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Medical aid in South Africa provides financial cover for medical expenses for members of schemes who pay a monthly contribution for this cover.
These contributions paid to medical aid schemes (including Discovery Health Medical Scheme) to be pooled and safeguarded to ensure the equitable access to benefits for the scheme's membership. South African medical schemes operate according to social solidarity principles and are non-profit entities. Medical scheme plans are not insurance products and differ from these in several important respects.
Medical aid covers members' healthcare costs such as hospitalisation, treatments and medicine. These costs are covered according to the rules of the medical scheme and the member's medical aid plan type.
Some medical aid plans optionally include medical savings accounts, which are designed to assist members to pay for some of their day-to-day medical expenses. All plans, however, cover Prescribed Minimum Benefits (PMBs) and these include emergency hospital cover. These benefits can never run out and are there to protect members in the event of severe or life-threatening situations where the cost of treatment may otherwise be unaffordable.
All medical schemes in South Africa are governed in accordance with the Medical Schemes Act 131 of 1998, and are regulated by the Council of Medical Schemes.
Discovery Health Medical Scheme is the best choice for you.
Everyone needs some form of medical aid cover. Few of us could afford the costs of long hospital stays or care for serious injuries, surgery, or chronic illnesses - for example, it costs R8 500 a night for a premature baby to stay in a private hospital's neonatal unit (some stay for five months), and that's just the bed, without any consultations, medicine or medical supplies. Medical schemes help us finance life's curved balls when we can't do it alone.
It's advisable to evaluate your medical aid coverage each year to make sure you have adequate cover for your needs or for any changes in your health, for example, deciding to have a child or being diagnosed with a chronic condition.
More importantly, traumatic events like a car accident, crime-related incidents or sport-related incidents can happen to anyone at any age or life stage. The costs associated with one of these random, high-risk events can run into many thousands or even hundreds of thousands of rands, which few people can afford at any life stage - especially when you're young.
For example, in 2024:
Across the top 10 claims, 98% of the costs were covered for members. These totalled R70.5 million: