We will focus only on health insurance, hospital plans, and gap cover.
The cost of living keeps rising, with Discovery Health Medical Scheme increasing its contributions from Wednesday, 1 April.
The latest hike to medical aid costs in the country is forcing many South Africans to decide what to prioritise and what to forfeit. Insurance and quality healthcare are often the first to go, since people don’t feel they need them until an emergency arises.
Rather than relying on faith alone because medical aids are too expensive, it’s wise to explore alternatives, similar to medical aids, that can still give you access to quality healthcare in the country.
Different healthcare cover options
For this article, we will focus only on health insurance, hospital plans, and gap cover. Health insurance mainly covers everyday medical needs such as doctor visits, basic tests, and medication.
Hospital plans, on the other hand, only cover you when you are admitted to hospital for serious illness or injury.
Gap cover is not a standalone option, but rather a top-up that helps pay the difference between what your medical aid or hospital plan covers and what healthcare providers actually charge.
Health insurance
Dis-Chem, a pharmacy retailer has health insurance plan from R549 per month. It is similar to a medical aid, but differs in that it offers more limited, defined benefits rather than comprehensive cover.
What Dis-Chem’s health insurance covers is Private Doctors (GPs) consultations, medication, maternity care, dentistry, eye exams and glasses, tests, scans and screenings, and counselling.
Discovery Health also has a health cover starting from R459 per month offering unlimited GP consultations, X-rays, Flu vaccine, including maternity benefit amongst others.
However, another plan starting at R539 per month, which offers more benefits such as Specialist consultations, Dentistry, Optmetry. What health insurance does not cover is unlimited hospital treatment and full benefits for chronic or long-term conditions like a medical aid would.
Hospital plans
Then there are hospital plans for people who hardly make visits to the doctors’ offices, however, these are a bit more pricy than health insurance plans.
Affinity Health has hospital plans starting from R1 438 per month, to add a spouse it would cost an additional R1 328, an adult dependant would cost the same amount as a spouse. While a child dependant would cost an additional R438 each.
However, for seniors over the age of 54 it would cost R1 578 per month for policyholders, and an additional R1 478 for a spouse. The plan covers hospitalisation due to accident, illness, serious illness and major trauma. Also Emergency Casualty Room Treatment and 24-Hour Emergency Services.
Gap cover
Sanlam is one of the companies that offers gap cover plans. This is the type of insurance that helps pay the difference between what your medical aids or hospital plan covers and what doctors or specialists actually charge.
The company noted that the cost for in-hospital procedures or outpatient treatment can often exceed the base medical aid rate by an additional six times. The additional amount would have to come out of the individual’s pocket, but with gap cover, one would not have to worry.
Sanlam offers gap cover plans starting from R346 per month for people under the age of 60, those over the age would pay from R899 per month.
Costs differs by age
Zestlife, a company that focuses on gap cover and other insurance products has three different options.
Zestlife’s Optimal Gap Cover is designed for people under the age of 35 and costs R276 per month.
While the Essential Gap Cover is a middle‑tier option with broader cover for common shortfalls and is priced from R429 per month depending on age, with slightly higher rates for older adults.
The most comprehensive is Universal Gap Cover, which provides higher limits and wider protection for both individuals and families but costs more, typically from R591 per month depending on age and whether dependants are included.