South African Medical Aid : Advantages and Disadvantages

South African Medical Aid : Advantages and Disadvantages

You insure your cars, home and other material items, so why would you decide to put yourself last? Car or home repairs can be very costly, but have you thought about what it would cost to fix YOU if something went wrong?


  1. Through medical scheme cover, members can access some of the best private hospitals in the world.
  2. Medical schemes pay for many other healthcare needs such as nursing, surgery, dental work, medicine, physiotherapy and eye-care.
  3. Medical scheme membership protects members financially if they suddenly have to pay large, unexpected medical costs.




  1. It is expensive and contributions increase every year.
  2. There are sometimes co-payments that need to be made for certain medical services or procedures, many hidden costs involved with schemes. Your scheme might only pay a small amount of your healthcare costs, while you have to pay the rest out of your own pocket
  3. If you live in a rural area, you might not have easy access to private health care facilities.

The reality is that your health, and that of your family, holds immeasurable value to you. It’s also the least predictable factor in your life. This unpredictability is precisely what makes medical aid so important, because you can’t tell for certain when you’ll need it. Sports injuries, road accidents, stress-related illnesses, and terminal illnesses are not examples of things that afflict the elderly. Rather, they’re representative of what can go wrong in anyone’s health at any time.

If you are already on a medical aid scheme

Before you choose the best medical aid option, you need an idea of what your typical health care costs are.

You should also consider the following for you and your dependants over the past twelve months:

  • How much you spent on day-to-day healthcare expenses
  • Where you or any of your dependants admitted to hospital
  • Did you need to visit a specialist regularly
  • How much often do you or your dependants visit a GP
  • Do you and your dependants have any chronic conditions
  • How much do you spend on dentistry, optometry and over-the-counter medicine
  • Did you exhaust your day-to-day benefits and/or savings this year
  • How much did you pay in co-payments and/or deductibles

Then consider which of the expenses listed above were once-off and won’t come up again soon (like childbirth) and which are likely to come up again and again (such as flu).

You should be able to find a list of your medical claims on your current medical aid’s website.