Medical Insurance vs Medical Aid

Many people question whether they should get Medical Insurance because of the higher costs incurred by a Medical Aid. While their costs differ, it’s because they offer different services and benefits. The plan you inevitably choose depends on your life stage, lifestyle and needs.

What is the difference between Medical Insurance and Medical Aid?

Medical Aid and Medical Insurance are two different products. Medical Aid provides in-hospital cover and pays for treatment according to the specific medical scheme tariff. Medical Insurance, however, traditionally pays out a set amount for each day spent in hospital or a set maximum amount per incident, regardless of the type of treatment that’s required. Medical Insurance can be taken out as a stand-alone product or can be used as a top-up product for when your Medical Aid savings have run out.


With Medical Aid, payment for medical treatment is usually made directly to the hospital and/or service providers. With Medical Insurance, payment is usually made directly to you and you must settle your own accounts. The reimbursement can be used to pay for the cost of medical treatment or to pay for other daily expenses incurred whilst in hospital.


Both Medical Aid and Medical Insurance can provide cover for day-to-day medical expenses such as GP visits and medication. Medical Insurance usually offers limited cover for these day-to-day costs, and you will have to cover most of these medical expenses yourself. With Medical Aid, you have far more cover and benefits when it comes to day-to-day health appointments and medication, depending on the option that you choose. Some providers will expect you to pay for the day-to-day benefits yourself and then claim them back from your Medical Aid.


Another difference between Medical Insurance and Medical Aid is cost. The cost to take out Medical Insurance is lower than that of Medical Aid because it offers fewer benefits. The best way to decide which plan is right for you is to assess your medical needs. If you’re generally healthy and unlikely to incur ongoing day-to-day medical costs, then Medical Insurance might be adequate for you. If you are older and prone to health issues, a Medical Aid might be a better fit. Once you’ve worked out these needs, you can compare quotes and benefits online to find a plan to best suit your needs.