably South Africa’s biggest open medical plan. Anyone can join as long as they follow the Scheme’s rules and regulations.
👉 The Discovery Health Medical Scheme gives you more than 20 different health plans to choose from. Each plan includes unlimited coverage for private hospital care and a variety of other benefits that can be changed to fit your needs and budget.
Discovery Option Plans
👉 The following Discovery plans are available:
➡️ The Executive Plan offers customers the most extensive cover for in-hospital and day-to-day benefits, as well as extended chronic medicine cover and the Assisted Reproductive Therapy Benefit (fertility treatments).
➡️ This series of Comprehensive plans provide comprehensive cover for in-hospital and day-to-day cover with extended chronic medicine cover, and Assisted Reproductive Therapy Benefit (fertility treatments).
➡️ Series of Priority plans offer cost-effective in-hospital cover, essential chronic medicine cover and day-to-day benefits, but no fertility treatments.
➡️ The Saver Series is economical, provides in-hospital cover, essential chronic medicine cover and day-to-day benefits through a Medical Savings Account.
➡️ The Core Series is a series of hospital plans that provide unlimited private hospital cover and essential cover for chronic medicine but no day-to-day cover or other benefits.
➡️ The smart series of plans provide the most cost-effective in-hospital cover, essential chronic medicine cover plus limited day-to-day cover if you use providers in a specified network.
➡️ The basic Keycare Series of plans only offer affordable but basic medical cover providing you make use of providers in a specified network for both in-hospital and out-of-hospital treatment.
Benefits for Fertility Treatment under Discovery Medical Aid
👉 Discovery Health Medical Scheme added a new benefit that will help them if they are having trouble getting pregnant – the new Assisted Reproductive Therapy Benefit, which is part of both the Comprehensive and Executive plans.
👉 Along with insurance coverage for assisted reproductive technologies, Discovery Health Medical Scheme now offers a wider range of benefits. This is done with the Southern African Society of Reproductive Medicine and Gynaecological Endoscopy (SASREG), an organisation that specialises in reproductive medicine and gynaecological endoscopy, and in close consultation with them.
👉 The new Discovery Health Medical Scheme Assisted Reproductive Therapy Benefit covers a basic “basket of care” and coverage is available for a maximum of two cycles of therapy.
👉 For each cycle, this basket of care includes:
➡️ Consultations and medicine
➡️ Oocyte (egg) retrieval
➡️ Embryo transfer
➡️ Ultrasound scans
➡️ Admission costs and laboratory fees
➡️ Embryo and sperm storage
👉 Only females between 25 to 42 years who are members of the Executive and Comprehensive Plans have access to this benefit.
👉 Discovery will pay to up to 75% of the Discovery Health Rate for treatment up to a limit of R110 000 per person per year. The member has to pay 25% of the cost of treatment and any other costs not covered by the benefit.
Other benefits that makes it worthwhile to be a member of Discovery Medical Aid
👉 Vitality is the company’s health and wellness programme. If you live a healthy life, you can join and get rewards for doing so.
👉 The Executive Plan gives customers the most coverage for in-hospital and day-to-day benefits, as well as more coverage for chronic medicines and an unlimited Above Threshold Benefit.
2. Momentum Health
👉 The Momentum Medical Scheme is an open medical plan registered under the Medical Schemes Act 131 of 1998. The scheme is sustainable and is in a good position to take care of the needs of its members.
Momentum Health Option Plans
👉 The Momentum Medical Scheme provides members with access to six different medical aid plans.
➡️ The Ingwe Option – provides affordable entry-level medical coverage for medical care at any hospital in the Ingwe Network of private hospitals or state hospitals.
➡️ The Evolve Option – provides unlimited coverage for hospitalisation at any of the private hospitals that are part of the Evolve Network. Members have access to two consultations with virtual doctors, and any further day-to-day services will be subject to the HealthSaver+ membership fee.
➡️ The Custom Option – offers full coverage for hospitalisation as well as chronic conditions from any providers. Members can receive treatment at any hospital or choose from a predetermined list of private hospitals to reduce their co-payment.
➡️ The Incentive Option – provides comprehensive hospital and chronic cover from any of the connected providers. Your regular expenditures are taken care of by a separate savings account funded by 10% of your monthly premiums.
➡️ The Extender Option – offers comprehensive hospital coverage and chronic disease coverage from any doctor. Your dedicated medical savings account, funded by twenty-five percent of the total monthly contribution, pays for your day-to-day expenses. Once you have reached your Threshold, the benefit of Extended Coverage becomes available.
➡️ The Summit Option – grants limitless access to private hospital coverage through any provider. A chronic cover is offered for an additional 36 conditions, and day-to-day benefits are covered up to a maximum of R29 700 per beneficiary per year.
Fertility Treatment Benefits under Momentum Health
👉 No fertility treatments are covered by Momentum Health.
Other benefits that makes it worthwhile to be a member of Momentum Health
👉 Momentum Health provides affordable and easily accessible entry-level medical coverage with its Ingwe Option. Members can receive medical care at any hospital in the Ingwe Network of private hospitals or state hospitals.
👉 On the other end of the spectrum, the Extender Option offers comprehensive hospital coverage and chronic disease coverage for treatment by all doctors. A dedicated medical savings account that is funded by a large portion of your monthly contributions, is used to pay for any day-to-day expenses. After reaching a certain threshold, an Extended Coverage benefit becomes available to you.
3. BestMed Medical Aid
👉 BestMed is one of South Africa’s largest self-administered funds and the fourth largest open medical aid in the country.
👉 BestMed customers can choose between a set of 2 Hospital Plans, 2 Network Plans, 4 Savings Plans, and 5 Comprehensive Plan options.
➡️ The Hospital Plans comprise the Beat1 Network Plan and Beat1 Plan. The network plan covers members at a network of hospitals while the second option provides unlimited cover for hospital stays.
➡️ The BestMed Network Plans (Rhythm1 and Rhythm2 Network Plans) offer unlimited in-hospital cover with either limited essential day-to-today benefits, or comprehensive savings for consultations with designated healthcare providers.
➡️ BestMed Savings Plans (Beat2 Savings Plan and Beat2 Network Savings Plan) offer extensive hospital cover at private hospitals and a savings account for general day-to-day expenses. The Beat2 Network Savings Plan requires treatment at providers in a specific network.
➡️ BestMed Pace1Comprehensive Plan provides extensive hospital benefits with day-to-day cover at an affordable price, the Beat4 Comprehensive Plan includes chronic benefits and savings, the Pace2 and Pace3 Comprehensive Plans offer comprehensive cover with in- and out-of-hospital benefits and the Pace4 Comprehensive Plan provides the maximum available cover with extensive benefits and cover for hospital expenses and the flexibility of an individual medical savings account.
Fertility Treatment Benefits under BestMed Medical Aid
👉 Although infertility is a prescribed medical benefits (PMB) illness in South Africa, specialised fertility treatments are not covered by BestMed.
Other benefits that makes it worthwhile to be a member of BestMed Medical Aid
👉 All of BestMed’s plans have significant advantages for preventative health care, such as vaccinations, contraceptives, and more.
👉 Members can access specialists and hospitals throughout South Africa, as well as thousands of family doctors.
👉 The Bestmed Maternity Care programme provides a variety of services but not any assistance with specialised infertility treatments.
4. Medihelp Medical Aid
👉 Medihelp is one of the top five choices of medical aids in South Africa and provides services to students, young professionals who want to join a medical aid for the first time, and even self employed people.
👉 Medihelp offers the following plans:
➡️ MedElect Student – using a network of service providers for comprehensive cover at an affordable premium for students. Benefits include in-hospital cover, screenings and additional benefits.
➡️ MedVital – a healthcare solution providing affordable cover for minor medical expenses, private hospitalisation and emergency medical services.
➡️ MedMove – providing essential cover such as private hospitalisation and emergency medical services through specific networks, virtual and in-person doctors’ consultations and medicine, and a selection of other medical services.
➡️ MedAdd – offers a 15% savings account, additional insured cover once savings are depleted, dental and eye care coverage, and pregnancy benefits, but no infertility benefits.
➡️ MedSaver – provides cover for private hospitalisation, a 25% savings account for medical expenses incurred out of hospital, and an out-of-hospital cover once savings are depleted.
➡️ MedAddElect – for comprehensive care at premium networks.
➡️ MedPrime – cover for private hospitalisation, out-of-hospital services (from savings account), insured pooled benefits, and dental and optometry benefits.
➡️ MedElite – an all-inclusive plan with extensive healthcare benefits.
➡️ MedPlus – a top-of-the-range plan that offers extensive cover for medical emergencies, private hospitalisation, preventive care, acute and chronic medicine, radiology, pathology and other day-to-day medical expenses.
Fertility Treatment Benefits under Medihelp Medical Aid
👉 Medihelp Medical Aid does not cover any specialised fertility treatments under any of these options.
Other benefits that makes it worthwhile to be a member of Medihelp Medical Aid
👉 Medihelp’s top-of-the-range plans offer extensive cover for medical emergencies, acute and chronic medicine, private hospitalisation, preventive care, radiology, pathology and other day-to-day medical expenses.
5. Bonitas Medical Aid
👉 Bonitas keeps up with technological advances, and aims to detect lifestyle diseases before they develop into chronic conditions.
👉 Bonitas offers a wide variety of plans for individuals and families.
➡️ The Edge Option – gives day-to-day benefits including unlimited GP consultations, layers of virtual care, dental and optical consultations, a private hospital network and more.
➡️ Traditional, Standard and Standard Select plans – for overall day-to-day limits with sub-limits for GP and specialist consultations, acute and over-the-counter medicine, X-rays and blood tests and other out-of-hospital medical expenses.
➡️ Bonitas’ Savings Plans – give a set amount to use for out-of-hospital costs like doctor visits, optometry, and dentistry, as well benefits for maternity, wellness, and preventative care.
➡️ The BonFit Select Option – offers essential hospital and basic for day-to-day cover.
➡️ The BonSave Option and BonComplete Option offer savings for medical expenses and extensive hospital cover.
➡️ Bonitas Hospital Plans cover members for procedures in the hospital with some additional benefits for wellness and preventative care.
➡️ The BonCap income-based entry-level plan offers basic day-to-day benefits and hospital cover from network of doctors, hospitals and providers.
Fertility Treatment Benefits under Bonitas Medical Aid
👉 None of the above Bonitas Medical Aid plans provide infertility treatment, despite the fact that it is classified as a PMB illness in South Africa.
Other benefits that makes it worthwhile to be a member of Bonitas Medical Aid
👉 Most of Bonitas’ traditional plans give overall day-to-day coverage and essential benefits.
Are There Medical Aids That Cover Fertility Treatment?
Currently, only one medical aid, Discovery, covers fertility treatments under certain options.
Can You Join a Medical Aid Just for Fertility Treatment?
No, you cannot join a medical aid just for fertility treatments, since only one covers it and you have to be a member for at least 12 months for benefits like these.
How Much Does It Cost to Receive Fertility Treatment?
The cost of fertility treatment can range anywhere from R50 000 to R100 000.
Does Medical Insurance Cover the Cost of Fertility Treatment?
No, fertility treatment is not considered “medically necessary” therefore medical insurance does not cover it.