5 Best Medical Insurance for Kids in South Africa
The 5 Best Medical Insurance for Kids 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 insurance for kids in South Africa.
In this in-depth guide you’ll learn:
- What is Medical Insurance for Children?
- How do you find affordable medical insurance for your family in South Africa?
- How to choose the best affordable medical insurance for age of your kids?
- How to compare medical insurance against each other?
- How to sign up with your ideal medical insurance?
- How do you choose the best medical insurance for your family?
So if you’re ready to go “all in” with the best medical insurance for kids, this guide is for you.
Let’s dive right in…
Best Medical Insurance for Kids (2024)
| 🩺 Medical Aid | ✔️ Offers Medical Insurance for Kids? | ⚕️ Plan Offered | 👉 Sign Up |
| 1. Momentum Medical Aid | Yes | Ingwe Student Option | 👉 Apply Now |
| 2. Affinity Health | Yes | Hospital Plans | 👉 Apply Now |
| 3. Discovery Health | Yes | Discovery KeyCare Plan | 👉 Apply Now |
| 4. Bonitas | Yes | Boncap Student | 👉 Apply Now |
| 5. MediHelp | Yes | Savings Plans | 👉 Apply Now |
5 Best Medical Insurance for Kids (2024)
- Momentum – Overall, Best Medical Aid Under R1000 in South Africa
- Affinity Health – Best Pay-As-You-Go Private Healthcare
- Discovery Health – Top Extensive Medical Protection in South Africa
- Bonitas – Broadest Range of Low-Cost Medical Aid Plans
- Medihelp – Best Customer Service Medical Aid
About medical insurance for kids in South Africa
👉 There’s no question in my mind that you want nothing but the best for your kid. One aspect of this is making sure their health needs are met.
👉 A wide variety of healthcare options are available to you in South Africa. Many companies provide medical insurance for their workers and their families, but knowing which plan is best for your child can be challenging.
👉 Whether you are a single parent seeking coverage or a family with children of varied ages, this article will help you navigate the several plans that offer high-quality medical assistance for children.
👉 Due to the high expense of living in South Africa, many parents enquire if their children can qualify for medical insurance.
👉 With a few notable exceptions, children under the age of 18 in South Africa cannot be the primary members to medical insurance at this time. Anyone can apply for their own health insurance after they turn 18.
👉 A medical insurance plan may allow a dependent child to become the sole member upon the death of the primary member. Yet, the monthly cost is rarely reduced in this way.
Learn more about Medical Aid Plans
Choosing medical insurance for your kids
👉 The following should be taken into consideration when shopping around for medical insurance for your kids.
Consider extending the coverage of your current medical insurance
👉 If your existing medical insurance is insufficient to handle escalating expenses, as it may be if your child has developed a chronic illness, upgrading to a more thorough plan will cover the expense of prescription medications, longer hospital stays, and prolonged treatment and care.
👉 Please be aware that there is typically a waiting period before benefits kick in on medical insurance programmes, and that eligibility limitations apply to most of them.
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Find a medical insurance plan with child benefits
👉 The health of your family and your child, as well as your current financial status, are just a few of the aspects that should go into determining your immediate medical requirements.
👉 There are many different medical insurance plans, perks, and contributions to choose from. Comparing these options will help you find the best one for your family’s needs and budget.
👉 The best medical coverage would include not only coverage for unexpected hospitalisation but also for preventative services like primary care physician and paediatrician visits, over-the-counter medications, and even certain dental and optical work.
👉 In South Africa, minors under the age of 18 cannot join a medical insurance plan on their own but can join as dependents of an adult member.
👉 A child’s membership often terminates when a parent or legal guardian dies, unless there are sufficient monies in the estate to keep it going.
👉 Before including a newborn or young kid in your medical insurance plan, there are a few things you need to have in place.
👉 You want to make sure that your family is covered for any medical needs that may arise, including emergencies, with access to hospital treatment around the clock, routine care like paediatrician visits and medications, and preventative care like regular dental and vision exams.
👉 The best value can be obtained without compromising quality if one focuses on cost savings.
👉 If you tell your medical insurance broker about your family’s specific needs, they should be able to recommend the right coverage and benefits for you. Compare medical insurance quotes from different companies to find the cheapest price.
READ more about 5 Best Hospital Plans for Kids / Children in South Africa
5 of the Best Known Medical Insurance in South Africa For Kids
👉 There are a variety of leading medical insurance plans that offer comprehensive plans suited to families with children. We explore these options in more detail below.
1. Momentum
Overview
👉 Momentum Medical Scheme is one of the top three open medical schemes in South Africa, and it is run by one of the country’s largest and most reputable healthcare service providers.
👉 Momentum Health’s first priority is guaranteeing the scheme’s continued viability while also exceeding the expectations of its participants.
👉 If you sign up with Momentum Health Solutions, you’ll gain access to a group of medical professionals who work together to offer affordable, high-quality care.
👉 To better serve its members, Momentum has worked with many medical networks that offer financial incentives to their doctors in exchange for referrals.
👉 By the use of Momentum’s actuarial services, wellness incentives and reward programmes can be designed and priced to motivate members to improve their health.
👉 By grouping members into “care cohorts,” a revolutionary health coaching approach developed by Momentum enables the company to offer individualised assistance through its advocacy programmes, empowering individuals to make more educated healthcare decisions while reducing overall expenses.
Momentum Medical Insurance for Kids
👉 Six different health insurance plans are available from Momentum, with monthly premiums ranging from just under R500 to well over $10,000.
👉 You can have limitless coverage for a private hospital visits for children, which includes everything from expert consultations to rehabilitation to emergency caesarean sections, at the bottom of the price range.
👉 All the standard medical services, including doctor’s visits, prescriptions, and air ambulance transports, are available, as are services for people with chronic or life-threatening illnesses.
👉 All chronic diseases, as well as vision and dental care, are included in the premium plan’s lifetime coverage, and there is no annual maximum for hospitalisations.
👉 Incredibly, with Momentum health insurance, you can get free medical advice whenever you need it, 24/7. Furthermore, they have an incentive scheme where you can earn up to R3,000 per month in bonuses. You can easily compare their prices and features online.
How Much Are Momentum Health Monthly Premiums?
👉 Momentum monthly premiums start at R1 539 for the main member on the Evolve Option and go up to R12 345 for the main member on the Summit Option.
What Is the Waiting Period for Momentum Health’s 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 (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. Affinity Health
Overview
👉 Since its founding in 2011, Affinity Health has worked towards its stated goal of providing all South Africans with access to quality, private healthcare at a price they can afford. Since its inception, Affinity Health’s primary mission has been to offer long-term medical coverage to its members.
👉 Affinity Health’s ground-breaking work in the health insurance sector is the result of the company’s unparalleled expertise, dedication, and talent.
👉 One may argue that all citizens of South Africa should have access to at least some form of private health insurance. Affinity Health is working to broaden access to private medical aid options in South Africa. This will allow more people to afford the country’s world-class medical care.
👉 Affinity Health’s extensive partner network allows them to provide its market with a formidable team of specialists.
👉 Affinity Health is investing heavily in its staff and state-of-the-art technology to speed up product development and ensure the timely delivery of innovative goods to market.
Affinity Medical Insurance for Kids
👉 In South Africa, Affinity Health is among the very few providers who focus on providing health insurance for children only. You can choose to cover solely your children under the Affinity Junior option, whether you’re interested in a day-to-day, hospital, or mixed policy.
👉 If your primary care physician refers you for imaging or testing, the Junior Day-to-Day plan pays for all of it. Moreover, standard dental and optical care is provided. The initial payment is about R600 a month, and it goes up by about R300 for each additional child.
👉 Costing about R900 per month for the first child and an additional R300 for each additional child, the Junior Hospital plan is a worthwhile investment for parents.
👉 In addition to covering the expense of your hospital stay, this plan also pays for any necessary medical procedures you may need.
👉 Costing R1,400 per month for the first child and R500 per month for each additional child, the Junior Combination plan covers daily expenses as well as hospitalisation.
How Much Are Affinity Health’s Monthly Premiums?
👉 Affinity Health offers a comprehensive hospital plan from R1170.00 per month. The Day-to-Day Plan is available from R759.00 per month. The Combined Plan is available from R1 728.00 per month.
What Is the Waiting Period for Affinity Health Benefits?
👉 Depending on the medical aid scheme you join, the average waiting period for Affinity Health benefits is three months. Pre-existing conditions have a 12-month waiting period.
How to Claim Benefits from Affinity Health
➡️ General practitioner visits also need pre-authorisation. In the event of visiting a doctor who may not be on the Affinity Health network, you will need to pay the full consultation fee upfront. You can then claim up to R250.00 back from Affinity Health.
➡️ For assistance with reimbursement, please email the detailed account and a signed Affinity Health reimbursement form to [email protected].
➡️ Network doctors can claim directly from Affinity Health. The practice may charge additional administration fees, which cannot be recovered from Affinity Health. These will be for the member’s account.
➡️ Procedures conducted in the rooms of Affinity Health network doctors are also covered, provided you have obtained pre-authorisation.
➡️ If you need to consult a specialist, you will have to get a referral letter from your GP, for the consultation to be eligible for cover by Affinity Health. Once you have your referral letter, you will need to call to get pre-authorisation before the actual consultation.
➡️ With hospital cover, the insurer will pay a set portion of the cost. The patient is still fully liable for the bill and will need to claim from the insurance to pay the hospital.
➡️ As always, pre-authorisation is required before going into the hospital. Affinity Health has a 24-hour hospital pre-authorisation line.
Affinity Health Contact Details
1 Dingler Street, Rynfield, Benoni 1501
Call Centre: 0861 11 00 33
WhatsApp: 079 479 3230
Email: [email protected]
3. Discovery Health
Overview
👉 Discovering Medical Health is a non-profit organisation regulated by the Commission for Medical Schemes in accordance with the Medical Schemes Act 131 of 1998, as modified (CMS). According to the terms of the Scheme, it is an open medical system that is available to anyone.
👉 Members own the Scheme and an impartial Board of Trustees manages its day-to-day business (the Trustees or the Board). The Scheme has contracted with Discovery Health (Pty) Ltd. to handle its administrative and managed care duties.
👉 The Scheme places a high priority on value-based healthcare. Their method, which centres on the needs of their members, compensates doctors for positive health outcomes rather than for the number of procedures they perform.
👉 Members can take advantage of services and resources that are committed to improving their experience at all times.
👉 Discovery Health is committed to providing our members with access to the best possible healthcare in South Africa by implementing a number of quality-of-care programmes and innovations, all of which are subject to regular assessment by the Scheme.
👉 If you’re a member of the Scheme, you’ll have access to material tailored specifically to your needs.
Discovery Medical Insurance for Kids
👉 Discovery has 23 options to choose from, which is a large number (the website claims it has the most plans on the market). Don’t be intimidated: packages are extremely customised. You’re likely to find what you’re looking for here.
👉 All plans include unlimited hospital coverage for you and your child dependents. They also aid with the management of chronic diseases, while some plans cover a broader variety of ailments than others.
👉 Then there are plans that include screening and prevention, plans that allow you to add extra daily coverage or optometrist and dentistry charges, travel plans, and plans designed specifically for maternity and early childcare. Costs range from less than R1000 to more than R7000
👉 You can enjoy a savings plan on select accounts, and any unused cash can be spent on everyday needs. Discovery also sells a reasonably priced gap cover.
How Much Are Discovery Medical Aid Monthly Premiums?
👉 Monthly premiums start from R1102 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 goes 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
4. Bonitas
Overview
👉 Hospitalization, long-term care and pharmaceutical coverage are just some of the many low-cost medical aid programmes offered by Bonitas. In terms of health coverage, this company is ideal for both single workers and those with families.
👉 With its quick expansion since its inception in 1982, Bonitas has become the leading health insurer in South Africa.
👉 The 4,500 medical professionals who make up Bonita’s network are committed to providing their patients with excellent care at fixed prices.
👉 Customers can choose between Bonitas’ oncology management system or its hospital and medicine management solution to combat the ever-increasing cost of healthcare.
👉 Several Bonitas plans include coverage for Lasik eye surgery in addition to dental and vision care. Each participant’s unused balance accumulates interest for usage in the following year.
Bonitas Medical Insurance for Kids
👉 According to their website, Bonitas has “South Africa’s largest GP and specialist network.” There are thirteen distinct packages available to them.
👉 Prices start at just over R1000 and go up to well over R7000. For infants and toddlers, free medical advice is available 24/7 through a “baby guidance line” that is included in nearly all plans. There are four distinct categories of Bonitas plans.
👉 You can minimise your out-of-pocket costs for things like hospital stays, doctor’s appointments, glasses, and dental work under the Conventional tier.
👉 Paramedical treatment, medication, hearing aids, blood tests, x-rays, contraception, maternity care, newborn care, chronic care, and preventative care may all be included in your plan’s coverage, but it all depends on the specifics of your situation.
👉 Like their other plans, their Savings plan allows you to set aside a certain amount each month and use it for non-medical costs. The most expensive health insurance in this bracket might pay for things like artificial limbs, inpatient mental health care, hospice care, and medical treatment for terminal diseases like cancer and HIV.
👉 Choose a plan from the Hospital category, and you’ll be responsible for your regular out-of-pocket costs, but you’ll be covered if you wind up in the hospital.
👉 The most expensive option here provides coverage for all of a hospital’s services, from paediatric care to end-of-life care to rehabilitation to organ transplants and cancer treatment.
👉 Bonitas Medical Scheme has the following plans to choose from:
- Bonitas Standard Medical Aid Plan
- Bonitas Primary Select Medical Aid Plan
- Bonitas Hospital Standard Medical Aid Plan
- Bonitas Standard Select Medical Aid Plan
- Bonitas BonStart Plus Medical Aid Plan
- Bonitas BonStart Medical Aid Plan
- Bonitas BonSave Medical Aid Plan
- Bonitas BonFit Select Medical Aid Plan
- Bonitas BonEssential Select Medical Aid Plan
- Bonitas BonEssential Medical Aid Plan
- Bonitas BonComprehensive Medical Aid Plan
- Bonitas BonComplete Medical Aid Plan
- Bonitas BonClassic Medical Aid Plan
- Bonitas BonCap Medical Aid Plan
How Much Are Bonitas Medical Aid Monthly Premiums?
👉 Bonitas monthly contributions start at R 2 033 for a Principal Member, R 1 555 for a spouse/adult dependant and R 596 per child (max 3) on the BonEssential Hospital Plan and go up to R 8 217 for a main member, R7 749 for additional adult, and R 1 672 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.
How to Claim Breast Reduction 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 ICD-10 code.
Bonitas Contact Details
34 Melrose Blvd, Birnam
Johannesburg
2196
Phone for General Queries: 0860002108
Email: [email protected]
Email: [email protected]
5. Medihelp
Overview
👉 As a self-administered medical insurance, Medihelp’s primary goal is to serve its members by satisfying their healthcare requirements.
👉 Whether you’re a student, a new employee looking to join medical insurance for the first time, the owner of a business in need of a solid healthcare plan for your staff, or the head of a family with expanding medical requirements, Medihelp is here to serve you.
Medihelp Insurance for Kids
👉 There are just four different options available through Medihelp. Plans range in price depending on specifics, but all begin at ridiculously low thresholds.
👉 The website’s design and functionality are both straightforward. Decisions can be made quickly and easily after a quick review of the options available.
👉 Its most basic plan, the student plan, costs less than R600 a month and provides coverage for routine medical needs, long-term medical conditions, and hospitalisation. Screenings and prenatal care are examples of optional extras that can be purchased for a price.
👉 General practitioner and specialist visits, dentist and optometry care, hospital costs, and maternity and newborn care are all part of the all-inclusive package that starts at less than R3000 per month.
👉 There is a savings plan where money from your savings account is used to cover regular expenses and a hospital plan that covers some of your regular expenses in addition to your hospital bills.
👉 Medihelp is a great, no-cost resource for helping people maintain healthy lifestyles. Here you can look over your health records, sign up for no-cost activities, lose weight, and even take part in a special programme designed for expectant and new parents.
How Much Are Medihelp Medical Scheme’s Monthly Premiums?
👉 Medihelp monthly premiums range from R756.00 pm for the student hospital plan, R1 254.00 pm for the Vital Plan, R2 310.00 pm for the Savings plans, and R2 394.00 pm for Comprehensive plans.
👉 Medihelp Medical Scheme has the following plans to choose from:
- MediHelp Medprime
- MediHelp MedPrime Elect
- MediHelp MedPlus
- MediHelp MedElite
- MediHelp MedVital
- MediHelp MedVital Elect
- MediHelp MedSaver
- MediHelp MedMove
- MediHelp MedElect
- MediHelpMedAdd
- MediHelp MedAdd Elect
What Is the Waiting Period for Medihelp Benefits?
👉 Depending on the medical aid scheme you join, the average waiting period for NetCare benefits is three months. Pre-existing conditions have a 12-month waiting period.
How to Claim for Benefits from Medihelp Medical Scheme
👉 Members can submit claims using one of the following:
👉 Doctors and healthcare practitioners usually submit claims for their services directly to Medihelp on your behalf, but some healthcare practitioners require you to pay their accounts first and then claim a refund from Medihelp.
👉 To ensure that your claim is valid according to the Medical Schemes Act and Medi help’s Rules, please ensure that the following details appear on the printed account:
➡️ Your membership number and correct dependant code (e.g. “01” for the principal member)
➡️ The member’s name and surname
➡️ The name, surname and date of birth of the patient
➡️ Medihelp Medical Scheme – not “Private” (this has tax implications)
➡️ The healthcare practitioner’s name and practice number
➡️ Your proof of payment (attached)
➡️ The amount you have paid
➡️ The amount charged per item
➡️ The relevant codes such as ICD-10, NAPPI and item codes
➡️ The date on which the service/procedure was rendered/performed
Medihelp Medical Scheme Contact Details
086 0100 678
Frequently Asked Questions
Can I get medical insurance for a child?
Child health insurance is generally available for children aged up to 18 or potentially 24 if in full-time education.
How to choose medical insurance for my child?
The health of your family and your child, as well as your current financial status, are just a few of the aspects that should go into determining your immediate medical requirements.
There are many different medical insurance plans, perks, and contributions to choose from. Comparing these options will help you find the best one for your family’s needs and budget.
Can I buy medical insurance for just my child?
With a few notable exceptions, children under the age of 18 in South Africa cannot be the primary members to a medical insurance at this time. Anyone can apply for their own health insurance after they turn 18.
Will my child be covered immediately if I buy medical insurance?
Please be aware that there is typically a waiting period before benefits kick in on medical insurance programmes, and that eligibility limitations apply to most of them.
What should I look for in medical insurance for my kid?
There are many different medical insurance plans, perks, and contributions to choose from. Comparing these options will help you find the best one for your family’s needs and budget.
The best medical coverage would include not only coverage for unexpected hospitalisation but also for preventative services like primary care physician and paediatrician visits, over-the-counter medications, and even certain dental and optical work.
