5 Best Medical Aid for SASSA Pensioners in South Africa
The 5 Best Medical Aids for SASSA Pensioners in South Africa revealed.
We tested them side by side and verified their medical aid plans for SASSA Pensioners.
This is a complete guide to the best medical aid for SASSA Pensioners in South Africa.
In this in-depth guide you’ll learn:
- ☑️ What is a Medical Aid?
- ☑️ How do you find affordable medical aid in South Africa?
- ☑️ How to compare medical aids against each other?
- ☑️ What is the best way to sign up for medical aid if you don’t have access to the internet?
- ☑️ Which medical aid has the most comprehensive coverage for pensioners?
So if you’re ready to go “all in” with the best medical aid for SASSA pensioners in South Africa, this guide is for you.
Let’s dive right in…
Best Medical Aid for SASSA Pensioners in South Africa (2024)
| 🩺 Medical Aid | ✔️ Offers Plans for SASSA Pensioners? | ⚕️ Plan Offered | 💵 Pricing | 👉 Sign Up |
| 1. Momentum Medical Aid | Yes | Evolve Option | R1 687 per member per month | 👉 Apply Now |
| 2. FedHealth | Yes | myFED Option | R1 590 per month per member | 👉 Apply Now |
| 3. Discovery Health | Yes | Discovery KeyCare Plan | R1 102 per member per month | 👉 Apply Now |
| 4. Bonitas | Yes | BonStart Plan | R1 378 per member per month | 👉 Apply Now |
| 5. BestMed | Yes | BestMed Beat1 Network Hospital Plan | R1 873 per member per month | 👉 Apply Now |
5 Best Medical Aid for SASSA Pensioners in South Africa (2024)
- Momentum Health – Overall, Best Medical Aid for SASSA Pensioners in South Africa
- Fedhealth – Top Extensive Medical Protection in South Africa
- Discovery Health – Broadest Range of Low-Cost Medical Aid Plans
- Bonitas – Best Pay-As-You-Go Private Healthcare
- BestMed – Best Customer Service Medical Aid
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The importance of medical aid for SASSA pensioners
👉 The SASSA Older Person’s Grant (or state pension) is available to those who are 60 or older, are no longer working, and experiencing financial hardship.
👉 To demonstrate financial necessity, you will be required to take a “means test.” To qualify for the grant, your normal income must be below a specified threshold (this includes income from investments, rental property, and private pensions). You cannot receive a state pension if your assets are worth more than a specified sum.
👉 The current pension amount is R1 990 per person, per month (if you are below 75 years old) and R2 010 per person, per month (if you are over 75 years old). The amount will be revised again in April 2024.
👉 Those who are in retirement can get medical aid coverage through a programme called Medical Aid for Pensioners. There is no upper age limit for participation in a South African medical aid programme; however, there is a late enrolment fee for those who sign up for coverage beyond the age of 35.
👉 Medical aid for retirees can be challenging to evaluate. Many retirees find that their health risks rise while their disposable income declines. That’s why it’s smart to consult a financial counsellor or a Medical Aid broker before making any major decisions.
👉 If you’re a SASSA pensioner worried about how to pay for rising medical costs while living on a fixed grant, you should know that there are solutions that can meet your needs.
👉 Medical aid plans that cover routine doctor visits, prescription medication, and dental and vision care are all important considerations for retirees.
👉 But, if you are a retiree who has never signed up for Medical Aid before, you will be subject to a late joiner penalty cost that can increase your monthly premiums by as much as 75%. Someone in their 60s will pay a smaller penalty than someone in their 80s because the cost is age-based.
👉 All medical plans have the right to exclude coverage for any pre-existing conditions for a minimum of 12 months and to implement a general waiting period of 3 months during which no claims will be reimbursed.
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Choosing a medical aid as a SASSA pensioner
👉 SASSA pensioners will have special considerations when looking for a medical aid plan since their options will be limited by their grant money. There are also additional considerations to factor in, which we outline below.
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1. Affordability
👉 With the rising expense of medical care and the possibility of reduced income in retirement, careful consideration must be given to the selection of a medical aid policy.
2. Any pre-existing conditions
👉 Medical aid plans often have a 12-month waiting period before they will cover any pre-existing conditions. If you join a medical aid plan before you really need it, you reduce the likelihood that you won’t be covered for any pre-existing conditions.
3. Consider applying for medical aid before retiring
👉 It is illegal for South African medical aid programmes to exclude potential members based on age, and all members of a given plan pay the same base monthly premiums regardless of age or pre-existing conditions.
👉 Note, however, that medical aid schemes may impose a “late joiner fee” on any new member aged 35 or older. If you’ve always been covered by a medical aid plan, switching to a new one won’t incur the late joiner cost.
👉 However, if you’ve had coverage gaps in the past three years or are signing up for coverage for the first time after turning 35, you will be charged the fee.
👉 New members of any medical aid plan are required to wait three months before receiving any services. There will be no reimbursement for any costs incurred during this time.
👉 Even if you switch from one medical aid to another, there will still be a three-month waiting period before any benefits may be claimed. Nevertheless, the criteria may differ depending on the member’s prior medical assistance, and the new plan may be required to cover specific disorders.
4. Assess your current and future health risks
👉 Being older dramatically increases your likelihood of requiring hospitalisation for medical care. Thus, you should seriously consider investing in an in-hospital medical aid plan that includes essential PMB chronic illness protection.
👉 After that, you’ll have to come up with the cash for things like regular doctor’s appointments, trips to the dentist and the eye doctor, and prescription medication.
👉 When compared to the cost of a medical aid plan that covers both in- and out-of-hospital care, your monthly premium will be much lower.
👉 Certain medical assistance plans are only valid within a specific group of institutions, but even so, they offer a wide range of benefits.
👉 If you only require basic coverage on an occasional basis, a low-cost network provider package could be a good option for you (services that are not provided by hospitals). Your premiums are likely to be less than R1,000 per month on average and will be depending on your wage.
👉 It’s important to keep in mind that the advantages may come with restrictions, such as having to see just the hospitals and doctors that are part of the scheme’s network.
👉 Nonetheless, they do offer reasonably priced protection for emergency situations (heart attack, stroke, accident) and chronic disorders (cancer, kidney) treated in a private hospital and by private practitioners.
👉 Discounts on your monthly premium are available through various plans if you agree to use the services of linked suppliers.
👉 Access to government-run healthcare is guaranteed for all South Africans, including retirees. Yet, given the state of public healthcare in South Africa, it’s understandable why only those who absolutely can’t afford anything else resort to it.
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5 of the Best-Known Medical Aids for SASSA Pensioners
👉 When it comes to medical aids, SASSA pensioners should look for plans with cheap monthly costs and comprehensive coverage for chronic ailments.
👉 You may need to reevaluate and make changes to your current medical aid plan as retirement approaches.
👉 Hospital plans are gaining popularity as an alternative to comprehensive medical aid since they provide enough chronic coverage without the high monthly costs.
👉 Unfortunately, hospital plans do not cover routine medical expenses like doctor’s visits, over-the-counter medication, and diagnostic tests.
👉 Here, we explore the top 5 medical aid plans for SASSA pensioners, which provide comprehensive coverage at an affordable premium for those on pension grants.
1. Momentum Health
Overview
👉 The parent company of Momentum Medical Scheme, one of South Africa’s top three open medical plans, is widely considered a market leader.
👉 Momentum Health is dedicated to ensuring the long-term viability of the plan and providing unparalleled value to its subscribers.
👉 By going with Momentum Health Solutions, you may get in touch with a group of doctors who are committed to providing you with low-cost, high-quality service.
👉 To provide for its customers, Momentum has teamed up with commercially driven physician networks. Also, consumers can get their medical questions answered by a doctor via phone at any time by dialling the Hello Doctor number.
👉 Momentum’s actuarial services can be used to determine the cost of incentive and reward programmes, which can be used to attract and retain healthy members.
👉 Using a ground-breaking health coaching model, Momentum’s advocacy efforts equip members to make educated healthcare decisions and reduce costs.
Momentum Medical Aid Plans Suitable for SASSA Pensioners
👉 Momentum offers a wide range of options for members’ medical coverage, including some plans that cost less than R1000 per month for SASSA pensioners.
Ingwe Option Plan
👉 The Ingwe plan allows you and your family to utilise whatever network hospital you want, up to an annual maximum. You can only go to private Ingwe-affiliated hospitals. In order to qualify for the plan’s cheapest premiums, participants must use public hospitals and clinics.
👉 Opposed to many other forms of medical aid, the Ingwe choice does not limit annual spending on medical care. You have the option of using either private Ingwe hospitals or public hospitals for a lesser monthly charge, depending on your financial situation.
👉 The Ingwe Active Network and the Ingwe Primary Care Network are the only ones to whom you can turn for both immediate medical attention and ongoing medical management, such as prescriptions and doctor’s appointments.
👉 Momentum has a stellar reputation in the field of medical assistance. In terms of membership, it is South Africa’s third-largest medical aid scheme and fifth-largest medical aid provider. That’s 3.2% of the market and 5.8% of the open sector, or 284 400 persons.
- ➡️ The Ingwe Option Plan is available at R541.00 per month
How Much Are Momentum Health Monthly Premiums?
👉 Momentum monthly premiums start at R1 687 for the main member on the Evolve Option and go up to R13 573 for the main member on the Summit Option.
What Is the Waiting Period for Momentum Health Benefits?
👉 The general waiting period is 3 months, but since pregnancy is considered a pre-existing condition, it is excluded from all benefits for the first 12 months of scheme membership.
How to Claim Momentum Health Benefits
👉 You can submit a claim in several ways:
- ➡️ Use the Momentum App
- ➡️ Use the web chat facility in the bottom left corner.
- ➡️ Send an email to [email protected] or send normal mail to PO Box 2338, Durban, 4000
👉 To make sure your claim is processed quickly and accurately, including the following information:
- ➡️ Membership number.
- ➡️ Principal member’s surname, initials, and first name.
- ➡️ Patient’s surname, initials, and first name.
- ➡️ Date of treatment.
- ➡️ Amount charged.
- ➡️ ICD–10 code (code to indicate what condition you’ve been diagnosed with), tariff code (product-specific code for procedures and claims), and NAPPI code (a unique identifier for a given ethical, surgical, or consumable product).
- ➡️ Service provider’s name and practice number.
- ➡️ Proof of payment if you’ve paid the claim out of your own pocket.
Momentum Health Contact Details
201 Umhlanga Ridge Blvd
Cornubia
Blackburn
PO Box 2338
Durban
2. Fedhealth
Overview
👉 The necessity for medical care in South Africa inspired the founding of Fedhealth in 1936. There have been many shifts over the years, but one constant has been their dedication to offering excellent service at reasonable rates.
👉 Because it is still a cooperative run for the benefit of its members, Fedhealth is always on the lookout for better ways to deliver healthcare to its members.
👉 To emphasise the importance of individualization, Fedhealth allows you to participate in the creation of your own personalised health care plan. Fedhealth is committed to providing superior service to its members because it values their needs.
👉 With a reserve of more than the minimum 25% needed by law, the Scheme is in a strong financial position to provide for its members, as evidenced by its AA- Global Credit Rating, which it has maintained for the past 14 years.
👉 Fedhealth is well-known not just for its basic benefits, but also for its novel Risk-based awards, which significantly enhance the value of those benefits for members.
👉 There are no restrictions on seeing doctors within the plan’s network, and you can acquire a free plan upgrade at any time during the year if your medical needs change significantly (within 30 days of a major life event).
Fedhealth Medical Aid Plans Suitable for SASSA Pensioners
👉 Fedhealth offers a wide range of options for members’ medical coverage, including some plans that are affordable for SASSA pensioners.
flexiFED 1
👉 You can use the Fedhealth Savings made available by the MediVault and the Threshold Benefit, which is triggered when your claims surpass a certain threshold, to cover the costs of routine medical care and any unforeseen emergencies that may happen.
- ➡️ flexiFED 1 is available at R1 716.00
How Much Are Fedhealth Medical Scheme Monthly Premiums?
👉 The monthly premiums for the salary-banded myFED option is from R 1 590 per month for the main member.
👉 The maxima PLUS extensive medical cover will cost R14,289 per month per the main member.
Waiting Period for Fedhealth Medical Scheme Benefits?
👉 The general waiting period for Fedhealth benefits is usually three months, depending on the medical aid scheme you join. The waiting period for pre-existing conditions is 12 months.
How to Claim Benefits from Fedhealth Medical Scheme
👉 Members can submit claims using one of the following:
- ➡️ In the Fedhealth Family Room,
- ➡️ Through a WhatsApp service
- ➡️ On the Fedhealth Member Phone App
- ➡️ You may also email, fax or post the claims to email: [email protected], fax: (011) 671 3842 or post to Private Bag X3045, Randburg, 2125.
Fedhealth Medical Scheme Contact Details
Flora Centre Shop 21 and 22
Corner Conrad street and Ontdekkers Rd
Florida Glen
Johannesburg
Phone: 0861 116 016
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3. Discovery Health
Overview
👉 According to the Commission for Medical Schemes Quarterly Report for the quarter ended 30 June 2019, Discovery Health Medical Plan (DHMS) had 2,808,106 members as of December 31, 2019.
👉 The Medical Schemes Act 131 of 1998, as amended, and the non-profit Council for Medical Schemes control the operation of Discovery. Anyone who meets the requirements can sign up for the System because it is a public healthcare system.
👉 The decisions taken by the Scheme are driven by a desire to help its participants. Discovery uses common goals to balance the interests of its participants with those of the overall Scheme.
👉 In South Africa, members of Discovery Health Medical Scheme (DHMS or the Scheme) have access to a pooled fund administered with a priority on social solidarity rather than the commercial gain to cover their medical expenses.
Discovery Medical Aid Plans Suitable for SASSA Pensioners
👉 Discovery offers a wide range of options for members’ medical coverage, including some plans that cost less than R1000 for SASSA pensioners
Discovery KeyCare Plan 
👉 KeyCare’s wide medical coverage is provided via the hospital networks it is associated with. All hospitals in the KeyCare network, and up to 100% of the Discovery Health Rate for all other doctors and hospitals, are covered for the full cost of hospitalisation (DHR).
👉 Both KeyCare Plus and KeyCare Start include coverage for lab work, X-rays, and prescription medication if obtained from a participating pharmacy within the KeyCare network, and primary care visits are limitless.
👉 When you see a doctor who is a KeyCare participating provider, you will receive complete coverage for any condition that is on the KeyCare Chronic Disease List (DSP). The coverage you get is determined by the policy you choose.
- ➡️ Discovery KeyCare Start is available at R1 239.00 per month
How Much Are Discovery Medical Aid Monthly Premiums?
👉 At the time of writing, monthly premiums started from R1,102 per member for the KeyCare Series with medical cover for both in-hospital and out-of-hospital treatment by providers in a specified network and ranged up to R10 303 per member for the Executive Plan with extensive cover for in-hospital and day-to-day benefits, extended chronic medicine cover, and unlimited Above Threshold Benefit.
What Is the Waiting Period for Discovery Medical Aid’s Benefits?
👉 Discovery Health Medical Scheme’s general waiting period is 3 consecutive months and the condition-specific waiting period is 12 consecutive months.
How to Claim for Discovery Medical Aid Benefits
👉 You can submit a claim fast and easily in the following ways:
- ➡️ Scan and upload your claims on the website.
- ➡️ Scan and email your claims to [email protected].
- ➡️ Use the Discovery app on your smartphone. If the claim has a QR code, scan the QR code or alternatively take a photo of the claim from within the app.
- ➡️ You can also submit your claims by post.
Discovery Medical Aid Contact Details
PO Box 784262,
Sandton,
2146
Phone: 0860 99 88 77
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4. Bonitas
Overview
👉 Bonitas is rated AA- on the international scale for financial stability. Its solvency ratio is 30.7%.
👉 Given that the median age of both Bonitas members and beneficiaries is under 30, the average size of annual contribution increases is naturally smaller.
👉 Bonitas offers a selection of affordable medical assistance plans that include hospitalisation, long-term care, and pharmaceuticals. When it comes to medical coverage, this company is ideal for both single workers and those with families.
👉 Even though Bonitas wasn’t the first medical aid in South Africa, it has quickly grown to become the largest. It was founded in 1982.
👉 The 4,500 medical professionals who make up the Bonita’s network are committed to providing their patients with excellent care at affordable prices.
👉 Bonitas offers oncology management and hospital and medicine management as separate solutions to its clients in an effort to combat the ever-increasing costs of healthcare.
👉 The Lasik eye surgery is just one of the dental and vision therapies covered by several Bonitas plans. Each participant’s unused balance accumulates interest for usage in the following year.
Bonitas Medical Aid Plans Suitable for SASSA Pensioners
👉 Bonitas offers excellent healthcare and medical aid plans suitable for SASSA pensioners.
Bonitas Edge Plans
👉 Bonitas, like other medical aid providers, provides a variety of coverage plans to choose from. Now retirees can choose the plan that works best for them, with the Edge plan starting at just R1378 per month. Specifically, a retiree should maximise the benefits of the following coverage options:
- ➡️ Hospitalisation benefits from a private hospital
- ➡️ No deposits to pay upfront.
- ➡️ Chronic medications are ones that your doctor may prescribe for you.
- ➡️ Payment for both therapy that is life-threatening (such as an accident, stroke, or heart attack) and treatment that is life-sustaining (such as for cancer or renal disease).
- ➡️ Care when injured
- ➡️ Consultations and diagnostic procedures such as MRI and CT scans.
- ➡️ Radiography and pathology within the hospital
- ➡️ Diagnostic scopes – gastroscopy, colonoscopy, sigmoidoscopy and proctoscopy
- ➡️ Procedures such as biopsies and operations on the eye, ear, nose, and throat.
How Much Are Bonitas Medical Aid Monthly Premiums?
👉 Bonitas monthly contributions start at
R 2 287 per month for a Principal Member, R 1 690 for a spouse/adult dependant and R 739 per child (max 3) on the BonEssential Hospital Plan and go up to R 9 853 for a main member, R 9 292 for additional adult, and R 2 006 for a child for the BonComprehensive plan that offers abundant savings, an above threshold benefit and extensive hospital cover.
What Is the Waiting Period for Bonitas Medical Aid Benefits?
👉 The minimum general waiting period for Bonitas medical aid is three months for all benefits. Some plans, however, have a waiting period of 12 months, especially regarding a pre-existing condition.
👉 Pregnancy is considered a pre-existing condition; therefore it is excluded from all benefits for the first 12 months of scheme membership.
How to Claim Benefits from Bonitas
👉 You can send in your claim in the following ways:
- ➡️ Email your claims to [email protected].
- ➡️ Post your claims to Bonitas Claims Department, PO Box 74, Vereeniging, 1930.
- ➡️ Submit your claims in person at one of the walk-in centres.
👉 Follow these simple steps to get your claims paid quickly:
- ➡️ Ensure your banking details are correct for refunds by electronic transfer (EFT) into your bank account
- ➡️ Make sure that your account and receipt show your name and initials, membership number, treatment date, the name of the patient as shown on your membership card, the amount charged and the ICD-10 code.
Bonitas Contact Details
34 Melrose Blvd, Birnam
Johannesburg
2196
Phone for General Queries: 0860002108
Email: [email protected]
Email: [email protected]
5. BestMed
Overview
👉 BestMed has a long history of offering members with exceptional value for money, comprehensive coverage, and wellness benefits for people of all ages.
👉 BestMed claims to be the largest open medical system in South Africa and the fourth largest in the world.
👉 The corporation brags about its annual raises being under 10% for the previous five years in a row and its 13 choice plans that take into account the financial status of retirees.
👉 Prevention of illness, including measures like a vaccination against communicable diseases like influenza and pneumonia, benefits greatly from all of its available alternatives.
👉 Access to more than 4,300 primary care physicians and specialists across South Africa is included.
👉 To aid the management team, the members of BestMed elect trustees to serve on various committees, and the board also appoints trustees to serve in various capacities.
BestMed Medical Aid Plans Suitable for SASSA Pensioners
👉 Pensioners can choose between BestMed Hospital Plans, Network Plans, Savings Plans, and Comprehensive Plans.
Hospital Plans
👉 Plan members of any age can use any hospital in the Hospital Plan’s network for both elective and emergency care.
Network Plans
👉 The BestMed Network Plans comprise Rhythm1 and Rhythm2 Network Plans, which provide either extensive discounts for visits to preferred healthcare providers or unlimited in-hospital coverage with either restricted critical day-to-day benefits or no benefits at all. The Rhythm 2 programme has income restrictions.
Savings Plans
👉 There are three different types of BestMed savings plans: Beat2, Beat3, and Beat3 Network.
👉 All provide substantial coverage for medical care in private facilities as well as a savings account to help with regular monthly bills.
👉 The hospitals and doctors who participate in the Network plans are predetermined.
Comprehensive Plans
👉 The various BestMed Comprehensive Plans are great possibilities for SASSA seniors and the elderly, provided that their budgets can accommodate the high monthly payments.
👉 Whether you choose the Beat4 Comprehensive Plan, the Pace1 Comprehensive Plan, the Pace2 Comprehensive Plan, the Pace3 Comprehensive Plan, or the Pace4 Comprehensive Plan, you’ll have access to excellent and comprehensive hospital benefits, including extensive day-to-day cover, chronic benefits, and a flexible spending account for medical expenses.
👉 Coverage details vary somewhat from one policy to the next.
How Much Are BestMed Medical Aid Monthly Premiums?
👉 At the time of writing, monthly premiums for the cheapest BestMed Beat1 Network Hospital Plan started at R1 873 for a member, with an additional R1 456 for an adult dependant and R789 for a child dependant, to a maximum of 3 child dependants. Additional children join at no additional cost.
👉 The most expensive plan at the time was the Pace4 Comprehensive Plan, with monthly contributions of R10 343 per member and R10 343 per adult dependant. For a child dependant, the extra contribution was R2 423, up to 3 child dependants with additional children added as beneficiaries of the scheme at no extra cost.
What Is the Waiting Period for BestMed Medical Aid’s Benefits?
👉 There can be a general waiting period of three months or a specific waiting period of 12 months for a certain condition.
👉 BestMed Medical Scheme will sometimes only pay a claim if it is a PMB. This can happen if you are in a waiting period or if you are getting treatment for a condition that your plan doesn’t cover.
How to Claim Benefits from BestMed Medical Aid
👉 If your healthcare provider does not submit claims to BestMed, one must submit the original claim directly to the fund administrators.
👉 You can claim by means of the BestMed App, or by scanning and emailing your claim to them.
👉 Details that should appear on all claim documents include:
- ➡️ Member’s name and contact details
- ➡️ BestMed membership number
- ➡️ Patient’s details
- ➡️ Service provider’s name, contact details and practice number
- ➡️ Details of treatment, including applicable tariff and ICD-10 codes
- ➡️ Whether payment should be done to the service provider or the member
👉 You will receive an email confirmation when your claim is received and indexed.
BestMed Medical Aid Contact Details
Head Office:
BestMed Medical Scheme,
Glenfield Office Park
361 Oberon Avenue
Faerie Glen
Pretoria
PO Box 2297
Pretoria
Emails: [email protected]; [email protected],
Phone: +27 (0)86 000 2378
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Frequently Asked Questions
Are there specialized medical aid schemes for SASSA pensioners?
Yes, there are specific medical aid schemes designed for SASSA pensioners that meet both their healthcare needs and financial constraints. Such plans provide benefits and premiums tailored to these pensioners’ individual circumstances.
What should SASSA pensioners consider when choosing a medical aid?
☑️ Medical aid for pensioners can be challenging to evaluate. Many find that their health risks rise while their disposable income declines.
☑️ That’s why it’s smart to consult a financial counsellor or a Medical Aid broker before making any major decisions. SASSA pensioners worried about how to pay for rising medical costs while living on a fixed grant, should know that there are solutions that can meet their needs.
☑️ Medical aid plans that cover routine doctor visits, prescription medication, dental and vision care are all important considerations.
Can SASSA pensioners receive financial assistance for medical aid premiums?
Yes, financial assistance towards medical aid is available by way of the Grant-in-Aid that assists them with medical bills, nutritious food and paying caregivers. To qualify for this grant you need full-time care since you are unable to do so on your own owing to a physical or mental disability. Evidence that you require round-the-clock care must be provided in the form of a verified medical report or assessment report (from a private doctor or state doctor).
What healthcare services are covered by medical aids for SASSA pensioners?
Medical aid coverage for SASSA pensioners typically extends to hospitalization, physician consultations, prescribed medications and specialist visits as well as certain medical procedures; the exact range may depend upon which plan they select.
Can SASSA pensioners switch to a different medical aid scheme?
Yes, SASSA pensioners do have the option of switching medical aid schemes should one better meet their needs. When making their decision it is essential to take into account factors like waiting periods, preexisting condition exclusions and application processes associated with switching.
