Best Medical Insurance Under R500

Securing a health insurance plan in South Africa is crucial for financial peace of mind, especially considering how healthcare expenses can quickly add up. It’s important to find a plan that offers substantial benefits for less than R500 per month. This guide is designed to familiarize you with the top five medical aid insurance options that offer substantial coverage while still being affordable. You’ll learn:

• ✅ Why more South Africans need affordable medical insurance
• ✅ The 5 best medical aid insurance that cost less than R500 per month
• ✅ Frequently asked question about the importance of affordable medical / health insurance

Read on to discover which plan could be the best fit for you, as we explore their key features, benefits, and overall value.

Unique Features

Why more South Africans need affordable medical insurance?

South Africa is facing a growing urgency for affordable medical insurance. This is driven by a mix of economic pressures, public health challenges, and inequalities in healthcare access. There are several crucial reasons why affordable medical insurance is becoming increasingly important for South Africans:

Economic Challenges

Many South Africans face economic hardship, with high unemployment rates and low incomes limiting access to healthcare services. Affordable medical insurance can help bridge the gap by providing access to necessary medical services without the burden of prohibitive costs.

Public Healthcare Limitations

The public healthcare system in South Africa is often overwhelmed, with issues like overcrowding, long waiting times, and shortages of medical staff and supplies.

Private healthcare, while generally offering higher quality services, is unaffordable for most without insurance.

High Prevalence of Chronic Diseases

South Africa has high rates of chronic diseases such as HIV/AIDS, tuberculosis, and non-communicable diseases like hypertension and diabetes. Consistent and affordable healthcare is crucial for managing these conditions effectively.

Impact of COVID-19

The COVID-19 pandemic has underscored the importance of accessible healthcare. The economic fallout has also made it more difficult for many to afford healthcare costs out of pocket.

Medical insurance can play a key role in ensuring that individuals and families can access necessary care during such crises.

Preventative Care

Preventative care can significantly reduce long-term healthcare costs and improve quality of life. However, without affordable health insurance, many South Africans may forego regular check-ups and early treatment, leading to more severe health problems down the line.

Healthcare Equity

There exists a notable discrepancy in healthcare access and quality among various socio-economic groups in South Africa. Ensuring access to affordable medical insurance is a crucial step in promoting equal healthcare opportunities for all individuals, regardless of their economic circumstances.

Economic Benefits

Ensuring that the workforce is healthy has direct economic benefits, such as increased productivity and reduced absenteeism. Access to affordable healthcare via health insurance can support a healthier, more productive workforce.

By tackling these concerns, affordable medical insurance has the potential to make a substantial impact on the overall health outcomes of the South African population and can play a role in stabilizing the broader social and economic landscape of the country.

The 5 best Medical / Health Insurance Under R500

Below, we explore the 5 best medical aid insurance that cost less than R500 per month.

Clicks Flexicare ( Powered by Discovery Flexicare)

Clicks Flexicare is a health insurance product offered in South Africa, not a medical aid scheme. It’s designed to provide affordable healthcare options through a range of benefits, which are managed and administered by Discovery Health and underwritten by Auto & General Insurance​.

Flexicare allows customization of the cover based on the member’s needs, including options for adding dependents. The plan also integrates with the Clicks ClubCard system, offering cashback benefits on premiums paid.

Flexicare Primary Healthcare Benefits

• ☑️ Main Member
• ☑️ Monthly Premium: R350
• ☑️ Coverage Includes:
• ☑️ Unlimited GP consultations
• ☑️ Unlimited nurse consultations
• ☑️ Dentistry
• ☑️ X-rays
• ☑️ Flu vaccine
• ☑️ Eye care
• ☑️ Medicine
• ☑️ Health check
• ☑️ Maternity benefit
• ☑️ Procedures in GPs’ rooms
• ☑️ Blood tests
• ☑️ Private ambulance service
• ☑️ HIV care

Flexicare Plus Primary Healthcare Benefits

• ☑️ Main Member
• ☑️ Monthly Premium: R469
• ☑️ Enhanced Coverage:
• ☑️ All the benefits of Flexicare Primary plus additional coverage limits.

What is the monthly premium for the Clicks Flexicare insurance plans?

Clicks Flexicare monthly premiums will differ depending on the coverage you select but are available starting from R350 to R469 per month for the main member.

What Is the Waiting Period for Clicks Flexicare Insurance Benefits?

The following standard waiting periods apply to all individual members joining Flexicare:

• ☑️ 1 month general waiting period on all services except accidental harm
• ☑️ 3 month general waiting period on dentistry and optometry
• ☑️ 12 month condition specific waiting period for any condition (includes chronic illnesses and HIV) which existed prior to the inception date.

No waiting periods apply to treatments as a result of bodily injury caused by violent, unintentional, external or physical means (Accidental Harm), unless these occur as a result of the exclusions, as defined in the policy agreement.

No waiting periods apply to membership that is implemented on a compulsory basis by an employer on behalf of their employees.

How to Claim for Clicks Flexicare Insurance Benefits?

Clicks Flexicare claims are submitted by the service provider in the following ways:

•  ☑️ The provider either contacts the Call Centre to confirm benefits or, the provider can access this information electronically, via the designated service provider dashboard.

•  ☑️ The provider will then submit a claim to the designated service provider.

Clicks Flexicare Contact Details

Cnr. Searle and Pontac Streets

PO Box 5142

Cape Town

8000

South Africa

Dis-Chem Health

Dis-Chem Health offers an affordable range of medical insurance plans that could be a great option for individuals or families looking for healthcare coverage under R500 per month.

These plans are complemented by Dis-Chem’s extraRewards program, which offers policyholders a 20% discount on a wide range of health, home care, personal care, and baby products, available year-round at all Dis-Chem stores and the online store.

This rewards program is a valuable addition for regular Dis-Chem shoppers, enhancing the overall value of their health insurance plans​. Overall, Dis-Chem Health’s insurance options are well-suited for those looking for basic to moderate medical coverage while managing a tighter budget.

MyHealth Core Plan

One of Dis-Chem Health’s popular products is the MyHealth Core Plan, priced at approximately R469 per month for adults. This plan provides coverage for day-to-day medical needs, such as GP visits, basic dentistry, eye exams, over-the-counter medications, and more. It’s designed to offer essential healthcare services at a cost-effective rate​.

Accident Cover Plan

Dis-Chem Health incorporates an Accident Cover plan, which can be purchased separately or combined with the day-to-day plans to provide enhanced protection against accidental injuries. This Accident Cover starts at R153 per month and covers emergency treatments and hospitalization due to accidents​.

What is the monthly premium for the Dis-Chem Health insurance plans?

Monthly premiums for the different plans available have a range of R153 to R649.

Affordable private Day-to-Day Insurance options & Accident Cover options for you and your family.

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What Is the Waiting Period for Dis-Chem Health Insurance Benefits?

•  ☑️ Dis-Chem Health insurance plans may have varying waiting periods depending on the type of coverage and plan chosen.

•  ☑️ There is no waiting period for accident claims.

•  ☑️ Typically, patients can expect to receive coverage for prescription medication, medical appointments, and basic dental treatment within a span of one to three months.

•  ☑️ There may be longer waiting periods of 6-12 months for hospitalisation benefits and coverage for major diseases or surgeries.

How to Claim for Dis-Chem Health Insurance Benefits?

•  ☑️ Begin by completing the claims form. You can easily find this form at any Dis-Chem Health location or online. Ensure accuracy to meet the deadlines for your claim.

•  ☑️ Remember to attach all relevant supporting documents to your completed claim form when submitting it. Customers have the option to submit claims to Dis-Chem Health through various channels, including email, regular mail, or by visiting any branch location in person.

•  ☑️ Your claim will be processed by Dis-Chem Health in accordance with your insurance policy once you have submitted it. Ensuring the accuracy of all claim facts and paperwork is the focus of this process.

•  ☑️ Dis-Chem Health will provide you with an update regarding Dis-Chem Health’s decision on the claim. They will promptly reimburse you for any out-of-pocket expenses you incurred once they have reviewed your claim.

Dis-Chem Health Insurance Contact Details

Building A 2nd Floor

52 Corlett Dr

Illovo

Sandton

2196

OnePlan Health Insurance

Founded in 2010, OnePlan has carved out a niche in the health insurance market by offering a range of health insurance products that emphasize simplicity and accessibility. The company makes use of a unique OnePlan Claim Card, which allows policyholders to pre-load claims funds onto the card, enabling them to access medical services without upfront payment hassles.

OnePlan Health Insurance is known for its comprehensive range of services including hospital plans, day-to-day benefits, as well as specific coverage for accidents, illness in hospital, and emergency situations. The company also offers specialized plans for dental care, optometry, and accidental disability, among others​.

OnePlan uses technology to enhance user experience, such as their mobile app which provides easy access to plan information, claims submissions, and direct communication with healthcare providers​.

Core Plan

This entry-level plan, priced at R480 per month, provides a variety of valuable benefits. These services encompass doctor’s visits, prescription medication, dental care, eye exams, and emergency hospital and ambulance services.

If you’re in search of cost-effective basic healthcare, this option is highly recommended.

What is the monthly premium for the OnePlan Health insurance plans?

OnePlan provides a variety of plans tailored to meet various requirements. For individuals seeking a basic plan, the monthly fee starts at R480. However, for those in need of more extensive coverage, the price rises to R1765.

What Is the Waiting Period for OnePlan Health Insurance Benefits?

•  ☑️ Usually, medical treatments are eligible for coverage after a three-month waiting period, based on the daily benefits. Regrettably, there will be restrictions on the benefits you can access during the first three months of the policy.

•  ☑️ There is a 12-month waiting period for any pre-existing medical condition. It is crucial to understand that in order to be eligible for coverage of pre-existing conditions with OnePlan, a waiting period of one year from the beginning of the policy must be observed.

•  ☑️ Maternity claims cannot be submitted until the waiting period, which usually lasts around 10 months, has passed.

•  ☑️ Usually, there is no need to wait when it comes to accidental claims. You can file for coverage right away after an accidental injury.

How to Claim for OnePlan Health Insurance Benefits

•  ☑️ Make sure to download and install the OnePlan app on your phone. Claims registration and policy management can only be done through the app.

•  ☑️ Begin by launching the app, inputting your credentials, and conveniently accessing your policy details and claims options.

•  ☑️ It is important to ensure that you have all the required documents in hand before submitting your claim. These can include bills, receipts, and relevant medical records.

•  ☑️ Please utilize the app to submit your claim. Using the app, you can easily submit your claim details and any required paperwork for added convenience. Using it is incredibly easy, thanks to the helpful prompts provided at every step of the process.

•  ☑️ OnePlan provides a unique offering known as the OneCard. Once your claim is approved, funds will be deposited onto this card in a timely manner. Utilizing the OneCard for medical payments can result in significant long-term cost reductions.

•  ☑️ After you’ve submitted your claim, the app will give you the convenience of effortlessly tracking its progress. The claims processing app has been carefully designed to ensure that users receive immediate updates on the status of their claims.

OnePlan Health Insurance Contact Details

163 5th Street Nelson Mandela Square

South Tower 2nd Floor Sandton

Sandown

Johannesburg

2196

Episodic Health

Episodic Health is a South African health insurance provider focused on offering affordable and flexible health insurance options to cater to diverse healthcare needs. Established in collaboration with Essential Med in 2019, Episodic Health positions itself as a dynamic and adaptable choice for health insurance, providing services that were previously managed under the Essential Med brand.

One of the distinguishing features of Episodic Health is its flexibility in coverage limits and the lack of a restricted hospital network, which means policyholders can receive care at any hospital. They offer structured plans with stated benefits that provide clarity on what is covered, allowing for straightforward claims processing.

Episodic Health is recognized for its customer-centric approach, ensuring that policyholders receive personal attention and support throughout their membership. The insurer is known for its responsive customer service and the ability to quickly address and resolve queries and claims, contributing to a positive overall customer experience​.

Day-to-Day Plan

This plan offers comprehensive out-of-hospital benefits including unlimited visits to network doctors, with certain procedures and consultations covered. It’s designed to manage everyday health needs effectively, ensuring access to general practitioners and basic medical care.

The plan includes a managed number of out-of-network consultations per year, reimbursed up to a specific amount, which adds flexibility when traveling or away from home.

Hospital Plan

As an affordable alternative to medical aid, this plan covers hospital expenses with stated amounts for defined events. It does not restrict members to a specific hospital network, allowing freedom to choose any hospital for treatment.

This plan is ideal for those seeking cover for more severe medical interventions that require hospitalization​.

What is the monthly premium for the Episodic Health insurance plans?

Episodic Health offers a diverse selection of plans to meet various needs, with prices ranging from R186 for hospital coverage to R446 for daily benefits.

What Is the Waiting Period for Episodic Health Insurance Benefits?

Episodic Health has chosen to implement different waiting periods for its various benefits, rather than enforcing a one-size-fits-all waiting period. This approach offers enhanced flexibility and customized coverage for their members. Allow me to present the waiting period structure:

•  ☑️ Accidents are quickly addressed by your insurance, ensuring that you receive immediate coverage for any injuries you may sustain right from the start.

•  ☑️ Usually, there is a waiting period of one to three months for commonly used benefits like prescription medication and doctor’s visits.

•  ☑️ Given the nature of high-risk benefits, like critical illness coverage, it is possible that a waiting period of 6 to 12 months may be required. This waiting period is implemented to effectively address and mitigate any potential risks that may arise from these benefits.

•  ☑️People who have pre-existing medical conditions might have to wait for a longer period of time, typically between twelve to twenty-four months.

How to Claim for Episodic Health Insurance Benefits

•  ☑️ Episodic Health requires prior authorization for various treatments, particularly hospitalization. Ensuring smooth coverage and timely claims processing requires obtaining pre-approval for your treatment and its associated costs.

•  ☑️ Make sure to request the required documents from your medical professional following your treatment.

• ☑️ If  you’re looking to submit a claim with Episodic Health, you have the choice of accessing the required documentation through their website or reaching out to customer care. To achieve maximum efficiency, it is essential to make sure that all fields are filled out with precision and attention to detail.

•  ☑️ Ensure that the completed claim form is submitted to Episodic Health, accompanied by any required supporting documentation. There are several ways to ensure timely submission of these papers, including email, traditional mail, or an online portal, depending on the specific circumstances.

•  ☑️ Episodic Health will process your claim in accordance with the terms of your policy, ensuring a smooth and efficient experience for you. It is crucial to verify the validity of the claim, thoroughly review the information, and evaluate the costs in relation to your coverage limits.

•  ☑️ Episodic Health will notify you of the outcome once your claim has been processed. Payment for healthcare services can be made directly to the provider or reimbursed to you, depending on the approval and the terms of your plan.

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

Clientele Health

With a history stretching over three decades, Clientèle has built a reputation as one of South Africa’s leading direct distributors of financial service products. The company offers a range of products including life and health insurance, legal cover, and investment products, primarily through direct marketing and sales distribution channels​.

Clientèle is known for its Clientèle H.E.L.P Plans (Health Event Life Plans), which provide insurance coverage for unforeseen hospital-related expenses, offering cash payouts to mitigate the financial impact of hospitalization.

Clientèle Health Accident Plus Plan

The primary focus of this plan is on providing coverage for accidents.

With a straightforward structure, this plan provides essential assistance for unexpected injuries, along with extra perks like disability insurance and coverage for accidental death.

What is the monthly premium for the Clientele Health insurance plans?

The H.E.L.P. plans offered by Clientele Health range in price from R406 to R546 per 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 a waiting period. There is immediate coverage.
• ☑️ Typically, it takes about three months for illnesses to be eligible for hospitalisation payments.
• ☑️ Pre-existing conditions are subject to a 12-month waiting period.

How to Claim for Clientele Health Insurance Benefits

• ☑️ It is important to complete the Clientèle Health claim form with utmost accuracy and attention to detail. To ensure maximum efficiency, please make sure to complete all fields thoroughly to prevent any possible delays in processing your claim.

• ☑️ Ensure that you submit the claim form along with any additional documentation required.

• ☑️ Clientèle Health provides a range of submission options for your convenience. You can choose to submit your documents via email, fax, conventional mail, or online uploads.

• ☑️ Once you’ve submitted your claim, it’s crucial to closely monitor its progress. Getting help is a breeze with the Clientèle Health website or by contacting their dedicated customer service team.

• ☑️ Clientèle Health may need to reach out to your healthcare providers for verification or to gather more information from you to assess your claim.

• ☑️ Once your claim has been processed, you will receive a prompt notification regarding the outcome. If all goes according to plan, your health insurance should cover the expenses. If you encounter rejection, you are entitled to a written explanation and guidance on how to proceed with an appeal.

• ☑️ Every step of the claims process is crucial to ensuring you receive the benefits you deserve smoothly and efficiently.

Clientele Health Insurance Contact Details

Clientèle Office Park Corner

Rivonia and Alon Road

Morningside

2196

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Frequently Asked Questions

Why is inexpensive medical insurance important in South Africa?

Inexpensive medical insurance is crucial in South Africa because it ensures broader access to healthcare services for all socio-economic groups. With the high costs associated with medical treatment and the challenges facing public health services, affordable insurance helps to reduce the financial burden on individuals and families, ensuring that more people can receive timely and quality medical care without significant financial distress.

How does inexpensive medical insurance contribute to overall public health?

By making medical insurance reasonable, more individuals and families can access preventative and ongoing medical care, which can lead to earlier diagnosis and treatment of illnesses, reducing the severity of diseases and their impact on the community. This helps improve the overall health standards of the population and reduces the strain on public health facilities.

What are the barriers to getting medical insurance in South Africa?

Key barriers include high premium costs, lack of awareness about the benefits of insurance, complex enrolment processes, and limited tailored products for low-income families. These factors often prevent widespread adoption of medical insurance, especially among the lower-income groups.

How can the government and private sectors improve the affordability of medical insurance?

The government can implement policies to regulate insurance premiums and provide subsidies or tax benefits to make insurance more accessible. The private sector can innovate by creating low-cost insurance products that cover essential health services with reasonable premiums. Both sectors can also engage in educational campaigns to raise awareness about the benefits of having medical insurance.

What should consumers consider when choosing an affordable medical insurance plan?

Consumers should consider the extent of the coverage, including what medical services are covered, the size of the network of approved healthcare providers, any exclusions or limitations, premium costs, and the reputation of the insurance provider for customer service and claim handling. It’s also important to assess whether there are additional benefits like maternity or mental health coverage, which can be important depending on the individual or family’s health needs.