FREE TO READ | Medical Cover Options

With the government seeking to implement a taxpayer-funded National Health Insurance, common ground must be found between private providers of medical cover and the ambitions for the national provider

The high cost of medical aid membership is one of the biggest challenges facing schemes. About 16% of the population contribute to medical aid schemes, providing them with access to private sector health care.

Many South Africans in formal employment are not members of medical schemes though they do use private primary healthcare services. To better meet the needs of this sector of the market, a number of companies including retailers, insurers and even hospital groups have introduced alternative insurance solutions that provide more affordable access to private health care.

Their greater affordability is because they don’t need to cover the prescribed minimum benefits that medical schemes are required to pay for. 

The government is also pushing for National Health Insurance to extend health services to more people, but its current model is facing criticism from many quarters, which foresees curtailment of the role of medical aids in providing certain services, forcing citizens to use the NHI for these services. 

However, a number of private healthcare companies have offered to collaborate with the government to ensure healthcare excellence and to retain expertise in the health system to the advantage of all South Africans.

 

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