Best and worst medical aid schemes in South Africa – with prices

With Discovery Health announcing an average increase in premiums of 10.2% in 2017, it is bound to force many South Africans to look more closely at their medical aid cover.

Discovery Health claims a 54% share of South Africa’s medical aid market, with close on three million customers.

On Wednesday, the company announced that it will be increasing its premiums by between 7.8% and 14.9% across its various schemes from January 2017. The average increase of 10.2% is significantly higher than the 8.6% increase in 2016, and much higher than the CPI forecast of 6.8%.

According to Discovery, the increase is due to a larger number of claims in 2016 than in previous years. Global Credit Ratings has warned that other medical aids will likely follow suit with similar increases.

Other medical aids are expected to announce their price hikes in the coming weeks – with some planning hikes even larger than Discovery’s.

Comparing medical aid schemes is notoriously difficult, as each medical aid provider has a wide array of options, each with its own benefits, terms and limits, making like-on-like comparisons near impossible.

However, one area which speaks to consumers is price, and comparison data drawn up by medical aid brokers, Informed Healthcare Solutions, does an excellent job breaking down medical aid options from major providers, across five main categories.

For a full breakdown of medical aid schemes by each provider, and each category, as well as a detailed comparison of the services you are offered, check out the listings at Medicalaidcomparisons.co.za.

These are the cheapest and most affordable medical aid schemes from 7 insurers, across all 5 categories in South Africa: hospital plans, hospital plans with savings, day-to-day cover, GP networks plans, and comprehensive coverage.

For more comparisons, including other medical aids, which take into account full year costs, factoring in macro and micro comparisons of each scheme, check out our previous coverage of the GTC Medical Aid Survey for 2016.

Note: the prices below refer to 2016 prices, and relate to the cost of the principle member only. Other costs for dependents are listed in the full breakdown. 

Hospital Plans

Hospital plans cover hosptial services used when admitted, typically including anesthetist and surgeon fees. According to IHS, hospitals usually have agreed rates with medical aids, with bills being paid in full.

Hospital Plan with Savings

These plans are the same as the above, but provide members with a limited savings account for day-to-day use.

Hospital Plans with Day to Day Cover

These plans are the same as the above, but typically come with annual limits for day-to-day use, which fall away and are renewed at the end of each year.

GP Network Plan

These plans are typically designed for younger members entering the market for the first time, IHS said. Medical aids work with specific doctors frequented by members. The scheme prices vary depending on income.

Comprehensive Medical Aid

These are the top-tier schemes that typically have unlimited hospital cover, and comprehensive day-to-day benefits.

More on medical aids

Massive increase for Discovery medical aid premiums in 2017

The astonishing number of South Africans who do not have medical aid

South Africans rank the best and worst medical aid schemes

Best and worst medical aids in South Africa