Medical Aids

Looking for information on medical aids? Browse through our articles on medical aids in South Africa. Please note that Vitacare Health & Lifestyle is an online health magazine and we are not associated with any medical scheme. Policies among medical aids may differ and each year brings about new changes. Some of the information could be outdated. Always speak to a medical aid scheme or accredited medical aid broker about individual policies.

• Medical Aid Short Paid Provider’s Bill
  Short payment by medical aid is becoming more common these day as more practitioners move away from NHRPL tariffs and charge private rates. Until recently, patients were not aware that they would be faced with a bill above and beyond what medical aid pays for these procedures. However, practitioners are now required by law to ...
• How Medical Aid Rates Differ From Private Cash Rates
  Over the years, more doctors and other service providers in South African have opted to contract out of medical aid and charge private rates. It has been an issue of contention among medical aid members who find that they still have to pay cash to health care practitioners despite paying their monthly medical aid contribution. ...
• Cost To Company (CTC) Medical Aid Tax Benefits and Credits
  These days your salary package is quoted as cost-to-company. This means that your actual pay as well all the benefits should not exceed the CTC amount. It gives you some flexibility in deciding in how your salary package will be structured but it can be confusing at times, especially if you are not financially-inclined. The ...
• Will Medical Insurance Replace Medical Aid?
  Most of us in South Africa have come to accept that medical aid is a matter of necessity rather than an optional extra. If you want to access private health care services, be it your GP, a specialist, blood tests and scans or treatment in a private hospital, then medical aid is the only means ...
• Get The Right Medical Aid Cover For You
  These days it is practically inconceivable to be without medical aid. But with diminishing benefits and rising contributions, medical seems unaffordable at times. If you have decided that you need medical aid cover then shop around carefully. The fact is that most medical aids offer pretty much the same benefits for similarly priced plans. But ...
• Choosing Between Hospital Cash Plan and Medical Gap Cover
  We all want to ensure that we have the maximum cover for funding our healthcare needs should the situation arise. While medical aid is the primary option for doing so, it may not always pay for every service, procedure, test or drug. Sometimes it is related to doctors who charge above the rate that the ...
• 5 Reasons Not to Give Up Your Medical Aid
  Medical aid is not cheap. But the benefits of a medical aid, and the situations you may face without it, is often motivation enough for most of us to pay the premiums. When times are tough and your budget is close to breaking point, giving up your medical aid may seem like a consideration. A ...
• Low Medical Aid Premiums May Mean Poor Service From Your Scheme
  Medical aids were quick to respond to the growing demand for cover from the lower income sector. In recent years we have seen a number of different plans emerge among the big medical schemes that offered cover from as little as R500 per month. Not just hospital and chronic cover – it also included benefits ...
• Medical Aid for Pregnant Women (Pregnancy and Childbirth)
  Finding out that you are pregnant when you do not have medical aid cover can be a concern for most women. Government health facilities are available but most South African women prefer a private hospital for childbirth. It can be expensive without medical aid cover. South African medical schemes cover pregnancy and delivery, which can ...
• Gap Cover for Medical Aid
  There is no denying that private healthcare costs in South Africa, especially with regards to hospitalisation, is exorbitant by any measure. South Africa has one of the world’s best private healthcare systems and this is largely fuelled by the well managed private hospital groups. However, without medical aid most South Africans would not be able ...
• Find the Best Medical Aid Quotes
  Before signing up for medical aid cover, you should shop around for the best deal for you – basically it is a matter of cover that suits your budget and your healthcare needs. Although most medical aids in South Africa pretty much offer the same products and services for the same price, there may be ...
• Medical Aid Refuses to Pay for Treatment Reasons and Recourse
  Medical aids can refuse to pay for certain treatments and this is not considered unlawful. It is often the misconception of medical aid members in South Africa that once you have cover, you are then entitled to reimbursement for all your health related bills. Not so. Medical aid is a form of insurance that is ...
• Medical Aid When Travelling Abroad, Overseas in a Foreign Country
  Whether you are going overseas on a short holiday or having to stay for an extended period of time for personal or work commitments, you should not forget that the onus of proper medical coverage for you and your family rests on your shoulders. Many of us think that since we have medical aid cover ...
• Medical Aid Options for In and Out of Hospital
  Every medical aid has several options to suit different budgets and individual needs or preferences. These options are known as plans and are pre-structured. In this way a prospective member can choose the best medical aid option for themselves and their family. Medical aid options cannot be tailor made for an individual – you need ...
• Changing Medical Aids – Procedures and Factors to Consider
  Changing medical aids is a not a difficult task provided that various procedures are followed to ensure that it is done properly. The greater challenge lies in taking the risk of changing from one medical aid to another and whether this will work in your favour or not. Many medical aid members make decisions rather ...
• Medical Aid Tariffs and Codes
  Reading through your monthly medical aid remittance can often be confusing with columns of codes that makes little sense to the average person. These tariff codes are a standardised means by which medical aids can communicate with each other, healthcare practitioners and other service providers. It removes the need to describe each consultation, medication or ...
• List of Medical Aids Schemes in South Africa (Phone Directory)
  The list of registered South African medical aids was sourced from the Councils of Medical Schemes website. Some of these medical aids may have discontinued business or changed their contact details. This list serves as a guide and Vitacare Health will not be held liable for any incorrect information. Always refer to the medical aid’s ...
• Full Medical Aid Cover or Hospital Plan Only
  Deciding on whether to opt for full (comprehensive) medical aid cover or a hospital plan only, depends largely on the individual and one’s budget. A hospital plan is more affordable and offers protection for the most expensive of services – hospital care. However, one’s medical needs may not require hospitalisation and can still be costly ...
• Is Medical Aid Necessary?
  Private medical aid is not compulsory for South Africans but is often considered as a necessity by most given the overburdened public health system. Medical aid is a form of insurance that differs from medical insurance and national health insurance. The latter, national health insurance, is not as yet available in South Africa (2011). However, ...
• Medical Aid for Foreigners
  Medical aid is a form of insurance that covers the cost of medical services. It is available for foreigners and their family living and working in South Africa but depends largely on the type of visa one has while in the country. Any foreigner who is staying in South Africa for extended periods of time ...
• New Medical Aid with a Change in Job
  Many employees do not consider the impact on their medical aid cover by changing jobs but this is an important consideration from the moment you hand in your notice of resignation. Much depends on whether you are a member of a open (public) medical aid or closed (restricted scheme). Without proper planning you may find ...
• Medical Aid Hospital Pre-Authorisation Number Approved or Denied
  Being a member of a medical aid does not entitle you to walk into a hospital and demand hospitalisation unless it is a medical emergency. Hospitalisation is costly and medical aids carefully regulate which patients are to be hospitalised. This largely depends on the request by the attending doctor and medical reasons that make hospitalisation ...
• Prescribed Minimum Benefits (PMBs) For Medical Aids
  Prescribed minimum benefits are list of conditions and treatments that a medical aid has to cover for every member on its scheme, irrespective of the individual plan or availability of funds for that year. Basically prescribed minimum benefits are an assurance that every member will have medical aid cover when they need it the most. ...
• Medical Aid Membership, Pre-Existing Conditions, Waiting Periods
  Medical aids are an essential form of financial assistance for any person who wishes to utilise private medical services in South Africa. With the spiralling costs of private healthcare in the country, most of us need a medical aid to ensure that we can meet with the financial obligations should we fall ill or be ...
• Medical Aid for the Elderly (Parents and Grandparents)
  Medical aids in South Africa do not have an age limit or age-based restriction. This means that elderly South Africans can join a medical scheme later in life and still enjoy cover. However, when it comes to medical aid for the elderly it is important to understand that there may be higher costs involved. Furthermore ...
• Medical Aid for Professionals
  Certain medical aids only cater for professionals and are therefore restricted schemes. This means it is not open to the general public and there are certain criteria that an applicant has to meet in order to qualify for membership. With medical aids for professionals, the criteria almost always involves having a recognized degree from a ...
• Medical Aid for the New Year
  As the new year approaches, many of us reassess our medical aid cover as many schemes only allow a change in plan at the end of the year. The decision to change your medical aid plan in the new year should be based on both your needs and your budget. It is not possible to ...
• Alternatives to Medical Aid | Hospital Cash Plans, Gap Insurance
  Medical aid can be quite a costly cover and the monthly contributions may consume a significant amount of your income depending on your level of cover. If affordability is an issue, you may consider switching to a cheaper medical aid plan or opting for one of the low cost medical aids. However, other financial products ...
• Medical Aid Cover for a Newborn Baby
  Most medical aids cover newborn babies immediately upon birth at no additional cost for 30 days. Some medical aids may extend this to up to 60 days after the birth. Cover is dependent on at least one parent being a medical aid member and with the hospital birth certificate clearly indicating the parent’s details. However, ...
• Unlimited Medical Aid Benefits
  Having medical aid cover does not mean that you are protected all year round for private healthcare irrespective of the cost. All medical aids cap the out-of-hospital benefits although many schemes offer unlimited benefits for hospitalisation and emergency services. There is no medical aid that offers unlimited benefits for your day-to-day medical expenses. With a medical ...
• Medical Aid for Road Traffic Accident Injuries (Car Crashes)
  Medical aid cover, especially if you are young and healthy, seems like an unnecessary monthly expense. However, if some mishap should befall you like a road traffic accident, you will quickly appreciate the quality of health care that medical aid cover will afford you. Nobody wants to think of the worst case scenario. But living in ...
• Life Insurance for HIV Positive People
  Life insurance is an essential cover that takes care of your family when you are no longer around. Apart from the benefits to your loved ones, life insurance is also necessary if you want to access a large amount of credit like a home loan. However, being HIV positive means that you may not qualify ...
• Medical Aid for Cancer Patients
  The costs associated with treating cancer can be staggering. Without medical aid cover or the financial means to pay for your treatments in cash, you will have to settle for treatment at a public hospital. Public service strikes, understaffed facilities and overworked state employees are some of the considerations one has to deal with if ...
• Switching Over to a Cheaper Medical Aid Plan
  Although a medical aid is an essential insurance cover these days, at times it can be unaffordable and you may  have no other choice but to consider a cheaper option. If you want to keep your medical aid but cut the costs then you will have to switch over to a lower plan or even ...
• Medical Aid for Domestic Workers
  Any person can join a medical aid irrespective of their job and domestic workers are no exception. However, domestic workers are among the lower paid workers in South Africa and medical aid cover may not always be possible without an employer’s contribution. Unlike UIF and pension, medical aid cover is not obligatory for the employer. Many ...
• How to Change your Medical Aid Plan
  While you can leave a medical and join another at any time, most medical aids have strict policies about changing your plan within the same scheme during the course of the year. This may be restricted altogether or limited according to specific criteria for a number of reasons. If you intend on changing your medical ...
• How to Join a Medical Aid – Apply and Complete Membership Forms
  Joining a medical aid is a simple process. You can either go through an accredited broker who acts as an intermediary between you and the medical aid or you can contact the medical scheme directly and request application forms. Most medical aids now have online platforms where you can enter your details and the scheme ...
• Doctors and Therapists Contracted In and Out of Medical Aid
  Being a member of a medical aid does not mean that you can access medical services from any provider without having to pay any cash fees. At times there is a misconception by medical aid members that a doctor or other medical service provider is forced to treat you and accept payment directly from the ...
• Abortion on Medical Aid, Termination of Pregnancy
  The termination of a pregnancy is the right of every expectant mother in South Africa. However, many women experience difficulty in getting the appropriate advice on the costs and facilities associated with an abortion. There are many private abortion clinics in South Africa and while government hospitals should also offer this service, the strained public ...
• Medical Aid and Childbirth – Cover for Mother & Newborn Baby
  Pregnancy is one of the times when a person reassesses their medical aid cover as the costs associated with childbirth can be expensive. Considering the high costs of private health care, it is only natural for mothers to be concerned about the extent of cover for their pregnancy and childbirth, as well as cover for ...
• Medical Savings Account for Out-of-Hospital Benefits
  Many medical aids now offer a medical savings option on some plans which fund day-to-day medical expenses but can also be used to supplement any in-hospital costs that are not covered by your medical aid. Unlike the predefined day-to-day limits or insured out-of-hospital benefit, a medical savings account does not expire at the end of ...
• Company Medical Aid – Employer Contributions, Employee Cover
  A company medical aid is any medical scheme cover subsidised by the employer. Sometimes this is cover on a restricted or closed medical aid which is only available to employees of a specific company or sector of industry. At other times, employers may subsidise monthly medical aid contributions for their employees on open medical aids. Employers ...
• Medical Aid Hospital Plans
  A hospital plan is medical aid cover that provides benefits for in-hospital (inpatient) visits and procedures. Most medical aid hospital plans also provide chronic medication cover. Private health care is expensive and hospital costs are staggering should you not have medical aid cover. A hospital plan is not a complete medical aid with day-to-day cover ...
• Medical Aid for Pensioners, Retirement and Senior Citizens
  Medical aid is an important cover that is more often required as you get older. Chronic conditions are more likely to arise in your senior years. Therefore your health care needs grow exponentially, at a time when you may be a pensioner with a limited income.  The issue of affordability always arises in retirement and ...
• HIV Pregnancy – Falling Pregnant when HIV Positive
  People living with HIV have the same reproductive rights as any other person and it is not uncommon for an HIV positive man or woman to consider having a child despite the risks associated with conception. However, women who are HIV positive and planning to fall pregnant or women who are negative but wanting to ...
• Medical Aid for the Disabled, Handicapped
  Many people living with disabilities are as healthy, if not more so, than a person without any handicap. However, not all disabled people are able to take care of themselves or function to such a high degree. The medical costs for a person who is physically disabled and/or mentally handicapped can be significantly more as ...
• How to Prevent the Flu and a Common Cold
  The seasonal flu (influenza) and the common cold are two viral infections that are contracted many times in a person’s life. These conditions are not life threatening in a healthy person and within 3 to 5 days, the most severe stages of the infection should pass. It is not unusual to get the flu or cold ...
• Low Cost Medical Aids for Low Income Earners
  Medical aid cover for low-income earners continues to be a contentious issue. The cost of medical aids in South Africa means that it is unaffordable for most low-income earners and up until a few years back, any portion of the medical aid premium that was subsidised by the employer was liable for tax. However, even ...
• What is Medical Aid?
  What is Medical Aid?
• Medical Aid for Single Child, Minors, Children
  Medical aids in South Africa do not accept a child or children under the age of 18 years to be the only members on the scheme without an adult member (main member). There are certain special circumstances where this will be allowed but it should be discussed with the individual medical scheme or an accredited ...
• Medical Aid When Retrenched and Unemployed
  Facing the prospect of retrenchment can be quite taxing on any person and one has to consider a host of financial hardships that will inevitably arise due to the lack of employment. Most people choose to trim unnecessary expenses and insurance cover as well as medical aid is often stopped in order to stretch the ...
• Medical Aid Cover for HIV Positive People and AIDS Patients
  Medical aid cover is open to a person who has been diagnosed as HIV positive and in most instances, there is no additional cost for the benefits. Most medical aids in South Africa do have strict exclusion policies where any pre-existing chronic condition will not be covered in the first year of joining the medical ...
• Do Medical Aids Pay For LASIK (Eye), Cosmetic, Plastic Surgery?
  Medical aids classify certain procedures as non-essential – meaning that it is not of a life-threatening nature should it not be conducted. LASIK eye surgery and cosmetic surgery are considered as non-essential service. While most medical aids in South Africa will partly cover the costs of the LASIK procedure, almost all medical aids do not ...
• What to Look for in a Medical Aid?
  Medical aid cover is essential if you want to quality medical care at a private facility. While there are hundreds of options, with different medical aids in South Africa offering a variety of plans, making the correct choice at the outset is important – both for your budget and your health care needs. The reality ...
• Is Your Medical Aid Financially Stable?
  The past two years (2008, 2009) have seen a few small medical aids in South Africa becoming insolvent and filing for dissolution before the year end. This has left their members in the lurch, despite promises to pay outstanding medical bills to doctors and other practitioners. While medical aid members may claim to be ignorant, ...
• Medical Aid Exhausted – Insufficient Funds
  Out-of-hospital medical aid benefits are not unlimited and most members would have experienced a situation where their medical aid funds were exhausted. Once your funds are depleted for the year, you will have to wait for the following year in order to qualify for the new benefit allocation. This is every medical aid member’s nightmare ...
• Insurance Policy Declined – Medical Reasons
  There are a number of reasons why your insurance application may have been rejected and this varies among different companies and types of policies. For insurance policies providing life cover, dread disease or disability benefits as well as physical impairment and income protection, certain medical tests would be required. The results of these tests in ...
• No Medical Aid
  Medical aid cover is considered essential these days as the cost of private health care continues to rise. Even the simplest of ailments can be financially crippling if you need to be hospitalized or require extensive tests and investigations. While the public health care system strives to meet the needs of the population, there is ...
• Best Medical Aid in South Africa
  Searching for the best or cheapest medical aid available in South Africa, you will undoubtedly discover that most medical schemes have plans that are pretty much the same in price and benefits. No single scheme really stands out as the best medical aid in South Africa and each have pros and cons which you should ...
• Family Medical Aid
  Providing medical aid cover for your family is an essential undertaking that does not come cheap. Medical aids in South Africa can be pricey to say the least but without medical cover, you will be at the mercy of the understaffed and overworked public health sector. Family medical aid usually involves the main member along ...
• Affordable Medical Aid
  Medical aids in South Africa are not cheap but the number of medical schemes with different plans and options will contain an affordable medical aid that is right for you. It is not a matter of joining the ‘best’ medical aid. All medical aids offer various plans which are similar. The decision you make for ...
• Medical Aid Suspended – What does it mean?
  Under certain conditions, your membership of a medical aid may be suspended. In the event that this occurs, you should contact your medical aid immediately and find out why they have suspended your membership If they have a valid reason then you should follow their instructions to get your membership reinstated. If your membership was ...
• Student Medical Aid
  Once you reach the age of 18 years, you may not be eligible to remain on your parent’s or guardian’s medical aid at the same dependent rate for children. Most medical aids in South Africa may want to increase the rate at age 18 while others will do so at the age of 21 years. ...
• Medical Aid Doctors and Private Rates
  Medical aids in South Africa are essentially a health insurance. In the event that you need to access medical services, your medical aid will ensure that you have financial cover to meet your bills. Many practitioners, pharmacies and all private hospitals claim directly from your medical aid so as not to inconvenience you with up ...
• How to Claim Back From Your Medical Aid
  Being a member of a medical aid does not guarantee that all your medical bills will be paid directly by your scheme. Certain medical aid restrictions and providers contracted out of medical means that you have to pay cash for these services. In most instances, your medical aid will then reimburse you directly for these ...
• Cheap Medical Aid in South Africa
  The high cost of private health care in South Africa usually means that if you do not have a medical aid, you will have to settle for the public health facilities. Unfortunately medical aids in South Africa are not affordable for a large portion of the population and only 1 in 7 South Africans have ...
• Travel Insurance Policy, Medical Benefits and Health Care Abroad
  Travel insurance should be an essential part of  your holiday plans as it offers comprehensive benefits for the duration of your travel. Apart from the lost luggage and stolen credit card cover, a good travel insurance plan should also offer a wide range of medical benefits. Travelling in a foreign country, you cannot be certain ...
• Hospital Plans Providing Cash Back Are Not Medical Aids
  There has been much confusion about the concept of hospital insurance plans which offer the beneficiary a daily cash remuneration for each day in hospital. These insurance plans are not medical aid hospital cover. Most private hospitals in South Africa will not recognise these insurance plans as being suitable financial backing for medical services and ...
• Compare Medical Aids, Rates and Budget Plans
  Joining a medical aid is always recommended especially if you have a family as the rising costs of private health care is not affordable for most South Africans. Medical aid cover will provide you with a sense of security and should any medical emergency arise, you can rest assured that your comprehensive cover will allow ...
• Medical Aid Scheme Exclusions for New Applicants
  Most medical aids in South Africa will accept any applicant wishing to join their scheme without requesting blood tests to verify diseases or medical disorders. However, applicants are requested to divulge all their pre-existing conditions or significant past medical history to the medical aid upon application. Failure to do so could have serious implications in ...
• Road Accident Fund Claims in South Africa
  The influx of foreigners to South Africa with the upcoming sporting events means that the Road Accident Fund (RAF) will once again be in the spotlight should it face hefty claims from visitors. In 2008, a R1.6 billion payout to a Swiss tourist after a road accident that left him paralysed meant that the Road ...
• About Medical Aids in South Africa
  What is a medical aid? A medical aid is a form of financial where the medical scheme covers the costs of a member’s medical needs. Should you require medical attention, you can visit a doctor or a hospital and your medical aid will pay for most, if not all, of your medical expenses. In South Africa, ...