Plans and cover
What is a hospital plan?
A hospital plan gives you cover for private hospital stays at an affordable price.
Medihelp’s MedVital plan offers unlimited cover at quality hospitals if you’re admitted due to an accident, illness, or emergency. As a bonus, it also includes some basic everyday benefits.
You can save up to 22% on your monthly contribution by choosing MedVital Elect, the network option.
What is the difference between a hospital plan and comprehensive medical aid?
A hospital plan mainly covers treatment in hospital. A comprehensive medical aid plan covers both hospital stays and everyday medical costs, and may include a savings account.
Our hospital plans include some day-to-day benefits, while our comprehensive plans are perfect for individuals or families with extensive healthcare needs.
Which Medihelp plans have a savings account (MSA)?
Medihelp’s MedAdd, MedAdd Elect, and MedSaver are affordable medical aid savings plans for those looking to have more control over their medical expenses. MedSaver offers a generous 25% savings account, while MedAdd and MedAdd Elect offer a 15% savings account.
Medihelp’s MedPrime, MedPrime Elect, and MedElite medical aid plans offer a 10% savings account and rich insured cover for day-to-day medical expenses, allowing for greater flexibility and less out-of-pocket expenses.
What does medical aid cover?
Medical aid in South Africa can cover hospital stays, chronic conditions, and everyday medical costs, depending on your plan. All medical aids must also cover prescribed minimum benefits (PMBs).
What is not covered by my medical aid?
Things your medical aid won’t pay for are called exclusions. Exclusions are conditions and treatments not included in your plan. Check your plan to make sure what’s covered.
Does medical aid cover pregnancy?
Maternity benefits may cover doctor visits, scans, and delivery, depending on your plan. It’s important to note that pregnancies that started before joining are not covered.
Can I join a medical aid if I’m already pregnant?
You can join a medical aid if you are already pregnant. However, most medical aids in South Africa apply waiting periods to new members, which may affect cover for pregnancy-related healthcare services and maternity benefits.
If you're planning to join a medical aid while pregnant, it's important to understand which benefits will be available immediately and which services may only be covered after the waiting period has ended. A medical aid adviser can help you compare plans and understand how waiting periods may affect your maternity cover.
Tip: If you're planning to start or grow your family, joining a medical aid before falling pregnant can help ensure you have access to the full range of maternity benefits when you need them.
Is cancer treatment covered on my medical aid?
Yes, cancer treatment is covered under PMBs, including diagnosis and approved treatment. Medihelp members have access to comprehensive cancer benefits through our designated service providers (DSPs). You’ll need to register on Medihelp’s Cancer Programme and get approval (pre-authorisation) for treatment.
Is mental health covered by medical aid?
Depending on underwriting, medical aids cover certain mental health conditions by law (PMBs), including hospital treatment. Any extra cover such as cover for medication and therapy will depend on your plan.
Does my medical aid cover eye exams?
Yes, medical aid has eye care benefits that may cover tests and glasses or contact lenses, depending on your plan. These benefits are usually paid from your savings or day-to-day benefits.
Medihelp uses Opticlear to manage these benefits, with a network that includes most optometrists in South Africa.
Does medical aid cover the dentist?
Yes, depending on your plan. Medical aid may cover check-ups, fillings, and basic dental care. You can check the Member Zone to see what’s included on your plan.
Does my medical aid cover physiotherapy?
Physiotherapy is covered on certain Medihelp plans, either from your savings account or as part of day-to-day benefits, depending on your chosen plan. To view your available benefits, visit the Member Zone.
Does my medical aid have benefits for men?
Yes, Medihelp’s benefits for men include screenings, preventive care, and treatment for prostate and other conditions, depending on your plan.
Does my medical aid have benefits for women?
Yes, Medihelp’s women’s health benefits include screenings, maternity care, and preventive services such as Pap smears, mammograms, and bone mineral density tests, depending on your plan.
Does Medihelp cover hip, knee, and shoulder replacements?
Yes, several Medihelp plans cover joint replacements.