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Cost of the top 10 Hospital Plans in South Africa in 2019

What will the top 10 hospital plans in SA cost in 2019?

Media reports suggest that less than 16% of South Africans can afford private healthcare cover making medical scheme cover an unaffordable luxury for the majority of South Africans. Many of those that are fortunate enough to afford medical scheme cover select hospital plans as an “affordable” choice making their popularity increase. Medical aid plans can broadly be categorised in two types of cover:

  • Hospital plan benefit options provide cover for treatment when a member is admitted to hospital. Hospital and related accounts, such as theatre costs, X-rays, medication, blood tests, blood transfusion, etc., are usually covered in full, whereas doctors’ and specialists’ fees will be reimbursed at the medical scheme rate.
  • Extended cover plan benefit options usually provide the same level of in-hospital cover as hospital plans, but over and above that, members have additional out-of-hospital benefits in the form of a medical savings account. Some medical schemes also provide additional cover by means of stated benefits, i.e. where members will have a defined benefit for acute medication, consultations, optometry benefits, etc.  Extended cover plans are generally more expensive than hospital plans, as the additional benefits that members have via their savings or other stated out-of-hospital benefits, are included in the monthly contributions.

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

The most recently published GTC Medical Aid Survey, annually conducted by GTC Healthcare, compared different categories of medical aid benefit options. According to Jill Larkan, Head of GTC Healthcare Consulting, the 2018 GTC Medical Aid Survey included both micro (performance of plans based on monthly premiums) and macro (overall health of a medical aid) rating factors, as well as the likelihood of member support towards a particular medical scheme and its plans.

Based on the results of the 2018 GTC Medical Aid Survey, the top 10 (out of 37) open medical scheme hospital plans in South Africa, are listed below (in order of single adult contributions).
The table lists the cost per adult member, as well as the cost of two adults + 2 children for 2019. It also highlights the likelihood of member support of each of the plans.

The GTC survey is described as a “definitive national survey”, however, whilst it is a powerful tool in itself, it is best used as a basis for evaluating and rating different medical aid plans. Anyone choosing a medical aid should always try and select the medical aid benefit option that will provide the best cover considering their healthcare needs along with what they can afford.

The information provided herein 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. Nothing herein contained is intended to be advice and any uncertainty regarding anything said should be referred to an accredited financial advisor.

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