The difference between Medical Aid and Medical Insurance

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The difference between Medical Aid and Medical Insurance

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For a long time, having access to private healthcare belonged only to a privileged few. According to data released by Statistics South Africa in 2018, this was approximately 9.4 million South Africans. Without a doubt, having medical aid to take care of your health is necessary, but what about those who cannot afford it? Well, we’ve got good news for you. There is another option.

The emergence of medical insurance in the last few years has drastically shifted the dynamics, allowing many more South Africans access to medical cover for their most essential medical needs. In summary, medical insurance, also known as health insurance, is a form of insurance cover that focuses on your essential healthcare needs and covers those medical expenses or part thereof. The benefit of medical insurance is that it allows you to take care of your healthcare needs without worrying about medical costs. It has provided more South Africans with the opportunity to access private medical care in a much more affordable way. Medical insurance is not a medical aid nor a substitute for medical aid but it is an alternative option to both medical aid and public health facilities.


The difference between medical aid and medical insurance.

To help you understand the difference between medical aid cover and health insurance, the Council for Medical Schemes explains that there are three main areas where they differ:

Types of cover

Medical aid schemes cover a wide range of medical expenses such as in-hospital benefits according to the National Recommended Price List and Prescribed Minimum Benefits (PMBs).

Medical Insurance, on the other hand, covers your essential needs such as your day-to-day medical expenses or covers the cost of a specific medical procedure but does not have to provide for PMBs.


Medical Aid vs Medical Insurance: Hospital & Chronic Benefits

Medical aid schemes, depending on the plan type, provide comprehensive coverage for dreaded diseases and are accepted by most private hospitals for both elective and emergency procedures.

Medical insurance provides cover for your day-to-day healthcare needs which include chronic diseases, but does not cover hospitalisation.


Medical Aid vs Medical Insurance Price

Medical insurance is typically more affordable than most medical aid options as medical insurance does not cover hospitalisation for Prescribed Minimum Benefit conditions.


What can Medical Insurance powered by Dis-Chem Health offer you?

We offer affordable plans for every South African family. We deliver solutions that are simple, cost-effective and structured to ensure that you get exactly what you need. We offer an extensive product selection and cover options that are aimed at every income bracket in South Africa. Through these plans, you and your family can access trusted, private medical care, helping you to weather any of life’s unforeseen accidents and unfortunate health issues.

The MyHealth Core and MyHealth Plus plans cover essential everyday medical expenses such as Doctor visits, Optometrists, Dentists and Medicine (limits depend on the option chosen). These start from R469 per month.

We also offer another product called Accident Cover, which starts at R151 per month. This product provides cover for emergency medical treatment in the event of an accident, heart attack or stroke, and if you choose the buy-up option, the product will also cover emergency medical treatment in the event of an emergency illness.

Policyholders also get access to Lifestyle Benefits and extra by Dis-Chem, a rewards programme available to Dis-Chem Health Policyholders. Lifestyle benefits include family counselling from registered social workers and psychologists as well as legal and financial advice from qualified professionals to take care of your well-being.

What’s more, if you need both Day-to-Day cover and Accident cover, you can save on costs by choosing to combine the two. The combined product starts from only R527 per month, instead of R620.

You and your family deserve the best medical care when you need it. Having medical cover is no longer a luxury, but a necessary investment in the health and future of your family.

To sign up or get more information, get an agent to contact you.

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6 thoughts on “The difference between Medical Aid and Medical Insurance

  1. I want to enquire if you have an HOSPITAL PLAN and what does it cover as well as the associated pricing model

    1. Hi There. Dis-Chem Health does offer Accident Cover, which can be combined with day to day cover. Accident cover, covers medical emergencies due to accidents, heart attack and stroke, limits apply.
      Pricing for Accident cover (stand alone product) starts at R123 for adults, and R110 for Children (2023).
      *Accident cover is not the same as a Hospital Plan that is offered by a Medical Aid

    1. There are 470+ Private Hospitals that you can access as part of the PrimeCure network include: Life Healthcare, Netcare, Mediclinic,JMH, Lenmed and more.

    1. Hi Kirsty, It will cover broken bones as long as they are caused by an “external force”. The definition of an “Accident” or “Accidental Harm”: means bodily injury caused by violent, unintentional, external and physical means. Examples include motor vehicle accidents, severe burns, exposure to poison that is not self-inflicted.

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