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Health Care and Medical Aid in South Africa

Public versus Private medical facilities in South Africa

Healthcare in South Africa has a huge quality gap between the private and public sector. Public health care sectors in South Africa experience a lack of resources and funding. Fees are charged according to a patient’s income and number of dependents. Fees are next to nothing however, waiting lists to see specialists are very long, and facilities shocking.

Visiting private health sectors are strongly recommended. South Africa’s private health sectors’ standard of treatment, facilities and professionals is of admirable quality.

South African private healthcare is comparatively costly. It is recommended that immigrants organise medical aid to ensure that they are able to pay for treatment received from a gp, specialist or while in hospital.

Who can get Medical Aid in South Africa?

All medical aid companies are open to everyone and no medical aid can decline your application. Because of this, the medical aid companies need to assess the risks they are taking on. Expect to be asked for illness history, bloods and lifestyle.

How to choose the right medical aid scheme in South Africa

There are a number of providers who offer a variety of schemes with varying degrees of cover. Monthly premiums are paid depending on your selected package plan and according to your income and medical history. The main differences between medical aid companies and options offered, is the cover provided with regards to specialists and other suppliers while you are in hospital.

Different medical schemes range from a basic medical plan that covers all in hospital medical fees, to the most comprehensive schemes. When looking for an appropriate medical aid scheme be sure to compare different medical aid plans, to ensure that your medical aid plan meets your individual needs. When considering medical aid, you should seek professional advice from a medical broker who is knowledgeable on all the health care requirements. This person will assist you taking out medical aid that is appropriate for your personal needs and your budget. The cover options include the chronic illness cover, maternity cover, hospital cover; cover for emergencies, operations and specialised treatments, and chronic illness cover as well as out of hospital treatment.

Remember, depending on the plan, your out of hospital treatment or day to day treatment will most likely come out of your medical savings account, which has a yearly limit. Once this limit is reached, then there are no more funds available until the following year. It is a good idea to ensure that this yearly limit is enough to meet your medical needs. You should also investigate the short fall gap cover, which is an option that kicks in once your savings account is exhausted. The GAP cover pays the difference between what the doctors’ charge in hospital and what the medical aid actually pays.

It is therefore often better to undergo expensive specialised tests in hospital, so that it doesn’t drain your medical savings account. E.g. cat scans.

Another thing to take into account is whether you just have a hospital plan or a hospital plan with out of hospital coverage too. There are certain medical conditions which your medical aid, under law, has to cover. This is known as the prescribed minimum benefits. If you are on the cheapest hospital plan option, for instance (which doesn’t cover out of hospital treatment or medication) and you contract one of the listed conditions (e.g. cancer), by law your medical aid will have to pay for your out of hospital treatment.

Medical aid companies in South Africa

The possible medical aid companies include:

Alternatively, immigrants may decide to use Bupa internationalHealthcare International or Aetna, which are all international insurance providers.

If you have any questions regarding medical aid or relocation to South Africa, please feel free to contact us.