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A Look At The Top 5 Medical Aid Schemes in South Africa

A Look At The Top 5 Medical Aid Schemes in South Africa

If you want to receive optimal medical care in South Africa, a decent medical aid is an absolute must-have. Without it, you will be at the mercy of the overcrowded public health services. However, when investing in a certain medical scheme, it is very important to know that the company is solvent and don’t take any unnecessary risks. You don’t want to be paying all of your hard-earned money into a scheme that may go bankrupt and lose all of your money and benefits. The top 5 Medical Aid Schemes in South Africa are the most popular for a reason. They are also the most stable and some have been running for years.

Discovery Health

Discovery Health is by far the largest medical aid scheme in South Africa, covering over 2.5 million people. The scheme offers a wide variety of health plans, making it more possible for members to find one that tailors to their needs. They claim to offer medical scheme contributions of up to 15% cheaper than other medical aids in South Africa. What also makes Discovery Health so attractive to people is their Vitality program, through which they are affiliated with many other businesses and where members get discount on movies, travel, visits to the gym etc.

Discovery members may also qualify for cash back on certain medicine from Clicks and Dischem and get discounts for frames at participating optometrists. In 2014, Discovery takes a total market share of 51% in the medical scheme industry of South Africa. The solvency ratio of the company is 23,4%, which is slightly lower than the recommended 25%, but with member reserves of about R9 billion, Discovery is deemed to be very stable financially. The scheme received an AA+ Global Credit Ratings score, which is the highest credit rating a South African medical scheme can get. Discovery is the only open medical scheme in South Africa to get this rating, and has been sustaining this rating for the past 12 years.

Bonitas

Although it isn’t half as popular as Discovery, Bonitas is the runner-up when looking at the top 5 medical aid providers in South Africa. Over 650 000 lives are covered by Bonitas, including employees of certain blue chip companies such as Eskom, Nestle and BHP Billiton. This medical aid scheme has been running for over 31 years, which shows that it is fairly stable. As with Discovery, they offer different plans to accommodate people with all kinds of needs and from different income groups. Bonitas has over 4500 GPs in their network who work at set rates, avoiding co-payments all together. Their rates are also very competitive. With a solvency ratio of 35.7%, this is a company that doesn’t take any risks. Bonitas has a Global Credit Rating of AA-, which means this provider is in a good position to meet all of the needs of its members.

Momentum Health

Momentum Health takes a firm third place when you look at the amount of beneficiaries which, in 2014, is just over 200 000. Through Momentum’s Provider Choice, it is possible for members to save up to 35% on their contributions by making use of associated providers. By remaining fit and active, Momentum’s members can earn back up to R5 400 per year on their contributions. Momentum Health also has a rewards program which gives members discounts on movie tickets, gym memberships, flights and other activities. They also have a special healthcare solution for employers to offer to low-income employees. Momentum Health has a Global Credit Rating of AA- and a solvency ratio of 28%, showing that this is a very stable medical aid that is more than capable of paying out claims.

Medshield

Operating since 1968, Medshield is one of the oldest medical aid schemes in the country and covers over 191,000 beneficiaries. This scheme offers eight different plans designed to suit people from all walks of life, depending on each individual’s needs. With a Global Credit Rating of AA- for the past 6 consecutive years, Medshield is capable of settling claims promptly. Their solvency ratio is 40%, which is way over the 25% required benchmark, so members can be rest assured that this is a financially stable scheme, with the ability of paying claims in full.

Fedhealth

Fedhealth is another medical aid that has been in business for a long time and is the 5th largest open medical scheme in South Africa with around 150 000 beneficiaries. Previously known as Reef Medical Scheme, the scheme started out in 1936 already and developed its medical aid plans through the years to meet the changing individual needs of South Africans. Fedhealth has an option called “Blue Door” for people with a low income who previously wouldn’t have been able to afford a medical aid. It also offers other, more comprehensive schemes in two major categories, the Maxima and Ultima, depending on the principal member’s age. Ultima is for older people who may require more benefits. Child dependants can benefit from the lower “child” rate up to 27 years of age. Fedhealth has a Global Credit Rating of AA- and a high solvency ratio of 37%, so they are financially able to pay out claims in full and promptly.

Conclusion

The 5 largest open medical schemes in South Africa are all considered to be financially stable, so you can’t go wrong by investing in one of them. Contributions charged for the different health plans vary widely, but simply choosing the most affordable plan is not the way to go. What you do need to look at is which one suits your needs the best. If you opt for a plan that only covers certain health providers in the scheme’s network, you need to check the list of providers to see if there is indeed one in your area, otherwise it would not really benefit you, especially during a medical emergency. Medical schemes are expensive which is why you really need to do your research before committing to a single health plan.

Naomi Bolton

Naomi Bolton

Naomi Bolton has worked as a journalist, photographer, designer, businesswoman and content writer for years. Her work has been widely published online on websites such as Ehow.com, AZ Central, Global Post and more. She holds a diploma in graphic design.
Naomi Bolton

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  • Marthinus Strydom

    So this is a list of the top medical aids based on the number of members. Quite misleading if you ask me. Top medical aids imply “best” medical aids based on value for money and the cover they offer. What is the point of this article? We need a detailed analysis of medical aids, what they cover and what they don’t, customer satisfaction and ratings.

    • Andr√©

      I agree , knowing who pays out the most and for what medical treatments would be great. Who rejects claims for treatments like pet scans etc. This is more like an advertisement for the top five medical schemes.

  • Beata Gers

    Thank you Naomi Bolton for this article. As a FedHealth member of 6 years, I can say that I’ve had numerous problems with them, but am grateful to be able to read a broad overview of the medical aid options available in South Africa. Thanks for the informative read.

  • Alexa_Ness

    The criteria for making this list is flawed. Being the biggest does not make you the best.

  • Franco E Conterato

    Best medical aid that covers braces?

  • Judy007

    Sorry? So where is LIBERTY in the whole scheme of things here? Extremely unsubstantive article. ZERO nuts and bolts. Yellow pages gives around the same info.