The cheapest and most expensive medical aid schemes in South Africa – pricing and what they offer
South Africa’s most prominent medical insurance provider, Discovery, has announced its new private health cover at a third of the price of its previous entry-level product to attract new customers at an affordable rate.
Discovery Health said it would offer primary care for about R350 a month, giving customers access to doctors, emergency procedures and treatment for chronic conditions including HIV.
Discovery is not the only insurer taking steps to acquire its portion of the market to address the nearly 8 million uninsured South Africans and sliding health insurance membership in 2020 due to a stagnant economy reducing disposable income.
Dis-Chem Pharmacies and digital bank Tyme have launched insurance offerings to tap into the country’s wider and under-served segment. Dis-chem is set to offer an R431 monthly fee whereas TymeHealth will charge R139, depending on the type of cover sought.
The chief executive officer of Discovery, Adrian Gore said that as Covid hit, the group saw correlations of risk factors such as diabetes and high body mass index as drivers of higher levels of severe disease and death. He stressed that this has, in turn, increased people’s “sense of wellness and resilience and why it is important”.
BusinessTech compiled a list of medical aid schemes offered by popular providers based on their affordability and price entry points.
Discovery
South Africa’s most prominent medical insurer with more than 40% of the market share offers various coverage options for customers. The cheapest offer available is Flexicare for individuals with a principal party paying a monthly fee of R399, with the optional addition of R160 for R400,000 of trauma cover or R224, for R1 million of trauma cover.
With regard to Flexicare, coverage for a spouse or adult costs R367 per month.
| Plan | Cost/month |
|---|---|
| Flexicare (Principle party) | R399 |
| Classic Saver | R3 485 |
| Executive Plan | R7 688 |
However, contributions for all of Discovery’s medical schemes will see an increase of 7.9% from 1 May 2022 to ensure that they remain on par with future medical inflation.
The most affordable plan, Flexicare, offers members day-to-day healthcare services for:
- Unlimited doctor consultations
- Procedures performed in doctors’ rooms
- maternity
- Health and wellness screening
- Over-the-counter medicine
- Chronic conditions and HIV treatment
- Covid-19 testing and treatment
- Ambulance services
- Optional trauma benefit
Whereas the Executive plan provides all that Flexicare does, including:
- Unlimited cover in any private hospital, including private ward cover
- Guaranteed full cover in hospital for specialists
- Full cover for chronic medicine for all chronic Disease List conditions
- An unlimited Above Threshold Benefit (ATB) for day-to-day healthcare needs
- Comprehensive benefits for maternity and early childhood
- Access to global treatment in South Africa and abroad.
- Additional cover when medical savings runs out for essential healthcare services.
TymeHealth
TymeBank has partnered with the National HealthCare Group to launch Tyme Health. TymeHealth aims to provide for the needs of underinsured South Africans in the market for a supplementary day-to-day scheme to be paired alongside their existing hospital plan.
| Plan | Cost/month |
|---|---|
| MediClub Connect | R139 |
| MediClub Premier | R299 |
| MediClub Elite | R399 |
TymeHealth’s cheapest option at R139, MediClub Connect, offers members:
- GP visits
- Basic pathology
- Basic radiology
- Acute medication
- Basic dentistry
- HIV benefit
- 24/7 telephonic employee
- Emergency transportation services provided by LifeMed
MediClub Elite, as TymeHealth’s most expensive plan, offers members all that the Connect plan has but extras include:
- Accidental hospitalisation, R200,000 per insured per event and R400,000 per insured per annum.
- Emergency casualty cover in a ward of a private hospital for injuries resulting from an accident up to a maximum of R18,000 per insured per annum
- Accidental death with R15,000 benefit payable on the death of the policyholder.
Bonitas
As a nearly 40-year-old medical aid provider, Bonitas is one of South Africa’s biggest insurers, with roughly 730,000 beneficiaries. Bonitas said it offers a wide range of plans to ensure that clients can meet their particular needs.
| Plan | Cost/month |
|---|---|
| BonStart | R1 338 |
| Standard Select | R3 822 |
| BonComprehensive | R8 217 |
The most affordable offering, BonStart, covers, but is not limited to the following:
- GP consultations
- GP-referred medical tests
- Over-the-counter medicine
- Spcialist consultations
- Optometry
- Basic Dentistry
- General appliances such as wheelchairs
- Physiotherapy
- Mental health
- HIV/Aids
- Maternity, child care and contraceptives
BonComprehensive at R8,217 per month offers all the standard elements, and includes the following:
- X-ray and CT Scans
- Hearing aids
- Specialised dentistry
- Maxillo-facial surgery and oral pathology
- International travel benefits
- Other in-hospital benefits
Momentum
Established in 1966, Momentum provides medical aid is a popular choice for South Africans.
The insurer has locked prices until September 2022. Slight increases on all schemes will then be instituted including its cheapest option, the Ingwe Option, which will increase from R455 to R482.
| Plan | Cost/month |
|---|---|
| Ingwe Option | R455 |
| Extender Option | R5 231 |
| Summit Option | R10 642 |
The Ingwe option aimed at the entry-level cover includes:
- Entry-level medical aid with hospital cover
- Day-to-day benefits
- Chronic illness benefits
- Treatment from any hospital that is part of the Ingwe network of private and state hospitals
The Summit Option, as one of the most expensive on this list, offers customer exclusive coverage such as:
- No overall annual limit for hospitalisation
- Access to specialists at any hospital
- Cover for over 62 chronic conditions
- A day-to-day limit of R28,000
- Various hospitalisation coverage for things from the prosthesis to mental health.
Medihelp
Medihelp offers 11 products catering for various income brackets and needs. In late 2021, Medihelp Medical Aid announced a price reduction of 5.57% on four of its options, while the remaining options will be increased by an average of 2.74% in 2022.
| Plan | Cost/month |
|---|---|
| MedVital | R1 650 |
| Savings plans | R2 148 |
| MedPlus | R10 122 |
Currently, the cheapest option available from Medihelp is MedVital which starts at R1,650 and includes core benefits as well as additional coverage including, but limited to:
- Specialised radiology
- Emergency transport services
- Trauma cover
- 270 PMB conditions – diagnosis, treatment and care
- Coverage for 26 chronic illnesses
The priciest option, MediPlus, provides customers with the most comprehensive cover, including:
- GP and specialist visits
- Unlimited cancer treatment
- Health screenings
- Organ transplants up to a limit of R342,000 for bone marrow/stem cell transplants
Dis-chem Health
As of 2022, Dis-Chem Pharmacies has launched Dis-Chem Health, a health insurance offering with premiums starting at R431 per month for the Core plan and increasing to R591 per month for the Plus plan with additional cover options available for accident and medical emergency illness cover.
| Plan | Cost/month |
|---|---|
| Core | R431 |
| Core and Accident Cover | R486 |
| Plus | R591 |
The Dis-Chem Health Core scheme provides for a broad spectrum of problems that may arise by offering:
- Private doctors
- Dentistry
- Optometry
- Medication for acute, chronic and over-the-counter
- HIV programme
- X-rays and blood tests
- Maternity scans
- Health screenings
- Covid-10 testing
The Plus day-to-day package expands on the Core to include:
- Unlimited acute medication scripts
- Coverage for 27 chronic conditions
- Access to specialists
Bestmed
Bestmed’s contributions are to see an increase of 3.9% across all options. The group offers networked and non-networked packages for its most affordable Beat schemes, which offer reduced rates for using scheme-networked healthcare providers.
| Plan | Cost/month |
|---|---|
| Beat 1 (principal member in network scheme) | R1 570 |
| Beat 4 | R5 062 |
| Pace 4 | R8 642 |
The Beat 1 offers networked plans at R1,570 a month and R1,746 for non-networked schemes. It offers customers in-hospital benefits such as coverage for:
- Hospital accommodation and theatre fees
- Take-home medicine
- Biological medicine during hospitalisation
- Treatment in mental health clinics
- Organ transplants
The top coverage, Pace 4, offers its clients extensive benefits for clients, including:
- All basic coverages offered by cheaper options
- 100% Scheme tariffs for medical events ranging from mammary surgery, oncology to midwife-assisted births
- Out-of-hospital benefits including; an overall day-to-day limit of R37,367 and diabetes care.
Read: Discovery to offer ultra-low-cost health cover in South Africa
