5 Best Medical Aids for Chronic Illness Cover
The 5 Best Medical Aids for Chronic Illness Cover 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 chronic illness cover in South Africa.
In this in-depth guide you’ll learn:
- ✅ What is a Medical Aid?
- ✅ What is chronic illness cover?
- ✅ Why do you need chronic illness coverage?
- ✅ What is a formulary list?
- ✅ When do you qualify for chronic illness cover?
- ✅ When is a disease classified as chronic?
So if you’re ready to go “all in” with the best medical aid for chronic illness cover in South Africa, this guide is for you.
Let’s dive right in…
Best Medical Aids for Chronic Illness Cover (2024)
| 🩺 Medical Aid | ✔️ Offers Plans that Covers Chronic Illness? | ⚕️ Plan Offered | 👉 Sign Up |
| 1. Discovery Health | Yes | Discovery KeyCare Plan | 👉 Apply Now |
| 2. Keyhealth Medical Aid | Yes | Platinum Option | 👉 Apply Now |
| 3. Medshield | Yes | Premium Plus Option | 👉 Apply Now |
| 4. BestMed | Yes | Network Plans | 👉 Apply Now |
| 5. FedHealth | Yes | flexiFED Savvy | 👉 Apply Now |
5 Best Medical Aids for Chronic Illness Cover Summary
- Discovery Medical Scheme – Overall, Best Medical Aid for Chronic Illness Cover
- Keyhealth Medical Scheme – Top Extensive Medical Protection in South Africa
- Medshield Medical Scheme – Broadest Range of Low-Cost Medical Aid Plans
- BestMed Medical Scheme – Best Pay-As-You-Go Private Healthcare
- Fedhealth Medical Scheme – Best Customer Service Medical Aid
What Is a Chronic Condition
👆🏾 Chronic diseases are illnesses that last for at least a year and need ongoing medical care or make it hard to do everyday things or both. Chronic diseases like heart disease, cancer, and diabetes are often the main causes of death and injury. They are also the main reasons why countries spend large amounts on health care.
👆🏾 There is a short list of risky behaviours that can cause many long-term diseases, such as tobacco use and being around people who smoke, diets that do not have enough fruits and veggies and are high in salt and saturated fats, a lack of exercise and excessive alcohol use.
👆🏾 A chronic condition (also known as chronic disease or chronic illness) is persistent or otherwise long-lasting in its effects. The term “chronic” is often applied when the course of the disease lasts for more than three months.
👆🏾 Common chronic diseases include diabetes, functional gastrointestinal disorder, eczema, arthritis, asthma, cancer, chronic obstructive pulmonary disease, Lyme disease, autoimmune diseases, genetic disorders and some viral diseases such as hepatitis C and acquired immunodeficiency syndrome.
📌READ more about the Best Health Insurance for Critical Illness.
👆🏾 Chronic diseases can go into remission or return, which means the illness goes away for a while and then comes back. Chronic illnesses are often linked to non-communicable diseases, which are different from infectious diseases because they do not spread from person to person. Some long-term conditions, like HIV/AIDS, are caused by diseases that can be passed on.
👆🏾 People often use the term “chronic condition” to describe syndromes, physical problems, injuries, and diseases that last for a long time. Epidemiologists are interested in chronic diseases because they can lead to illness, paralysis, and less physical and/or mental ability.
👆🏾 If you suffer from any chronic condition, it is important to choose a medical aid plan that covers treatment for that condition.
👆🏾 Here is a list of 5 best medical aids that cover chronic illnesses:
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1. Discovery Medical Scheme
Overview
☑️ The Discovery Health Medical Scheme offers more than 20 different health plan options, all of which are suitable for young adults because they include limitless private hospital coverage and a range of perks to suit everybody’s requirements and financial situation.
☑️ The plans give access to a variety of advantages, care plans, and services that guarantee any young adult will receive the best medical care when they need it.
☑️ Discovery option plans range from the most comprehensive but expensive private healthcare cover to basic and more affordable plans where you get cost-effective private healthcare cover through an extensive network of providers.
Comprehensive Series
📣 The Comprehensive series of plans provide comprehensive cover for in-hospital and day-to-day cover with extended chronic medicine cover and unlimited Above Threshold Benefit. With its fairly high premiums, only young adults already established in a secure job may consider this.
Priority Series
📣 The Priority Series of plans offer cost-effective in-hospital cover, essential chronic medicine cover and day-to-day benefits with a limited Above Threshold Benefit, which is ideal for young professionals.
Saver Series
📣 The Saver series is economical, provides in-hospital cover, essential chronic medicine cover and day-to-day benefits through a Medical Savings Account. Its premiums are reasonable, therefore many young adults become members.
Core Series
📣 The Core Series is a value-for-money series of hospital plans that provide unlimited private hospital cover and essential cover for chronic medicine to young adults who do not have a big income. The benefits do not include any day-to-day cover.
Smart Series
📣 The Smart series of plans provide the most cost-effective in-hospital cover, essential chronic medicine cover plus limited day-to-day cover for young adults if they use providers in a specified network.
2. KeyHealth Medical Scheme
☑️ Keyhealth provides a choice of 6 plan options of which several includes proper chronic illness cover. The Gold option is the most popular option due to its preventative care and chronic benefits. Other options are:
Platinum
📣 Platinum is for people who need a lot of medical coverage. It covers hospital stays for as long as you need through a network of hospitals and pays 100% of expert bills while you are in the hospital.
📣 A risk benefit pays out claims on a daily basis. After that, there is a self-payment gap, and then claims are paid from the income above the cutoff. The Health Booster can be used to pay for preventive care and childbirth benefits.
Silver
📣 The Silver choice is good for single people and young families. It covers hospital stays for as long as you need through a network of hospitals and pays 100% of expert bills while you are in the hospital.
📣 This choice has a short list of things that do not work in hospitals. Daily claims are made out of a set benefit pool, and dental claims have their own benefit. The Health Booster can be used to pay for preventive care and childbirth benefits.
Equilibrium
📣 Equilibrium is good for both single people and young families. It covers hospital stays for as long as you need through a network of hospitals and pays 100% of expert bills while you are in the hospital. This choice has a short list of things that do not work in hospitals.
📣 Claims are paid out every day with money from funds and a “defined benefit pool.” Basic dentistry and advanced radiology each have their own advantage. The Health Booster can be used to pay for preventive care and childbirth benefits.
Essence
📣 Essence is a treatment plan for people who are young and in good health. It gives you unlimited hospital coverage at a network of hospitals, and 100% of your expert bills while you are in the hospital are paid for.
📣 This choice does not cover a short list of things that cannot be done in the hospital, such as in-hospital surgery. Joint transplants are only covered in cases of severe damage (Prescribed Minimum Benefits only). This hospital plan also covers expert imaging, some kinds of preventive care, and maternity care.
Origin
📣 Origin is good for young families and single people. It covers hospital stays for as long as you need through a network of hospitals and pays 100% of expert bills while you are in the hospital.
📣 This choice has a long list of things that are not covered while in the hospital. A defined benefit pool pays out claims on a daily basis. The Health Booster can be used to pay for preventive care and childbirth benefits.
3. Medshield Medical Scheme 
☑️ Medshield lets you choose from 10 different plans and coverages.
☑️ Oxygen Medical Aid and Medshield are now one company. About 110,000 people belong to them. Since 1968, Medshield has been around, making it one of the most experienced and reliable health insurance plans in South Africa.
☑️ These medical aid plans are considered to be the best in South Africa. They have the best scores for medical care in the country and the longest track record. So you can be sure that if you use any of these medical help plans, you will get the best customer service, peace of mind, and payouts for chronic medication and treatment.
The plans are:
Premium Plus
📣 Premium Plus is good for couples and single people who need a lot of medical coverage. It covers hospital stays at any hospital of your choice and pays 200% of expert bills while you are in the hospital. The savings are used to pay for day-to-day expenses. After that, there is a self-payment gap, and then some claims are paid from the income above the cut-off.
MediBonus
📣 MediBonus is good for people who need a lot of medical coverage. It covers hospital stays at any hospital of your choice and pays 200% of expert bills while you are in the hospital. Co-payments are required for a long list of treatments, and only a few of them can be done in the hospital. Every day claims are made out of a pool of money called a “defined benefit pool.” There are also extra benefits for basic and specialised dentists, specialised radiology, and optometry.
MediPlus Prime and MediPlus Compact
📣 MediPlus has two options namely MediPlus Prime and Mediplus Compact. MediPlus is good for single people and young families. It gives you unlimited hospital coverage at a network of hospitals, and 100% of your expert bills while you are in the hospital are paid for.
📣 Co-payments are required for a long list of treatments, and only a few of them can be done in the hospital. Daily claims are made out of a set benefit pool, and there are also extra benefits for basic and specialised dentistry, specialised imaging, trips to specialists, and optometry.
MediSaver
📣 MediSaver is good for people and families who are young and healthy. It gives you unlimited hospital coverage at a network of hospitals, and 100% of your expert bills while you are in the hospital are paid for.
📣 There is a long list of medical treatments that have co-payments, and a short list of things that do not have co-payments. The savings are used to pay for day-to-day expenses.
MediValue Prime & MediValue Compact
📣 MediValue has two options namely MediValue Prime and MediValue Compact. This option is good for people and families who are young and healthy. It gives you unlimited hospital coverage at a network of hospitals, and 100% of your expert bills while you are in the hospital are paid for.
📣 There is a long list of medical treatments that have co-payments, and a short list of things that do not have co-payments. Day-to-day claims are paid out of set day-to-day amounts, and optometry, basic dentistry, speciality radiology, and specialist visits each have their own benefit.
4. BestMed Medical Scheme
☑️ BestMed is the largest self-administered medical plan in South Africa, as well as the fourth-largest open medical plan overall.
☑️ BestMed has a track record of giving members access to a network of healthcare experts, wellness benefits, and cost-effective healthcare coverage choices.
☑️ All of its choices offer young people important preventive health care benefits, like treatment for asthma, flu shots, and chronic conditions.
☑️ With this medical aid, people in South Africa can get help and support from more than 4,300 primary care doctors and networks of hospitals and experts.
☑️ There are BestMed Hospital Plans, Network Plans, Savings Plans, and Comprehensive Plans from which to choose.
Savings Plans
📣 BestMed Savings Plans are a good option, since they include extensive hospital cover at private hospitals and a savings account out of which general day-to-day expenses are paid.
📣 The following options are available:
- Beat2 Savings Plan
- Beat2 Network Savings Plan
- Beat3 Savings Plan
- Beat3 Network Savings Plan
📣 The Network Savings plans are associated with certain Network hospitals and providers.
Comprehensive Plans
📣 BestMed Comprehensive Plans are the most expensive in terms of monthly premiums but offers extensive chronic cover.
📣 Those who can afford it, may choose from the following:
- Pace1 Comprehensive Plan
- Beat4 Comprehensive Plan
- Pace2 Comprehensive Plan
- Pace3 Comprehensive Plan
- Pace4 Comprehensive Plan
5. Fedhealth Medical Scheme
☑️ Fedhealth is known for its unique benefits paid by Risk, which help members get more out of their regular benefits.
☑️ The company is still run by members for members, and they are always coming up with new ways to help people take care of their health in a world that is always changing.
☑️ Older people can choose from a variety of options, including coverage if they never had medical aid before.
☑️ The choice will depend on their health situation, available budget and how they prefer to manage their medical expenses.
☑️ Fedhealth Medical Scheme Option Plans that provide chronic cover are:
maxima EXEC
📣 Although expensive, the maxima EXEC offers comprehensive all-round cover. Apart from in-hospital, chronic medicine, screening and additional benefits, it has a day-to-day savings portion and Threshold benefit.
maxima PLUS
📣 The maxima PLUS option is the ideal choice because it offers extensive medical cover for every aspect of your healthcare, like generous in-hospital cover, chronic medicine, screening and additional benefits, a day-to-day savings portion, a Threshold benefit, and an optional hospital expense benefit.
📣 This option is quite expensive though and can only be considered by those who have a considerable income to spend on medical aid.
📌 Compare medical aid quotes that cover chronic illness.
Frequently Asked Questions
What is chronic illness cover?
Chronic illness cover refers to a type of cover by a medical aid that provides financial protection for long-term or recurring medical issues.
What conditions are typically covered under chronic illness cover?
Illnesses such as diabetes, asthma, heart disease, cancer, and other long-term health issues are typically covered by chronic illness cover.
How does chronic illness cover work?
Chronic illness cover works by paying for medical expenses associated with the treatment and management of chronic diseases, such as doctor visits, medication, hospital stays, and specialized treatments.
Is chronic illness cover different from regular health insurance?
Yes, chronic disease coverage is a subset of health cover that focuses solely on the costs associated with chronic medical disorders, whereas standard health cover, covers a larger variety of healthcare needs.
Can anyone get chronic illness cover?
The eligibility for chronic illness coverage varies based on the insurance provider and policy. Individuals with pre-existing chronic illnesses or a family history of such illnesses may be eligible for chronic illness coverage.
