There are currently approximately 34 schemes open to the public at this point. There are however approximately 84 registered medical schemes in South Africa. Within these 34 odd open schemes, there are approximately 177 different options to choose from. This certainly gives one choice, but maybe just a bit too much to take in all at once.
The 10 Biggest schemes (in alphabetical order)
- Bonitas Medical Fund
- Liberty Medical Scheme
- Medshield Medical Scheme
Not that bigger is always better, this list does give you an idea of who the players in the market are. You can then do some research on the companies which you feel you would possibly like to deal with.
All scheme options are based on 2 primary types. These being:
1 - Traditional Plans: These plans cover almost all medical expenses (subject to the rules of the individual scheme) and include benefits for in-hospital and day-to-day expenses.
2 - Hospital Plans and Hospital with Savings: These plans cover expenses incurred while in hospital however you are responsible for your own day-to-day medical expenses either via your savings plan or directly from your pocket. These plans are generally more cost effective and are widely available.
The main differences between different medical aids, and options within them, is the cover provided with regard to specialists and other suppliers while you are in hospital.
The Department of Health has published specific rules and tariffs for specific health services and procedures performed in or out of hospital. These tariffs for the Council for Medical Schemes are called the National Health Reference Price List or NHRPL. They are only a guideline for specialists and anesthetists to follow when they charge you for a specific procedure performed in hospital. Most medical providers charge a far higher fee than this rate. Should the specialist or anesthetist charge you 300%, he is actually charging you three times more than the guide price as per the National Health Reference Price List.