Best Medical Insurance Under R1500
Whether you’re looking for comprehensive health coverage, essential benefits, or a plan that fits a tight budget, this guide aims to equip you with all the information you need to make an informed decision. In this guide you will learn:
- ✅ The difference between medical aid and medical insurance
- ✅ When medical insurance is a better option
- ✅ The 5 best medical insurance under R1500
- ✅ Frequently Asked Questions
Let’s dive into the world of affordable medical / health insurance and find the plan that best suits your lifestyle and health care needs.
The difference between medical aid and medical insurance
Medical Aid
Medical aid schemes in South Africa are regulated by the Medical Schemes Act. These schemes are designed to provide more comprehensive health coverage.
They cover a broader range of health services, including doctor visits, hospital stays, maternity care, and sometimes even chronic medication. The benefits are structured around designated service providers and specific treatment protocols.
Medical aids often operate on a benefit structure based on annual limits and can offer cover for pre-existing conditions after a certain waiting period. They are generally more expensive than medical insurance but are preferred for their extensive cover, especially in severe or chronic health situations.
Medical Insurance
On the other hand, medical insurance in South Africa is governed under the Short-term and Long-term Insurance Acts.
These products are typically less expensive than medical aid and are designed to provide cover for unforeseen events rather than all-encompassing health needs. Medical insurance usually pays out a fixed amount per day of hospitalization or a lump sum for specific diseases or injuries.
The coverage is more limited, and pre-existing conditions are often not covered. However, medical insurance can complement a medical aid plan by covering additional costs that medical aid does not cover, or it can serve as a standalone product for those who cannot afford medical aid.
☑️ READ our more in-depth article about Health Insurance versus Medical Aid
When is Medical Insurance a Better Option?
Medical insurance might be a better option if the following factors apply to you:
Affordability
For individuals who cannot afford the premiums of medical aids, medical insurance offers a viable alternative to gain some level of health protection.
Supplemental Coverage
Those who already have a medical aid might choose medical insurance to cover gaps in their existing health care coverage, such as increased daily cash benefits during hospitalization.
Specific Coverage Needs
For individuals who are generally healthy and want coverage for specific situations, like accidents or certain critical illnesses, rather than comprehensive health coverage, medical insurance can be more suitable and cost-effective.
Short-term Requirements
Those who need cover for a brief period, perhaps during travel or between jobs, might find medical insurance more adaptable to their needs.
Ultimately, the choice between medical aid and medical insurance in South Africa depends largely on one’s health needs, financial situation, and the level of risk one is willing to assume.
Medical insurance is often more accessible and tailored for lower-cost, specific coverage, making it a suitable choice for those seeking basic or supplementary health protection without the higher costs associated with medical aids.
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The 5 Best Medical Insurance Under R1500
For those looking for affordable health insurance, below are the top options for less than R1500.
By comparing Clientele health, Affinity health insurance, Episodic Health, Dischem Health and Oneplan on the following criteria through customer surveys on quality health, access points, price care categories, online tools and customer care we created this detailed Pie Chart.
Clientele Health
Clientèle Health Insurance in South Africa offers a variety of health insurance plans under their H.E.L.P (Health Event Life Plans) series. These plans are designed to provide financial protection against unexpected medical costs due to hospitalization.
Clientèle is known for its direct marketing and sales distribution approach, providing easy-to-understand financial services products. It’s part of Clientèle Limited, a listed entity on the Johannesburg Stock Exchange, which has been a prominent player in South Africa’s financial services sector for over 30 years.
For those considering health insurance options in South Africa, Clientèle’s H.E.L.P plans offer a range of flexible and comprehensive coverages that can be customized to meet various health and financial needs.
Clientèle Health Accident Plus Plan
This plan is focused primarily on providing cover for accidents. It offers benefits like accidental death and disability cover, with a straightforward structure aimed at providing essential support in the event of accidental injuries.
Clientèle Health Standard H.E.L.P Plan
This plan offers basic health insurance coverage with an affordable premium. It includes essential hospital cover, emergency medical services, and other benefits, making it a suitable option for individuals or families looking for straightforward health insurance without extensive additional features.
Clientèle Health Ultimate H.E.L.P Plan
This plan provides enhanced coverage options including daily cash payouts for extended hospital stays, higher annual payment limits, and a premium payback feature. This feature returns 50% of premiums paid at age 65 and the remainder upon death. It also covers up to four children at no extra cost and provides maternity benefits.
What is the monthly premium for the Clientele Health insurance plans?
Clientele Health offers H.E.L.P. plans ranging in cost from R406 to R546 a month.
What Is the Waiting Period for Clientele Health Insurance Benefits?
Clientèle Health’s H.E.L.P. plans include specific waiting times:
- ☑️Accident hospitalisation does not require any waiting period. There is immediate coverage.
- ☑️Typically, it takes about three months for illnesses to be eligible for hospitalisation payments.
- ☑️Pre-existing conditions have a waiting period of 12 months.
How to Claim for Clientele Health Insurance Benefits
- ☑️ Formally complete the Clientèle Health claim form. To prevent processing of your claim being delayed, thoroughly fill out all fields.
- ☑️Return the claim form together with any other documentation. Clientèle Health provides several ways to submit, including email, fax, conventional mail, and online uploads.
- ☑️ Once you submit your claim, be sure to track its development. Help should be available from the Clientèle Health website or customer service.
- ☑️ Health could need to get in touch with your healthcare providers to verify information or request more information from you in order to assess your claim.
- ☑️ As soon as your claim is processed, you will be notified of its result. Should all go according to plan, your health insurance will pay the cost. Should you be rejected, you are entitled to a written explanation and details on how to file an appeal.
- ☑️ Every step of the claims process is crucial to ensure you receive the benefits you are entitled to hassle-free.
Pros and Cons
| ✅ Pros | ❌ Cons |
| Offers affordable plans with varying levels of cover | May have limited coverage for certain critical illnesses compared to other insurers |
| Provides financial assistance during critical illness | Specific policy details and exclusions should be carefully reviewed |
| Focuses on providing essential cover | May not be suitable for individuals with high-risk lifestyles or specific health conditions |
Clientele Health Insurance Contact Details
Clientèle Office Park Corner
Rivonia and Alon Road
Morningside
2196
Affinity Health
Affinity Health is a prominent provider of medical insurance in South Africa, known for its affordable and reliable health cover options tailored to meet the needs of a diverse client base.
Established in 2011, Affinity Health aims to revolutionize the medical insurance industry with its innovative and customizable health care products, designed with the intention to provide comprehensive yet straightforward health insurance accessible to all South Africans.
Day-to-Day Plan
At R809 a month, this plan covers out-of-hospital medical services like prescription drugs, dental treatment, vision tests, and doctor consultations. Being designed to manage routine medical costs, it is an inexpensive option for routine healthcare administration.
Hospital Plan
Starting at R1,258 a month, this plan pays for hospital visits brought on by accidents, major diseases, and maternity needs. It is made to cover significant medical situations that require hospitalisation in order to offer financial protection during difficult times.
What is the monthly premium for the Affinity Health insurance plans?
Affinity Health plans are available for a variety of price points, starting from R809 to R1, 258 per month for those plans under R1,500.
What Is the Waiting Period for Affinity Health Insurance Benefits?
Signing up with Affinity Health normally entails a three-month waiting period for health benefits. Those with pre-existing conditions must also wait a full year. It may take new members a certain amount of time to be qualified for benefits related to particular services or conditions.
How to Claim for Affinity Health Insurance Benefits
- ☑️ Fill out a claim form that Affinity Health provides online. Verify that all information about the treatment, the provider, and the costs is precise and all-inclusive.
- ☑️ You can file your claim and any accompanying paperwork in a number of ways
- ☑️ Together with your completed claim form, send scanned copies of all supporting documentation to the email address that Affinity Health has supplied.
- ☑️ If you’d like, you can fax the required documentation to Affinity Health.
- ☑️ Affinity Health has a physical address where you can mail the documents as well.
- ☑️ Direct claim filing is available if you are registered in the Affinity Health web site.
- ☑️ Tracking the status of your claim is possible by phoning or emailing Affinity Health customer service after submitting it. Updates may also be provided if you need any further information.
- ☑️ Affinity Health will assess your claim, looking over the specifics and assessing the coverage of your plan. Claim complexity and information quality can affect how quickly a claim is processed.
- ☑️ When your claim is processed, Affinity Health will let you know the result. Should all go according to plan, they will see to ensure that your health insurance covers it. They should explain what went wrong and how to file an appeal should your claim be denied.
Pros and Cons
| ✅ Pros | ❌ Cons |
| Wide range of cover options to suit different needs and budgets | Monthly costs can vary depending on plan chosen and individual factors |
| Provides cover for a variety of critical illnesses | May have exclusions or limitations on certain critical illnesses |
| Established and reputable insurer in South Africa | Important to carefully review the policy wording before purchasing |
Affinity Health Insurance Contact Details
1 Dingler St
Rynfield
Benoni
1514
Episodic Health
Episodic Health is popular for their range of customizable plans and their longstanding reputation in the industry for transparency and excellent customer service. They offer a good range of affordable medical aid insurance plans.
Day-to-Day Benefits Plan
Included in the R446 monthly benefit package of this plan are basic dental coverage, prescription medications, and doctor’s visits.
Hospital Benefits Plan
Up to a specific sum, this plan’s monthly premium of R186 covers hospitalisation expenses brought on by specific accidents or illnesses.
What is the monthly premium for the Episodic Health insurance plans?
With plans ranging from R186 for hospital coverage to R446 for daily benefits, Episodic Health offers something to suit everyone.
What Is the Waiting Period for Episodic Health Insurance Benefits?
For different benefits, Episodic Health has distinct waiting periods rather than one universal waiting period. Following is the waiting period structure:
- ☑️ Accidents are covered immediately under your insurance, so you can begin being covered for any injuries you sustain on the first day of coverage.
- ☑️For often used benefits like prescription drugs and doctor’s visits, the waiting time may be one to three months.
- ☑️ Because high-risk benefits—like critical illness coverage—are either less frequently utilised or carry a greater risk, there may be a 6- to 12-month waiting period.
- ☑️ Claimants with prior medical conditions may have to wait longer, typically between twelve and twenty-four months.
How to Claim for Episodic Health Insurance Benefits
- ☑️ For several treatments—especially hospitalization—Episodic Health needs prior authorization. Avoiding coverage problems and claims processing delays requires, first and foremost, that your treatment and associated costs be approved in advance.
- ☑️ Don’t neglect to request any documents you might need following your treatment from your medical professional. This includes bills and medical records attesting to the payment for and acceptance of medical care.
- ☑️ If you need to submit a claim with Episodic Health, you can get the required documentation from their website or by calling customer care. To avoid any unneeded delays, make sure that every field is filled out completely and precisely.
- ☑️ Send Episodic Health the filled out claim form together with any supporting documentation required. You might be able to turn in these papers right away via email, traditional mail, or an online portal, depending on the circumstances.
- ☑️ When you file your claim, Episodic Health will handle it according to the conditions of your policy. This means confirming the claim is legitimate, verifying the information again, and comparing the costs to your coverage limits.
- ☑️ Following their processing of your claim, Episodic Health will notify you of its outcome. They will either pay the healthcare provider directly if you are approved, or reimburse you depending on the specifics of the claim and the conditions of your plan.
Pros and Cons
| ✅ Pros | ❌ Cons |
| Affordable Premiums | Limited Comprehensive Coverage |
| Offers low-cost plans under R300, making healthcare more accessible. | Plans may provide limited comprehensive coverage, focusing mainly on episodic or short-term health needs. |
| Coverage for Specific Health Episodes | Limited Chronic Condition Management |
| Designed to cover specific health events or conditions, such as minor injuries or short-term illnesses. | Chronic conditions and long-term care are often not covered, requiring separate plans or out-of-pocket expenses. |
| Quick Access to Basic Care | Restricted Network of Providers |
| Provides prompt access to basic healthcare services for acute episodes. | The provider network may be limited, restricting where you can receive care. |
| Ideal for Young and Healthy Individuals | No Specialist Care |
| Suitable for those who generally have good health but want coverage for unexpected health episodes. | Specialist consultations and treatments may not be included, requiring additional costs. |
| Simple and Transparent Plans | No Hospitalization Coverage |
| Plans are easy to understand and designed for specific health needs. | Hospitalization or extensive treatment is typically not covered under these low-premium plans. |
| Preventive Care Options | Higher Out-of-Pocket Costs for Major Treatments |
| Some plans may include preventive care, such as vaccinations or health check-ups. | You may face significant out-of-pocket expenses for major health issues not covered by the plan. |
| Easy Enrollment Process | Limited Benefits for Ongoing Health Needs |
| Simplified sign-up process, often with minimal paperwork. | Plans may not cover ongoing or long-term health needs, focusing more on immediate care. |
Episodic Health Insurance Contact Details
Office No. S10
The Sanctuary Shopping Centre
Corner de Beers Avenue & Broadway Boulevard, R44
Paardevlei
Somerset West
7130
South Africa
Dis-Chem Health
Dis-Chem Health in South Africa offers a variety of health insurance plans designed to meet diverse healthcare needs, focusing on affordability and access to a broad range of health services. The insurance products are insured by Centriq Insurance Company Limited and administered by Kaelo Risk (Pty) Ltd.
MyHealth Core Plan
Beginning at R469 for adults and R329 for kids, this entry-level plan provides very little coverage for regular medical expenses.
MyHealth Plus Plan
You get more with MyHealth Plus than with MyHealth Core. Up to 27 chronic disorders are covered, and you can see any doctor in the network and have video consultations with specialists. At as little as R649 a month, it offers comprehensive health insurance.
Accident Cover
This plan, which concentrates on accidents and the associated emergency medical issues, covers ambulance services, hospitalisation, and emergency casualty visits. Adults start off at R270 a month, while dependent children will pay R153.
What is the monthly premium for the Dis-Chem Health insurance plans?
There are several plans available, and the plans cost anything from R270 to R649 a month.
What Is the Waiting Period for Dis-Chem Health Insurance Benefits?
The waiting periods for Dis-Chem Health insurance policies typically vary depending on the plan chosen and the type of coverage.
- ☑️There is no waiting period for claims pertaining to accidents.
- ☑️The waiting period for prescription medicines, doctor visits, and basic dental care is usually short—between one and three months.
- ☑️ Benefits for hospitalisation and coverage for significant illnesses or surgeries might have extended waiting periods (6–12 months) attached to them.
How to Claim for Dis-Chem Health Insurance Benefits
- ☑️ It is required by Dis-Chem Health that you complete their claim form. Usually, you can get this form online or at any Dis-Chem Health store. To avoid any delays, confirm the accuracy of all the information.
- ☑️ Send in your completed claim form along with any additional documentation that may be needed. Claims are typically sent to Dis-Chem Health via email, conventional mail, or in person at any branch location, depending on the method that works best for them.
- ☑️ Dis-Chem Health will handle your claim in accordance with your insurance after you file it. This entails checking that the claim details and related paperwork are correct.
Pros and Cons
| ✅ Pros | ❌ Cons |
| Very Affordable Premiums | Limited coverage for major medical events and surgeries |
| Access to Day-to-Day Benefits | Coverage may not include hospitalization |
| Basic Healthcare Services Included | Lower annual benefit limits |
| Easy Enrollment Process | May have limited access to specialist consultations |
| Access to Dis-Chem Wellness Benefits | Limited choice of healthcare providers |
| Discounts on Health Products and Services | May require co-payments for certain services |
| Flexible Payment Options | Excludes coverage for chronic conditions and medications |
| Good for Routine and Preventative Care | Not suitable for comprehensive healthcare needs |
Dis-Chem Health Insurance Contact Details
Building A 2nd Floor
52 Corlett Dr
Illovo
Sandton
2196
Affordable private Day-to-Day Insurance options & Accident Cover options for you and your family.
OnePlan
OnePlan Health Insurance in South Africa offers a range of health insurance products that are designed to be simple, affordable, and straightforward. The plans are not regulated by the Medical Schemes Act but are underwritten by Bryte Insurance Company Limited, making them a short-term insurance product.
The insurance plans provide access to private hospitals, ensuring quick and comprehensive care when needed. OnePlan emphasizes ease of use, affordability, and comprehensive coverage without the complexities often associated with traditional health insurance.
Core Plan
The primary benefits of this entry-level plan, which has a monthly starting price of R480, are as follows: doctor’s visits, prescription drugs, dental care, eye exams, and emergency hospital and ambulance services. For those seeking basic healthcare at an inexpensive price, it’s a terrific fit.
Blue Plan
For those who need more comprehensive coverage, the Blue Plan, which has a monthly starting price of R955, is a great option. It increases the daily medical limits and offers additional benefits like greater in-hospital coverage and specialist consultations.
Professional Plan
With a monthly starting price of R1330, this plan offers more comprehensive in-hospital coverage along with tighter restrictions on all daily benefits. Ideal for individuals or families that require comprehensive health coverage at a lower price.
What is the monthly premium for the OnePlan Health insurance plans?
The starting monthly fee for OnePlan’s entry-level plan is R480, and for more extensive coverage, it rises to R1765.
AFFORDABLE MEDICAL INSURANCE
What Is the Waiting Period for OnePlan Health Insurance Benefits?
When enrolling in OnePlan Health Insurance, one can choose from several coverage options with varying waiting periods:
- ☑️ Most medical treatments are covered by the daily benefits after a three-month waiting period. You won’t therefore be able to use many of your usual perks during the first three months of the policy.
- ☑️ Every pre-existing medical condition is subject to a 12-month waiting time. This means that in order to be covered for any costs related to ailments that existed before to your joining OnePlan, you will have to wait a full year after the policy begins.
- ☑️ Maternity claims cannot be lodged before the waiting period—which varies but is usually around 10 months has passed.
- ☑️ Since generally there is no waiting period for accidental claims, you can start filing claims for accidental injuries as soon as your coverage starts.
How to Claim for OnePlan Health Insurance Benefits
- ☑️ Verify if the OnePlan app is already installed on your phone. Without the app, you cannot register a claim or manage your policy.
- ☑️ Launch the app, enter your credentials, and view your policy details and claims options.
- ☑️ Get together all of your supporting paperwork before submitting your claim. These could include bills, receipts, and relevant medical records.
- ☑️ Make a claim using the app. Through the app, you can send in your claim details and any supporting paperwork. Prompts at every step of the process make it simple to use.
- ☑️ A unique element of OnePlan is the OneCard. The moment your claim is accepted, money will be put into this card. Paying for medical services directly with the OneCard will save you money over time.
- ☑️ Following submission of your claim, the app will let you track its progress. Real-time notification of the status of claims is the aim of OnePlan’s claims processing app.
Pros and Cons
| ✅ Pros | ❌Cons |
| Affordable Premiums: Budget-friendly options with plans under R1000. | Limited Coverage: Lower-cost plans may offer limited coverage, particularly for more extensive medical needs. |
| Preloaded Card for Claims: Convenient preloaded card for paying medical expenses directly without upfront payments. | Network Limitations: Some services might be limited to a network of specific healthcare providers. |
| Day-to-Day Benefits: Includes coverage for GP visits, dentist, and optometrist consultations. | Caps on Benefits: Benefit limits may apply to consultations, medications, and procedures. |
| No Waiting Period for GP Visits: Immediate coverage for GP visits with no waiting period. | Limited Hospital Cover: Hospital cover may be minimal or not included in plans under R1000. |
| Simple and Transparent Plans: Easy-to-understand plans with straightforward terms. | Exclusions: Certain treatments and conditions might be excluded from coverage. |
| Mobile App: The Oneplan mobile app allows easy management of claims and policy details. | Prepaid Claims System: While convenient, the prepaid system may require careful management to avoid running out of funds. |
| Wellness Benefits: Some plans offer wellness benefits like flu shots and health assessments. | Co-payments: Co-payments may be required, adding to out-of-pocket expenses. |
| Flexibility: Customizable plans allow adjustments according to personal needs and budget. | Limited Specialist Cover: Access to specialists may be restricted or come with additional costs. |
OnePlan Health Insurance Contact Details
163 5th Street Nelson Mandela Square
South Tower 2nd Floor Sandton
Sandown
Johannesburg
2196
☑️READ also about Hospital Plans below R1500 in South Africa
☑️READ also about Medical Aid Plans below R1500 in South Africa
Frequently Asked Questions
What types of medical insurance are available for under R1500?
For under R1500, you can typically find basic health insurance plans covering day-to-day medical expenses like GP consultations, prescribed medication, and emergency room visits. These plans may also offer limited hospital cover for accidents and emergencies. They are usually structured to provide essential healthcare services, keeping premiums affordable.
Are there any medical insurance plans under R1500 that include dental and optical benefits?
Yes, some health insurance plans under R1500 include dental and optical benefits, but these are often limited. These benefits might cover annual check-ups, basic procedures, and a portion of optical frames and lenses every 24 months. It’s important to check the specific details of what’s covered under each plan.
Can I get maternity coverage in medical insurance plans under R1500?
Maternity coverage in health insurance plans under R1500 is possible but typically comes with restrictions. Coverage might include a limited number of prenatal visits and possibly postnatal care, but it’s less likely to cover the costs of childbirth itself. Always verify the extent of maternity coverage before signing up.
What are the waiting periods for medical insurance plans under R1500?
Most medical insurance plans, including those under R1500, have waiting periods that can vary depending on the benefit. Common waiting periods include 1-3 months for day-to-day benefits and up to 12 months for specific conditions or surgeries. Emergency services are typically covered immediately.
How do I claim from medical insurance plans under R1500?
Claiming from medical insurance plans usually involves submitting proof of the medical expense, such as doctor’s invoices and receipts, directly to the insurer. Some plans offer the convenience of pre-loaded cards that can be used to pay for medical services directly. Most companies now also provide online platforms and mobile apps for easier claim submission and tracking.
