For those on a tight budget, finding an affordable yet comprehensive medical aid plan can be a challenge. The good news is that all the major medical schemes in South Africa offer lower-cost plan options that can provide basic coverage at cheaper monthly premiums. These plans are particularly favourable for young, healthy individuals and those looking to manage their finances carefully.
But as with all things in life, it comes with a trade-off. Budget medical aid plans don’t cover everything and often don’t have a savings plan or allow for day-to-day doctor’s visits. However, if you don’t want to lay in a gangrene-infested bed in a public hospital, then a cheap medical aid plan is for you.
What to look for in a medical aid
Medical aids are complicated, and rightfully so. It’s a homogeneous market with a big offering, it’s difficult for medical aids to differentiate themselves other than by including and excluding certain procedures, doctor’s visits, certain medications or only granting access to certain private hospitals. Therefore, it is recommended that you look into the following when choosing a medical aid:
- Provider Networks: Many plans require using specific provider networks to maintain lower premiums.
- Benefit Exclusions and Limits: Each plan has specific exclusions and limits that need to be understood.
- Medical Savings Accounts: Some plans offer or allow the addition of savings accounts for day-to-day expenses such as doctor visits and buying medication.
- Customization: Flexibility to upgrade or customize based on major life events and personal needs. For example, you might want to upgrade your plan to get more benefits.
Choosing the Right Plan:
I love generic lines such as ‘it depends on your unique financial situation’, however, it does. Older people have more doctor’s visits than students or young, working couples. There are also financial constraints and changes to your world to consider:
- Coverage Needs: Determine the level of hospital and day-to-day coverage you need. For example, as a young person you might not need to visit your house doctor every three days.
- Affordability: Ensure the monthly premium fits within your budget.
- Benefits: Consider the specific benefits offered, such as GP visits, dental, and optometry as well as pregnancy cover (which differs slightly between medical aids).
Prescribed minimum benefits
The South African Department of Health has a list of diseases, procedures, conditions and medications that all medical aid should cover. These include pregnancy (some gynaecologist visits and delivering the baby), some chronic medications (e.g. medicine for depression, HIV management such as PReP and antiretrovirals) and certain cancers.
The law requires all medical aid plans to offer the prescribed minimum benefits as part of their package. However, that doesn’t mean the medical aid will pay your hospital visit in full. The Department of Health also gave a base cost that it thinks the doctors should charge, but due to costs such as insurance, is often absurdly low. Therefore, you will need to pay the difference between the two.
Cheapest medical aid in South Africa
If you’re looking for cheap medical aid options, then this section is for you. Many of these are aimed at young professionals, so check the target group column to confirm your eligibility.
Here’s a comparison of the different medical aid offerings detailed in the article, presented in a table format:
| Medical Aid Scheme | Plan Name | Monthly Premium (From) | Hospital Cover | Chronic Medication | Day-to-Day Benefits |
|---|---|---|---|---|---|
| Discovery Health Medical Scheme | Essential Smart Plan | R1,565 | Unlimited network hospital cover | Full cover | GP visits, basic dentistry, maternity benefits |
| Momentum Health | Ingwe Option | R541 | Any private, network, or state hospital cover | Limited | GP/specialist benefits, basic dentistry, standard optometry benefits |
| Bonitas | BonStart Plan | R1,378 | Unlimited private hospital cover from a network | Limited | Unlimited virtual and in-person GP visits, basic optometry, dentistry, maternity benefits |
| Bestmed | Rhythm 1 Plan | R1,432 | Unlimited private hospital cover at network hospitals | Some preventative care covered | Unlimited GP visits, basic dentistry through network, no savings account |
| Fedhealth | flexi FED Savvy | R965 | Unlimited private network hospitalization | Covers 27 chronic illnesses | Flexible day-to-day benefits through savings or pay-as-you-go, virtual GP visits |
| Medical Aid Scheme | Plan Name | Optometry | Dental | Additional Benefits | Target Group |
|---|---|---|---|---|---|
| Discovery Health Medical Scheme | Essential Smart Plan | One eye test with R120 co-payment | One dental check-up with R180 co-payment | – | Younger, healthier individuals |
| Momentum Health | Ingwe Option | One eye test and pair of glasses every two years | One dental consultation per year, excluding specialized dentistry | – | First-time earners, students |
| Bonitas | BonStart Plan | One eye test per year with R115 co-payment | One dental consultation per beneficiary | – | No explicit age limits |
| Bestmed | Rhythm 1 Plan | One eye test per year | Basic dentistry through network providers | Pre-authorization required for planned procedures | No explicit age limits |
| Fedhealth | flexi FED Savvy | – | – | Health screenings, smoking cessation program, 24-hour nurse line access | No explicit age limits |
Discovery Health Medical Scheme – Essential Smart Plan
Discovery’s Essential Smart plan costs from R1,565 per month and covers unlimited private hospital care from a hospital network. It includes full cover for specialists that Discovery has a payment arrangement with, as well as chronic medication and maternity benefits. Day-to-day GP visits and basic dentistry are covered through a Smart GP network with fixed co-pays.
Momentum Health – Ingwe Option
The Ingwe Option from Momentum starts at just R541 per month for an individual. It provides affordable hospital cover either at any private hospital, a specified Ingwe hospital network, or state facilities. Limited chronic benefits and day-to-day GP/specialist cover are available through Ingwe’s provider networks.
Bonitas – BonStart Plan The BonStart plan from Bonitas has a relatively low starting premium from R1,378 per month and provides decent basic coverage, especially for hospitalizations. It includes unlimited virtual and in-person GP visits, limited emergency and acute medication benefits, and basic optometry, dentistry and maternity cover. For hospitalisations, it covers unlimited private hospital care from a network, specialist consultations, limited benefits for MRIs, mental health, rehab, childbirth and more.
Bestmed-Rhythm 1 Plan
The Rhythm 1 Plan costs R1,432 per month for the principal member and adult dependants, and R590 per month for child dependants. This plan is ideal for those who prefer using a network of designated service providers (DSPs) and value preventative care benefits with unlimited family practitioner visits. It offers unlimited private hospital care from a network of hospitals, including Netcare hospitals in South Africa, with pre-authorization required for planned procedures. Emergency admissions to non-DSP hospitals are stabilized and transferred to the closest DSP hospital. Day-to-day benefits are accessible through the Bestmed Rhythm network, covering most out-of-hospital services, with no savings account available.
Fedhealth Flexi FED Savvy Plan
The flexiFEDSavvy plan starts at R965 per month and offers affordable in-hospital cover within a network, unlimited GP and specialist consultations, and virtual GP visits. It also covers 27 chronic diseases at designated providers. Additional benefits include various health screenings, a smoking cessation program, and 24-hour nurse line access. You can choose between a savings plan or a flexible savings plan for day-to-day benefits.
How to Choose an Affordable Medical Aid for Your Circumstances
When evaluating these budget medical aid options, keep the following in mind:
- Use provider networks where required to lower premiums
- Understand benefit exclusions and limits carefully
- Consider tax-free medical savings accounts for day-to-day costs
- Only sign up for the level of cover your family truly needs
- Look for flexibility to upgrade after major life events
Conclusion
While these economical options have more limited benefits compared to top-tier plans, they provide:
- Affordable premiums suited to entry-level incomes
- Catastrophic cover for unexpected hospitalization
- Basic chronic, GP, and preventative benefits
- Flexibility to customize day-to-day expense coverage
While these budget plan options tend to have more limited benefits compared to comprehensive options, they can provide catastrophic cover at an affordable cost. Thought many of the cheapest plans are aimed at students and young people, there are some gems in the list too!
Happy investing!
