4 Best Medical Aid Co Payment Cover in South Africa
The 4 Best Medical Aid Co-Payment 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 co-payment cover in South Africa.
In this in-depth guide you’ll learn:
- What is Medical Aid Co-Payment Cover?
- Which hospital plans offer co-payment coverage in South Africa?
- How to choose the best affordable medical aid for your needs?
- How to compare medical aids and hospital plans against each other?
- What is the best way to sign up for medical aid for the first time?
- How do you choose the best medical aid for your family?
So if you’re ready to go “all in” with the best medical aid co-payment cover in South Africa, this guide is for you.
Let’s dive right in…
4 Best Medical Aid Co-Payment Cover Summary
- Discovery Health Medical Scheme – Overall, Best Medical Aid Co-Payment Cover
- Fedhealth Medical Scheme – Best Low-Cost Medical Coverage
- Momentum Health – Third-Largest Medical Insurance Provider
- Bonitas Medical Fund – Top Managed Care Programme
4 Best Medical Aid Co-Payment Cover in South Africa
👉 A co-payment is an additional form of medical insurance that covers the difference between the amount that a medical aid programme pays for a medical procedure and the actual cost of the procedure.
👉 It makes up the difference between what the patient’s medical aid contributes and what the patient is responsible for paying out of pocket, making it possible for the patient to more easily afford the care they require. Compare medical aid rates and benefits.
👉 There are a few different co-payment providers in South Africa who incorporate co-pay cover within the benefit packages of their products.
👉 The 4 best medical aids that provide co-payment coverage in South Africa are:
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1. Discovery Health Medical Scheme
👉 Coverage that is all-inclusive, including coverage for co-payments, is provided through the Discovery Health Medical Scheme. Depending on the level of cover that was selected, this protection allows members to submit claims for up to one hundred per cent of the cost of treatment and medication.
👉 The Comprehensive Plan and the Comprehensive Plus Plan are the two co-payment-based options that are available through the Discovery Health Medical Scheme. Both of these plans provide members with the option of making a co-payment, which can be used to assist in the payment of medical costs that are not covered by the scheme.
👉 The Comprehensive Plan is an all-inclusive insurance policy that takes care of the majority of a patient’s medical costs, such as hospitalisation, acute drugs, chronic medications, and specialised therapies. It also includes out-of-pocket fees and other types of payments, including out-of-pocket expenses and co-payments.
👉 The Comprehensive Plus Plan is an upgraded version of the Comprehensive Plan that provides more comprehensive coverage for a larger variety of medical expenses than the Comprehensive Plan does. This plan covers a higher daily charge for hospitalisation as well as a wider variety of medical services. It also includes out-of-pocket fees and other types of payments, including out-of-pocket expenses and co-payments.
Read more about Discovery Health Comprehensive Series
2. Fedhealth Medical Scheme
👉 Coverage that is comprehensive, including coverage for co-payments, is provided under the Fedhealth Medical Scheme. Depending on the level of coverage that was selected, this protection allows members to submit claims for up to one hundred per cent of the cost of treatment and medication.
👉 The Maxima Plus, Maxima Classic, and Maxima Standard are the three different co-payment plans that are available under the Fedhealth Medical Scheme.
👉 The Maxima Plus plan is the most all-inclusive of all the available options, providing complete coverage not just for hospital bills but also for day-to-day costs and co-payments. It also covers certain chronic diseases, in addition to providing unlimited consultations with general practitioners and unlimited consultations with specialists.
👉 Maxima Classic: This plan covers hospital fees, day-to-day expenses, and co-payment. In addition to that, it provides coverage for a selection of chronic diseases, as well as unlimited visits to your primary care physician and two visits to a specialist each year.
👉 This plan, known as Maxima Standard, provides coverage for co-payments in addition to hospitalisation costs and day-to-day expenses. Additionally, it covers certain chronic diseases and allows for unlimited visits to the primary care physician. However, it only offers one specialist consultation per year.
Read more about GAP cover
3. Momentum Health
👉 Comprehensive coverage is provided by Momentum Health, including coverage for co-payments. Depending on the level of coverage that was selected, this protection allows members to submit claims for up to one hundred per cent of the cost of treatment and medication.
👉 There are two different co-payment plans offered through Momentum Health:
👉 Coverage for co-payments is included in certain medical procedures that are covered under the Core Plan offered by Momentum Health. This covers trips to the doctor and stays in the hospital, in addition to certain medications that require a prescription. The co-payment will cover a portion of the total cost of the medical care; however, the policyholder will still be responsible for paying the remaining amount. The amount of the co-payment is based on the policyholder’s age, the kind of plan, and the level of coverage that they select. The coverage for co-payments that is offered by the Core Plan is intended to assist policyholders in lowering the total cost of their healthcare coverage.
👉 Momentum Health Core Plan Plus: This plan provides the same coverage as the Co-payment plan, but in addition to that, it also provides coverage for certain medical procedures and out-of-hospital cover for specialised treatments. In addition to this, it provides coverage for the gap in costs that exists between the rate paid for medical assistance and the rate charged by the healthcare provider.
READ more about the 5 Best Hospital Plans for Pregnancy Coverage in South Africa compared and revealed
4. Bonitas Medical Fund
👉 Bonitas Medical Fund: Bonitas Medical Fund offers comprehensive cover which includes co-payment cover. This cover allows members to claim up to 100% of the cost of treatment and medication, depending on the level of coverage chosen.
👉 Potential members have the following options: BonComplete, BonClassic and BonComprehensive. The latter is a first-class savings plan that offers ample savings, an above-threshold benefit and extensive hospital cover.
👉 Bonitas Medical Fund offers several co-payment plans, including the Bonitas Classic Co-payment and the Bonitas Comprehensive Co-payment.
👉 The Bonitas Classic Co-payment plan will cover up to one hundred per cent of the difference in cost that exists between the price that the medical practitioner charges and the tariff of benefits that the fund is obligated to pay. It will be paid out by the Savings account of the insured individual.
👉 Coverage of up to 200% of the difference between the medical practitioner’s fee that was charged and the Tariff of Benefits that was payable by the Fund is provided by the Bonitas Comprehensive Co-payment.
👉 It will pay up to a maximum of R344,200 per insured individual on an annual basis for cochlear implants. This plan also provides an extra Benefit that pays up to a maximum of R67,670 per insured person and per year for prostheses if it is not PMB.
Other providers of Co-payment in South Africa
👉 The entry-level Compact 300 plan offered by Stratum Benefits includes R20 000 worth of co-payment cover for each individual each year. Coverage increases to R198 660 with the Elite 500 options, and a non-network benefit of R15 000 is included in the plan.
👉 The Compact 300 plan is a low-cost health insurance plan meant to provide coverage for necessary medical treatments. The plan provides coverage for a comprehensive set of medical services, such as visits to the doctor, hospitalisation, emergency treatment, prescription medicines, and preventative care. In addition, the plan provides coverage for services related to mental health and substance misuse, as well as coverage for eye and dental care.
👉 Individuals and families are able to stay within their financial means thanks to the plan’s reasonable co-insurance and deductible amounts. Additionally, you will have access to a countrywide network of participating doctors through this plan, allowing you to receive medical attention in whichever location is most convenient for you.
👉 Co-paymentage can be purchased separately or bundled in with the plan for an additional charge.
👉 There are four different alternatives for co-payment provided by Sirago. These options provide limited co-payment benefits ranging from R10 000 to R20 000 for each claim.
👉 When clients receive medical treatment, Sirago helps them avoid having to pay for it by providing co-payment. Coverage is available for a variety of medical services and expenses, including hospitalisation, day-to-day costs, long-term medication, and others. In addition to this, it offers top-up benefits to medical aid members who are interested in receiving additional benefits.
👉 Liberty Health offers full coverage for any and all co-payments associated with hospital admissions, scans, and some treatments for customers who select either the Essential or the Universal co-payment option. You are only permitted to make one claim per year for a non-DSP benefit totalling R12 400 if you have the Universal plan.
👉 The Essential and Universal co-payment alternatives that are offered by Liberty Health are intended to assist in covering the gap that exists between the medical scheme tariffs and the medical costs that are charged by providers.
👉 The deficit is covered up to 200% of the medical scheme cost by the Essential option, while the Universal option covers the gap up to 300% of the medical scheme rate. Both choices have an annual maximum limit of R212 500 per family, and both can be upgraded to provide coverage equal to 500% of the standard medical scheme premium for an additional cost.
👉 They also provide a selection of additional advantages, such as cashback advantages, advantages for extended hospital stays, advantages for emergency situations, and advantages for cancer patients.
Frequently Asked Questions
How much does medical co-payment cover cost?
Depending on the provider and the type of coverage chosen, co-payment prices change. The cost of co-payments can vary from R150 to R500 per month, with the precise amount depending on the level of coverage chosen. You should browse around to find the most reasonable alternative because some insurance companies offer discounts to consumers who buy many policies from them.
How does co-payment cover differ from other types of insurance?
Depending on the provider and the type of coverage chosen, co-payment prices change. The cost of co-payments can vary from R150 to R500 per month, with the precise amount depending on the level of coverage chosen. You should browse around to find the most reasonable alternative because some insurance companies offer discounts to consumers who buy many policies from them.
What are the benefits of having medical co payment cover?
Co payment cover or Gap cover as it is also known assists in covering the additional expenses incurred after receiving medical treatment. It can assist you in avoiding out-of-pocket expenses so you can focus on getting healthier. If you find yourself suddenly needing hospitalization, it can spare you the stress of having to worry about money.
How can I find out if my medical aid offer co-payment cover?
If there is no information on your medical assistance provider’s website, you can call them to ask about co-payment coverage.
Can I purchase co-payment cover separately if my medical aid does not provide it?
If your medical assistance does not offer co-payment insurance, you can buy it from a different company. Be aware that co-payment choices supplied by medical aid providers generally offer more possibilities than those offered by third-party providers.
What types of co-payment cover are available?
Co-payment options may also cover extra costs like dental and vision treatment. Co-payment options should cover the gap between medical assistance rates and the rates charged by medical providers.
