Menu

New Members 0861 56 46 66

Existing Members 0860 10 20 10

Hospital Admission 0860 10 62 05

female surgeon looking at male surgeon wearing face masks

Cost of top 10 open medical scheme hospital plans in SA

Annually, GTC (formerly Grant Thornton Capital), a diversified financial services company, publishes an in-depth investigation into the array of medical aid plans and benefits. Their GTC Medical Aid Survey originated from the need to make informed recommendations to their clients on preferred plans and benefits for the following year.

 

The GTC Medic al Aid Survey includes the below categories from all open medical scheme plans in their survey:

  • Non-hospital cover plans;
  • Entry-level plans;
  • Hospital only plans
  • Saver with and without carry-over medical savings account plans;
  • Comprehensive plans;  and
  • Traditional plans.

The focus of the survey is predominantly on the comparison and rating of the major medical risk elements provided by medical schemes, i.e. in-hospital cover.  According the Council for Medical Scheme’s latest Annual Report, the majority of healthcare costs paid by medical schemes were for in-hospital procedures.

This article will specifically focus on hospital plans where members can make use of any private hospital or doctor and are not restricted to a selected network of providers.

Hospital plans are designed to provide cover for private healthcare funding for the unknown or perhaps unexpected and expensive mishaps in life, such as a big accident, illness, disease or planned hospital events, such as giving birth.  In order to keep contributions affordable, day-to-day (out-of-hospital) expenses are mostly funded by members, as and when needed.

Choosing a hospital plan that provides the best possible cover and value for money can be quite a daunting task as medical schemes in South Africa all market and position their benefit options differently.

The GTC Medical Aid Survey relating to non-network hospital plans (their “Core” analysis) evaluated the cost vs benefits provided by 21 open medical scheme hospital plan benefit options.  These plans provide in-hospital cover only with the exceptions of chronic illnesses and Prescribed Minimum Benefits (PMBs).

The below table lists the top 10 “Core” hospital plans from open medical schemes in South Africa included in the above survey, in order of their cost vs benefit rating (best value for money), but is now updated to indicate the 2017 monthly contributions which will be effective from 1 January 2017.

Ranking Medical Scheme Benefit Option Dependants Monthly Contributions Rate of Cover for Doctors / Specialists
1 Genesis Private Choice * 1 A

2 A

2 A + 1 C

2 A + 2 C

R1 000

R2 000

R2 325

R2 650

100%
2 Bestmed Beat 1 * 1 A

2 A

2 A + 1 C

2 A + 2 C

R1 257

R2 233

R2 762

R3 291

100%
3 Keyhealth Essence* 1 A

2 A

2 A + 1 C

2 A + 2 C

R1 278

R2 291

R2 718

R3 145

100%
4 Suremed Shuttle * 1 A

2 A

2 A + 1 C

2 A + 2 C

R1 320

R2 300

R2 840

R3 380

100%
5 Topmed Hospital *

(renamed to TopMed Essential)

1 A

2 A

2 A + 1 C

2 A + 2 C

R1 458

R2 632

R3 224

R3 816

100%
6 Bonitas BonEssential * 1 A

2 A

2 A + 1 C

2 A + 2 C

R1 473

R2 600

R3 032

R3 464

100%
7 Resolution Hospital * 1 A

2 A

2 A + 1 C

2 A + 2 C

R1 565

R2 900

R3 485

R4 070

100%
8 Genesis Private * 1 A

2 A

2 A + 1 C

2 A + 2 C

R1 500

R3 000

R3 365

R3 730

200%
9 Cape Medical Plan Premium ** 1 A

2 A

2 A + 1 C

2 A + 2 C

R1 548

R3 096

R3 367

R3 638

200%
10 Selfmed MedXXI Information not available at the time of compiling this table.

Choosing the right medical scheme and hospital plan to join is a pretty big, somewhat daunting task, as you are buying insurance cover for the unknown future mishaps in your life.  As medical cover (as well as unexpected medical expenses) can take a huge chunk out of your monthly income, it is important to do your homework properly.   Whilst most medical schemes will cover hospital and related accounts, such as X-rays and blood tests, in full, members must do their homework properly and find out about specific benefits and / or limitations, what the scheme rate is, the list of scheme exclusions, the solvency ratio and the payment record of the medical scheme, to name but a few.  Make sure that take the medical aid benefit option that will provide the best cover considering your healthcare needs along with what you can afford.

Please note that the information provided is for information purposes only and is not intended to flout or in any other way compromise the conditions prescribed in the Financial Advisory and Intermediary Services Act’s General Code of Conduct insofar as comparing different financial products with each other is concerned.

Ranking information contained in the above table has been obtained from the GTC Medical Aid Survey (2016).
* Benefits and pricing information contained in the above table have been obtained from BrokerTools.
** Benefits and pricing information contained in the above table obtained from the scheme’s website.

Article written by Elmarie Jensen: Genesis Medical Scheme.

LiveZilla Live Chat Software