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Medical Insurance

Medical Insurance for daily health care needs

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What is Medical Insurance?

Medical Insurance provides daily health care benefits, including GP visits and medication, with optional limited hospital cover for emergencies and certain procedures at a fixed rate. It does not fully cover all conditions, often leading to out-of-pocket expenses for hospitalization. While it can be more affordable than Medical Aid, the differences in benefits require careful analysis before choosing.

Benefits of Medical Insurance

Hospitalisation Cover
Hospitalisation Cover

Health insurance provides a limited lump sum or daily rand amount for hospitalisation costs, but it is usually a rand amount of events per year for Accidental and Emergency cover only.

Surgery Cover
Surgery Cover

This covers the cost of surgery, including the surgeon's fees, hospital fees, and anaesthesia for Accidental and Emergency procedures.

Prescription Medication Cover
Prescription Medication Cover

Medical Insurance typically includes cover for prescription medications, which is a vital component for managing health conditions and ensuring overall wellbeing. This cover operates based on a formulary—a predefined list of medications that the insurance policy agrees to cover.

Day-to-Day
Day-to-Day

These benefits are related to your general practitioner visits, basic dentistry, and optical benefits at designated network providers, ensuring accessible healthcare services for routine medical needs.

Key differences between Medical Aid
and Medical Insurance

Medical Aid

Regulation: Medical Schemes Act

Range of Cover: Wider

Premiums: Typically Higher

Claim Processing: Typically Faster

Medical Insurance

Regulation: Long-Term Insurance Act (LTIA)

Range of Cover: Narrower

Premiums: Typically Lower

Claim Processing: Typically Slower

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Medical Aid
Medical Aid
Our medical aid plans cover all your approved chronic medication, certain health checks, and emergency visits.