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Medical Aid in South Africa

  • What is a Medical Aid?

    Medical aid is a type of health insurance plan that provides financial assistance to cover in and out-of-hospital medical expenses.

    In other words, whether you are visiting a GP, buying medicine over the counter, or are hospitalised for any reason, your medical aid scheme will pay the costs.

    You pay a monthly premium to have a medical scheme for you and your family.

    Most medical aid plans cover hospitalization, doctor visits, prescription drugs, nurse, and some preventive care.

    You will also receive support for disability, rehabilitation, and therapy. Medical aid will pay for any patient medical costs.

    Types of Medical Aid

    There are various medical aid companies in South Africa. Each provider has its packages with various premiums from affordable to expensive.

    It all depends on your needs and what you can afford.

    There are other types of health plans available like hospital plans, health/medical insurance, and more.

    Benefits of a Medical Aid Scheme

    Firstly, it protects you financially against massive healthcare costs.

    Secondly, you can visit any private healthcare facility in South Africa. You do not have to visit a state hospital or clinic.

    Thirdly, you have the chance to make sure that your loved ones receive the best possible treatment for any medical reason whether it is an emergency or not.

    Lastly, it will settle most of the medical expenses even in events where it can lead to hundreds of thousands of rands.

    Cost of Medical Schemes

    Medical aid schemes vary in costs and restrictions. It goes from low to high premiums.

    Basic medical aid will have cover for everything, however, the amount of coverage is less than expensive schemes.

    Even though cheaper medical aid plans seem expensive, the benefits of having a scheme are greater.

    The cost of a medical aid plan depends on the type of coverage and the age and health of the insured.

    How to Apply for Medical Aid

    There are various ways you can apply for medical schemes. You can either call each provider that you are interested in to send you quotes. Or apply on each medical aid company’s website.

    The fastest and most efficient way is to find a quote-providing website like Clearwave, submit all requested details, and wait. Within 24 hours you will receive medical aid quotes from various companies.

    Once you have decided on the company and package you need, you apply for the medical scheme through the agent that provided you with all the information.

    How to Manage Medical Aid

    Medical aid plans may have deductibles, copayments, and coinsurance that the insured must pay out-of-pocket.

    Make sure that you stay up to date with your medical scheme, especially with annual increases and more. You can do it by downloading the medical aid company app or visiting them online.

    Medical aid plans are regulated by state and federal laws, including the Affordable Care Act.

    How to Make Claims on Medical Aid

    Normally, you provide the healthcare facility with your medical scheme details and they will receive payment directly from your medical aid. In other instances, you will have to request authorisation.

    Nonetheless, your medical aid will pay for all your health needs at any private healthcare facility.

    Alternatives to Medical Aid

    There are two other alternatives to choose from when you cannot afford a medical aid plan. It includes:

    Hospital plans – read more here.
    Medical/Health insurance – read more here.


    Medical aid is a necessity for South Africans, and the reason is simple. To get the best treatment is to visit a private healthcare facility or hospital.

    Our state hospitals and facilities are not equipped to provide you with the best possible treatment.

    There are other alternatives to medical aid, however, if you want full coverage then a medical scheme will be the best way to go.

    Companies in South Africa:

    There are great options like this for affordable medical aid under a R1000 or under R300, click the link.

    For more in Afrikaans, go to our goedkoop mediese fondse page.
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