Medihelp Medical Aid
Medihelp is one of the 5 largest medical schemes in South Africa and provides cover for approximately 201 000 people. It offers a choice of 11 options and premiums for a single member range from R702 (students) to R10 122. Members have the option of using a hospital of their choice or a plan that uses a network of hospitals – the Elect options and this lowers the contribution rate and makes these options more affordable. A defined list of procedures, on all options, needs to be done in a Network Day Hospital to avoid a co-payment. MedPrime is the most popular option. All options offer maternity benefits and preventative care benefits. Annual contribution increases will be effective from 1st January 2022.
Table of Content
- MedPlus
- MedElite
- MedPrime & MedPrime Elect Series
- MedAdd & MedAdd Elect Series
- MedVital & MedVital Elect Series
- MedSaver
- MedElect
- Lifestyle Programme
Medihelp Medical Aid Plans
Medihelp, one of South Africa’s largest schemes, covers 200,000 members and offers 10 plan options. Contributions range from R597 for students to R9,180. The Prime 3 plan is the most popular, with maternity and preventative-care benefits included.
| Plan | Contributions Range (Main) ZAR | Contributions (Main Member) | Contributions (Adult Dependant) | Contributions (Child Dependant) |
|---|---|---|---|---|
| MedElect Student | R750 | R750 | R750 | R750 |
| MedVital | R990 - R2,880 | R2,880 | R2,214 | R990 |
| MedAdd | R1,032 - R3,720 | R3,720 | R3,138 | R1,260 |
| MedSaver | R1,200 - R3,900 | R3,900 | R3,204 | R1,200 |
| MedElect | R1,014 - R3,126 | R3,126 | R2,448 | R1,014 |
| MedPrime | R1,548 - R5,304 | R5,304 | R4,482 | R1,548 |
| MedElite | R2,214 - R8,172 | R8,172 | R7,650 | R2,214 |
| MedPlus | R3,540 - R14,184 | R14,184 | R14,184 | R3,540 |
*Contributions may differ based on specific requirements. It is recommended to contact MediHelp for detailed and personalized information.
MedPlus
MedPlus (previously called Medihelp Plus) is suited for individuals requiring extensive medical cover. It offers unlimited hospital cover at a hospital of choice, with in-hospital specialist bills paid at 100%. Day to day costs are subject to defined annual limits and / or an annual benefit pool limit.
MedElite
MedElite (previously called The Elite option) is suited for individuals requiring extensive medical cover. It offers unlimited hospital cover at a hospital of choice, with in-hospital specialist bills paid at 100%. Co-payments are applied to specialized radiology and / or scopes and a few other in-hospital procedures. Day to day claims are paid from savings. Once savings depleted, claims are paid from an annual block benefit. Optometry and dentistry claims are paid from a separate benefit (risk).
MedPrime & MedPrime Elect
MedPrime (previously called Prime 3) is an all-round general cover plan which offers unlimited hospital cover at a hospital of choice or if selecting the Elect option, through a hospital network, with in-hospital specialist bills paid at 100%. Co-payments are applied to specialized radiology and / or scopes and a few other in-hospital procedures. Hip/ knee/shoulder replacements are only covered in the case of acute injury (Prescribed Minimum Benefits only). Day to day claims are payable from a savings benefit. Once savings have been depleted, a block benefit is available for certain claims. Additional risk benefits are also provided for dentistry, optometry and specialised radiology.
MedAdd and MedAdd Elect
MedAdd (previously called Prime 2) offers unlimited hospital cover at a hospital of choice or if selecting the Elect option, through a hospital network, with in-hospital specialist bills paid at 100%. Co-payments are applied to specialized radiology and / or scopes and a few other in-hospital procedures. Hip/ knee/shoulder replacements are only covered in the case of acute injury (Prescribed Minimum Benefits only). Day to day claims are payable from a savings benefit. Once savings have been depleted, a block benefit is available for certain claims. Additional risk benefits are also provided for specialised radiology.
MedVital & MedVital Elect
MedVital (previously called Prime 1) offers unlimited hospital cover at a hospital of choice or if selecting the Elect option, through a hospital network, with in-hospital specialist bills paid at 100%. Co-payments are applied to specialized radiology and / or scopes and a few other in-hospital procedures. Hip/ knee/shoulder replacements are only covered in the case of acute injury (Prescribed Minimum Benefits only). This is mainly a hospital plan which also provides some preventative care benefits and limited cover for GP and specialist consults, physiotherapy, acute and over the counter meds.
MedSaver
MedSaver (previously called Unify) offers unlimited hospital cover at a hospital of choice and is suitable for young, healthy individuals. In-hospital specialist bills are paid at 100% and co-payments are applied to specialized radiology and / or scopes and a few other in-hospital procedures. Hip/ knee/shoulder replacements are only covered in the case of acute injury (Prescribed Minimum Benefits only). Day to day claims are payable from savings with a separate benefit for specialised radiology.
MedElect
MedElect (previously called Necesse) is an entry level capitated network plan which is an affordable plan, ideal for low earning individuals or for full time students. ALL treatments are subject to network providers and network protocols.
Lifestyle Programme
HealthPrint is a free online health and wellness education platform. Members can track their health activity, access their health and benefit data and enjoy benefits/discounts from certain retailers.
