Health Insurance vs
Medical Aid - Know the difference! Get your health insurance quote here.
Now, more than ever, all South African families
need excellent health
insurance. You need to know the benefits of health insurance vs medical aid. Let us send you a
personal health insurance quote
Health Insurance vs Medical
Are you confident that you know what to do when you get sick? Before you go on any
holiday, do you know who to call and where to turn in case of an emergency? Do you know the difference
between benefits of medical aid vs health insurance also?
The most important thing is to be prepared. But with what? Health insurance vs
Health care is dreadfully expensive in South Africa. So expensive in fact, that some
people simply die. They never had the means to afford the treatment that they so badly needed.
If you are financially able, you should at least have some kind of medical cover. This
will require you comparing the more affordable health insurance with the more expensive medical aid plan.
There are some major differences between them.
Huge differences in costs and
It’s not just a case of cost, you have to look at the benefits
The Medical Schemes Act in South Africa regulates all the different closed- and open
medical aid schemes. These schemes all have to comply with their rules and regulations. One rule is that
people looking to join a medical aid can’t be turned away in terms of illness or their
When comparing medical aids and health insurance, you could say that one of the more
noticeable differences is the price. Medical aid plans are notably more expensive. Their monthly premiums
can be 3 or 4 times higher than health insurance premiums.
Yes, medical insurance is far more affordable, but paying less means you also get
That is why before you get lured by the lower prices, you need to look deeply at your
health needs. Yes, some of the more comprehensive health insurance plans
may include more. They may offer hospital care for an
accident or emergency, up to a certain amount. You have to check all
Medical aid schemes offer a full quota of hospital cover, and depending on your plan, they
will offer a huge selection of in-hospital
Gap cover – paying for medical aid
These days there is always a shortfall between
medical aid rates and those rates that the medical specialist charges. So essentially medical aid policy
holders have to pay their huge medical aid premium each month and then still pay for gap
Gap cover is what covers these shortfalls. This makes medical aid members feel that
medical aids aren’t doing their job properly. They’re taking more money but offer less and less services.
Health insurance offers less services but their premiums are far less.
In South Africa, most people don’t have the financial means to belong to a medical aid,
and then health insurance offers this affordable healthcare option. With health insurance you get a fixed,
lump sum, regardless of the treatment you receive.
Does the lack of PMB’s concern
Unlike medical schemes, health insurance is regulated by the Short-term Insurance Act.
Also, unlike a medical scheme that has to include cover for prescribed minimum benefits or PMBs, health
insurance plans don’t have to include cover for the
prescribed minimum benefits. Does this concern
As an insurance policy, these health insurance plans also provide the benefit of death and
funeral cover, whereas a medical aid can’t include these benefits. Something else to consider is that
medical aid contributions are deductible for tax purposes. Health insurance premiums
Whatever your choice, be
Medical schemes are expensive and it is exactly why so many South Africans are looking at
the more cost-effective health insurance. It is important to discover everything you can
about health insurance vs medical aid just so that you
minimise your risk of not being covered the way you expected.
Go here for a table of