The Top 5 Medical Schemes in South Africa
Staying healthy should be a top priority for everyone, but big medical bills can often stand in the way of South Africans getting the care they need (and deserve!).
That’s where medical aid schemes come in. They bridge the gap between affordability and world-class healthcare. The perfect plan ensures that you not only get the care that you need when you need it, but that you avoid developing certain health concerns in the first place.
So, how do you know which one is best? We evaluated several South African medical aid schemes to come up with a list of five of the top schemes that lead the pack.
How To Find the Best Medical Aid Scheme for Your Needs
There are a bunch of different points to consider when trying to figure out which medical aid scheme is the best in South Africa.
For this article, we chose to look at schemes not just according to their size (although that was a factor, too), but gauge how financially stable they are in terms of their ability to pay back debts and pay out claims. We also looked at another all-important figure – their average customer rating.
Below are the criteria we used:
- Market share: Bigger medical aid schemes have more members and can spread their risk across a broader pool, giving them negotiating power with healthcare providers.
- Global Credit Rating (GCR): The GCR evaluates the likelihood of companies to pay back their debts. It works on a scale from AAA to CCC, with AAA being the highest credit quality.
- Solvency ratio: This shows how well a company can pay its long-term debts. A high solvency ratio means they’re ready to pay out claims.
- Customer rating: Surveys and online ratings give us an idea of how people feel about their medical aid.
Note: When picking the best medical aid for you, weigh up the cost, coverage, benefits, and reputation for customer service and paying out claims. Check out our piece. What to look for when Comparing Medical Aids for more.
South Africa’s Five Best Medical Aid Schemes
The below medical aid schemes did well based on the criteria we mentioned above. Does this mean that other medical aids aren’t good? No, different medical aids might be better suited to different needs depending on the plans they offer.
| Scheme | Premiums* | Market share** | GCR | Solvency ratio | Average customer rating out of 100*** | Medicalaid.com average customer score |
|---|---|---|---|---|---|---|
| Bestmed Medical Scheme | R1,432 - R10,343 | 4.68% | AA | 41.73% | 78.6 | 4.2/5 |
| Bonitas Medical Fund | R1,378 - R9,853 | 15.05% | AA+ | 41.3% | 71.8 | 4.9/5 |
| Discovery Health | R1,102 - R10,303 | 57.8% | AA+ | 30.6% | 74.2 | 4.4/5 |
| Medshield Medical Scheme | R1,584 - R7,842 | 2.9% | AA- | 64.4% | Unknown | 3.5/5 |
| Momentum Health | R541 - R13,573 | 6.64% | AA | 34.9% | Unknown | 4.5/5 |
*At the time of writing, October 2024
**Market share was calculated by their total number of principal members.
***Source: South African Customer Satisfaction Index. (Industry par is 75).
Bestmed
Though on the smaller side when it comes to market share, Bestmed makes our list for consistently scoring the top spot in customer satisfaction. They’re the only medical aid on our list with an index above industry par, and they even scooped News24’s Medical Aid Scheme of the Year.
 
They have an AA credit rating and offer affordable options in the form of hospital plans as well as medical aids. They also have a variety of flexible offerings that allow members to customise their care.
- Premiums between R1,432 - R10,343 a month
- 10 medical aid plans
- Admin costs are 3-5% less than other SA medical schemes.
Bonitas Medical Fund
With approximately 353,763 principal members, Bonitas has 15.05% of the local medical aid market share. Though not the biggest medical aid in South Africa, their good solvency ratio and very high customer rating earns them a spot on our list.
 
Other Bonitas perks include free cover for your fourth and subsequent children, a contraceptive benefit for women aged up to 50, and managed care programs for chronic conditions, including cancer, mental health, HIV/AIDS and diabetes.
- Offers 15 plans across 5 categories
- Families with four or more children only pay for three
- Premiums between R1,378 and R9,853 a month
- Many Bonitas policies cover Lasik eye surgery + dental and vision therapies
Discovery Health Medical Scheme
Accounting for around 57.8% share of the open medical scheme market in South Africa, it should come as no surprise that Discovery Health features in the top five medical aid schemes. They’re known for comprehensive medical aid plans, hospital plans, as well as their popular rewards and wellness programme, Vitality.
In addition, they’ve got a very strong AA+ GCR. They have the lowest solvency ratio (30.6%) of the schemes on our list, but a high customer rating of 4.4 out of 5.
- Offers 22 plans across 7 categories
- Unlimited hospital cover for medical aid members
- Premiums between R1,102- and R10,303 a month
- Unlimited hospital cover for medical aid members
- Known for their Vitality wellness program that rewards members for healthy habits
Medshield Medical Scheme
Another oldie but goodie, Medshield has been around since 1968. They’ve made our list due to their high solvency ratio of 64.4% – which shows they’re very financially sound and able to pay out claims to their members.
Medshield’s 69,664 principal members earns them 2.9% in market share. They have a higher-than-average beneficiary age of 37 years, and a relatively high pensioner ratio of 20.2%.
- 11 medical aid plans
- Emphasis on preventative healthcare
- Premiums between R1,584 and R7,587 a month
Momentum Health
Momentum offers affordable plans and the Multiply rewards program. It has a customer base of over 156,000 members and a high customer rating.
- Offers 35 plans across 6 categories
- Premiums between R541 - R13,573 a month
- Known for its Multiply rewards programs
Why Do You Need Medical Aid?
The public healthcare system has its challenges. Long waiting times, limited resources, and overworked staff can result in less-than-great care. Private healthcare, on the other hand, offers more personalised care with much shorter waiting times.
That said, getting help from a private doctor or at a private hospital can cost you an arm and a leg. That’s where medical aid comes in, whether you choose a basic hospital plan or more comprehensive cover.
More than 11 million South Africans living with chronic health conditions like high blood pressure, diabetes, high cholesterol, arthritis, HIV, and others. With this number growing all the time, it’s important to ensure that you have adequate cover—just in case you end up with a chronic diagnosis.
The prevalence of diabetes, for instance, has rapidly increased in South Africa from 4.5% in 2010 to 12.7% in 2019. This means almost 5 million people need chronic medication to manage their condition. If you don’t have medical aid to help, it can be a huge burden to access and afford treatment.
Picking the right plan with the right scheme will give you access to care that will help to keep you healthy. It will also support you in managing chronic illnesses and give you the financial safety net you need so that getting healthcare doesn’t break the bank.
Disclaimer: This article is for informational purposes only and should not be construed as financial, legal, or medical advice.
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