What is emergency medical response

Medical insurance plans in South Africa

South Africa has a variety of medical insurance plans available, and it can be difficult to decide which plan is right for you. This blog post will look at the different types of health insurance in South Africa, and will help you decide which is best for your needs.


What’s the difference between medical insurance and a medical aid?


The most significant difference is that medical insurance plans are offered by for-profit organisations, while medical aids are run by non-profit organisations. Medical aid schemes are controlled by the Medical Schemes Act 131 of 1998, and medical insurance schemes are covered by the Long-term Insurance Act 52 of 1998


Here are a few more defining characteristics of each: 


Medical Aids:

  • Medical schemes pay out the actual medical costs directly to the hospital, doctor, or specialist
  • Medical schemes must provide minimum prescribed benefits for most medical treatments/conditions and 26 stipulated chronic conditions and life-threatening emergencies
  • No maximum entry age 
  • Yearly premium increases
  • Monthly premiums tend to be higher 


Medical Insurance:

  • Day-to-day benefits and hospital cover are limited to pre-determined amounts 
  • A maximum amount per event applies, as well as maximum annual limits 
  • Several serious illnesses are covered if the patient is below 65, but applicants aren’t assured acceptance and some medical conditions are excluded 
  • Clients aren’t necessarily charged the same premiums (their individual risk factors are taken into account)  
  • In general, medical insurance schemes offer less overall cover than medical aid schemes
  • Monthly premiums tend to be lower 


Types of health insurance in South Africa 


Of course, the main reason people choose health insurance over a full-cover medical aid is cost. If you can’t afford a medical aid, then these are some of the medical insurance plans you can look at as alternatives: 


  • Hospital plans cover all in-hospital treatment and medical costs incurred by the insured. The patient pays all other costs, like specialists, GP visits, procedures or tests 
  • Gap cover is a short-term insurance policy designed to cover the shortfall where specialists or doctors charge more than the medical aid amount.
  • Emergency medical insurance covers unforeseen medical emergencies and accidents, and often includes the provision of an ambulance, medical evacuation if needed and hospital admission. 
  • Hospital plans with some day-to-day benefits aim to bridge the gap between medical aid plans and hospital plans, and tend to cover casualty visits, GP visits, and chronic medicines, etc. with some annual limits applied. 


Tips on finding the best medical insurance in South Africa 


Here’s what to consider when shopping around for health insurance in SA


  • Do you or any of your family members have particular health issues or chronic conditions (like diabetes, hypertension, asthma etc) that need to be accommodated? Meticulously check all the benefits and exclusions against these. 
  • Your budget is crucial! To get the best insurance that you can afford, you must shop around. Just remember that very cheap medical insurance might not give you the cover you need.  
  • Consider the number of dependents you have and any chronic conditions they have. 
  • Are there any big life changes on the way in your life? Are you going to retire, get married, or have a baby in the near future? 
  • Check what the overall hospital limits are of your plan as compared to the cost of a week or two in hospital. You may be shocked!

Emergency medical insurance from EMERGIVAC 

If your budget really can’t stretch to any of the plans we talked about above, or you want additional cover and peace of mind in a crisis, then emergency medical insurance is the perfect solution. 


Here are just some of the benefits you’ll receive as an EMERGIVAC member: 


  • Death and disability cover 
  • Immediate medical emergency response 
  • Guaranteed hospital/trauma room admittance 
  • Helicopter transference to nearest healthcare facility if needed.
  • Emergency telephonic medical advice, emotional support, and tele-counselling.
  • Provision of life-saving medication and blood
  • Armed response, household, and roadside assistance 24/7/365


Premiums start from as little as R249 per month, so get a quote now!


Submit a Comment

Your email address will not be published. Required fields are marked *