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Private healthcare in South Africa is very costly. Medical aid is the common method of providing you with protection against these costs and access to medical professionals.

The private healthcare sector in South Arica is one of the nation’s greatest assets and is gaining both political and economic relevance, as it is playing a pivotal role in assisting the government to fulfil its constitutional mandate of providing quality healthcare services to the South African citizen.

In order for you to have a medical aid. You will need to apply for the medical aid scheme. This will also depend on how much you earn and this is the main factor that can determine the kind of medical plan (package) you will be on. The medical aid plans differ according to the amount you will be paying. It is expensive and the pricing varies. It is not the same for an average working mother and her child compared to a company CEO and her child. In order to get certain benefits, you would need to pay a very high amount. Sometimes patients are responsible for paying for healthcare visits where as they are still paying medical insurance, pharmaceuticals, and additional resources such as wheelchairs or crutches. Citizens who can afford to pay for private insurance use private healthcare. The majority of South Africans cannot afford private insurance, so the demand is lower than the demand for public health facilities. The lower demand is the reason there are fewer facilities, so even if someone has private insurance, there may not be a private healthcare facility nearby for them to use.

 

Some of the most common medical aid companies in South Africa and packages examples:

Fedhealth Medical Aid:

All plans include the following benefits: 25 Chronic conditions, Hospital cover, Network partner providers, screening and prevention.

However, the plans have different options like all the other medical aids’ here is an example of some plans:

Maxima EntryZone: The plan is R1424 per month for the main member with the above-mentioned benefits. However, this plan does not have the savings option.
Maxima EntrySaver: It is from R1759 per month for the main member. With this plan you get up to R3396 per year on savings.
Maxima Basis: R2722 per month for the main member for this plan, with savings of up to R4896 per year on savings that can be used for medication, etc.
Maxima Standard: From R2527
Maxima Exec.: This plan is R4805 per month for the main member. A plan that was designed for people who rely solely on medical aid and they want to take proper care of themselves and family.

Momentum Medical aid:

Ingwe plans: This plan depends on how much you earn and what you can be covered for.
Custom plans: The plan starts from R1515 – R2521 contribution per month, for the main member. This plan doesn’t pay for all medical costs. It pays for some, limits apply and all else is paid from the pocket.
Incentive plans: The plan starts from R2006 – R3406. This plan has limits in regards to what the patient can be covered for. And it is only available for certain income levels.
Extender plans: From R4580 – R6464. With this plan you have a savings option however if the saving run out, the self-payment gap with then open.  
Summit plans: This is the most expensive plan. The plan starts from R9269. This plan covers a lot of medical expenses but like all the others, there are certain terms and conditions that will apply.

Discovery health Medical aid:

Hospital - There is no overall limit for hospital cover on any Discovery Health Medical Scheme plan. You can go to any private hospital on most plans.
Chronic Illness Benefit (CIB) - All our plans cover approved medicine for the Prescribed Minimum Benefit Chronic Disease List conditions. Certain plans cover additional conditions
Screening & prevention - You and your children have access to screening and prevention benefits that cover tests to detect early warning signs of serious illness. Having these tests done helps you to stay healthy, because prevention is better than cure.
Above Threshold Benefit (ATB) - Certain plans have an Above Threshold Benefit (ATB) that gives you further day-to-day cover once you have reached your Annual Threshold.
Day-to-day Extender Benefit (DEB) - When you have spent your annual Medical Savings Account (MSA) allocation, we extend your day-to-day cover through the Day-to-day Extender Benefit (DEB) for essential healthcare services in our network.
 
Maternity Benefit - Comprehensive benefits for maternity and early childhood that cover certain healthcare services before and after birth.
Medical Savings Account (MSA) -  On selected plans, we pay your day-to-day medical expenses from the available funds allocated to your Medical Savings Account (MSA) to empower you to manage your spend.

 

All in all, all medical aids differ in prices and cover and members will then choose medical aid cover based on their needs and affordability.

 

Fast Facts

South African healthcare requires more innovation.
Private healthcare in South Africa is expensive. 
Our public healthcare infrastructure is overcrowded.
Many healthcare institutions servicing remote areas across South Africa lack the necessary capacity required to function at their best.
There is a lower to middle income market which cannot afford private healthcare at the current rates, however, they are willing to pay for quality healthcare at a reasonable price.
RH Bophelo identified an opportunity to provide South Africans with affordable private healthcare.

 

Source:

https://www.rhbophelo.co.za/understand-the-south-african-healthcare-industry/

https://theconversation.com/explainer-how-competitive-is-south-africas-private-health-care-sector-99799

https://www.fedhealth.co.za/medical-aid-plans/maxima-exec/

https://rehealth.co.za/momentum/momentum-summit/

https://www.discovery.co.za/assets/template-resources/medical-aid/plan-guides/product-info-document.pdf