Update: This article has been updated to include correct product information for Discovery Health, and to clarify the group’s Flexicare positioning in the market.
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 a R431 monthly fee product, whereas TymeHealth will charge R139, depending on the type of cover sought.
BusinessTech compiled a list of medical aid schemes offered by popular providers based on their affordability and price entry points.
South Africa’s most prominent medical insurance provider, Discovery, offers an affordable medical aid option through its KeyCare Series starting at R968.
This level entry offering includes the following:
- Unlimited hospital cover in our KeyCare hospital networks.
- Guaranteed full cover in hospital for specialists on the KeyCare network, and up to 100% of the Discovery Health Rate (DHR) for other healthcare professionals.
- Cover for comprehensive pre-and postnatal healthcare services for maternity and early childhood.
- Unlimited cover for medically appropriate GP consultations, blood tests, X-rays or medicine in the group’s KeyCare networks on the KeyCare Plus and KeyCare Start plans; and
- Essential cover for chronic medicine on the KeyCare medicine list for all Chronic Disease List conditions when you use a designated service provider (DSP).
The financial service provider, boasting a 40% market share in South Africa, also has a health insurance offering called Flexicare, costing R399 per month, with the optional addition of R160 for R400,000 trauma cover or R224, for R1 million trauma cover.
With regard to Flexicare, coverage for a spouse or adult costs R367 per month.
Flexicare is administered by Discovery Health and underwritten by Auto & General Insurance Company Limited. The Trauma Benefit is a non-life insurance policy, underwritten by Discovery Insure Ltd. The Funeral benefit is a life insurance policy, underwritten by Discovery Life Limited.
|Flexicare (health insurance)||R399|
|KeyCare Series (Core)||R968|
|Executive Plan||R7 688|
In October 2021, Discovery announced that contributions for 2022 will increase by 7.9%, effective from 1 May 2022
The Flexicare product offers members:
- Unlimited doctor consultations.
- Procedures performed in doctors’ rooms.
- Day-to-day maternity benefits, including GP visits, day-to-day medication, blood tests and ultrasound scans.
- Health and wellness screening.
- Over-the-counter medicine.
- Chronic conditions and HIV treatment.
- Covid-19 testing and out-of-hospital management and appropriate supportive treatment.
- Ambulance services
- Optional trauma benefit.
The group’s KeyCare Series (Core) offering is explained above – offering affordable medical cover if you’re willing to use providers in a specified network for both in-hospital and out-of-hospital treatment.
Discovery’s most expensive and extensive cover option is its Executive plan which includes the following:
- 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 in- and out-of-hospital maternity benefits for the full maternity episode of care.
Access to global treatment in South Africa and abroad.
- Additional cover when medical savings runs out for essential healthcare services.
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.
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.
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.
|Standard Select||R3 822|
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.
- Basic Dentistry.
- General appliances such as wheelchairs.
- Mental health.
- 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.
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.
The Ingwe Option offers full medical cover to students. It is an entry-level medical aid option with hospital cover, day-to-day and chronic illness benefits through a network of providers.
The group’s Evolve Option, starting from R1,345 (R1,424 after 1 September 2022), provides hospitalisation at the Evolve Network of private hospitals with no overall annual limit.
|Summit Option||R10 642|
The Ingwe Option 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 Evolve Option includes:
- Cover for hospitalisation at the Evolve Network of private hospitals. There is no overall annual limit for hospitalisation.
- A standard Evolve option co-payment for all Major Medical Benefits, except in the case of motor vehicle accidents, maternity confinements or emergency treatment.
- You need to use State facilities for all your chronic treatment, including doctors, scripts, and medication.
- You have cover for two virtual GP consultations from Hello Doctor or Evolve Network GPs. The Health Platform provides cover for a range of day-to-day benefits, such as preventative screening tests, certain check-ups, and more.
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.
Momentum Health Solutions also provides client flexibility through its Health4Me product, which sits alongside its medical scheme solutions. The product has grown to cover more than 120,000 members. It has a range of building blocks that cover day-to-day health care benefits as well as major medical insurance elements, such as emergency cover. In addition, it offers free airtime to it members if they improve their health.
Momentum Health Solutions also offers three day-to-day benefits options, these being Bronze, Silver and Gold with prices ranging from R189 to R299 depending on the level of cover the client wants to purchase.
- Health4Me Bronze R189
- Health4Me Silver R238
- Health4Me Gold R299
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.
|Savings plans||R2 148|
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.
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.
|Core and Accident Cover||R486|
The Dis-Chem Health Core scheme provides for a broad spectrum of problems that may arise by offering:
- Private doctors.
- 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’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.
|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 and oncology to midwife-assisted births.
- Out-of-hospital benefits, including an overall day-to-day limit of R37,367 and diabetes care.