Do Medical Aids Cover Pap Smears and Mammograms?
Get Medical Aid Coverage for Cancer Screening Today!
Find out if your medical aid covers Pap smears and mammograms and compare plans.
Get Medical Aid Coverage for Cancer Screening Today!
Find out if your medical aid covers Pap smears and mammograms and compare plans.
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According to the Cancer Association of South Africa, cancer will touch the lives of 1 in 4 South Africans, either through diagnosis of self, friends, family, or colleagues.
According to the latest National Cancer Registry (NCR) report from 2023, these are the top five cancers affecting women in South Africa:
| Cancer | Ranking |
|---|---|
| 1. Breast Cancer | #1 Most Common |
| 2. Cervical Cancer | #2 Most Common |
| 3. Basal Cell Carcinoma | #3 Most Common |
| 4. Squamous Cell Carcinoma (skin) | #4 Most Common |
| 5. Colorectal Cancer | #5 Most Common |
Based on the 2023 National Cancer Registry data from CANSA.
It's clear from these facts that women need regular cervical and breast cancer screening, among others. The best ways to check for these cancers are through Pap smears (for cervical) and regular mammograms (for breast).
But it's all good and well to say that women need to get checked — some screenings can be expensive, so many of us rely on our medical aids to pay for them.
In short, yes — most medical aids will have screening benefits for a range of health conditions, including breast and cervical cancer.
Medical aids prefer to cover things like diagnostic mammograms that either clear you for a clean bill of health or detect cancer early, as it costs them less in the long term to pay for a test than to pay for cancer treatment for extended periods. So, it's in their best interest to pay healthcare providers to perform these kinds of tests.
They may, however, have a limit as to how often you can get checked. For example, some medical aids might cover you to have a Pap smear once every year, while they'll cover a screening mammogram only every three years. These screening tests usually don't come out of your savings but rather from a day-to-day benefit set aside for tests like these.
Your medical aid may also cover tests like bone density scans, tuberculosis checks, and HIV/Aids assessments, plus general screening tests like body mass indexing, cholesterol, and blood pressure.
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A mammogram is a special X-ray test that doctors use to look at the inside of your breasts. It's a key tool to check for early signs of breast cancer. The process is quick: you stand in front of a machine, and it takes images of your breasts from different angles. This helps doctors spot any lumps or changes that might need more investigation.
Regular mammograms are important because they can detect problems before you can feel them, making treatment easier and more effective. Sometimes, mammograms can detect the cancer up to three years before it can be physically felt.
A Pap smear, also called a Pap test, is a simple procedure to check for changes in the cells of your cervix. The cervix is the lower part of the uterus that opens into the vagina.
During the test, a doctor gently collects a small sample of cells from your cervix using a soft brush. This sample is then examined under a microscope to look for any abnormal cells that could indicate cervical cancer or other issues. It's a quick and important test that helps catch problems early when they're easier to treat.
It's important at this point to mention the human papillomavirus (HPV), which is a virus with certain strains that can cause cervical cancer. If a Pap smear indicates unusual cells in the cervical tissue, an HPV test will likely be done next to see if the virus is in your cervix.
Frequency varies by scheme/option. Many fund Pap smears annually or every 24–36 months, and screening mammograms every 24–36 months for eligible age groups. Benefits are often paid from preventative/day-to-day pools rather than your Medical Savings Account.
Read more: Why preventative care is important
Screening Frequencies and Criteria
| Scheme | Pap Smear | HPV Test | Screening Mammogram | Diagnostic Mammogram / Additional Breast Imaging |
|---|---|---|---|---|
| Discovery Health | 1 every 3 years (unless high risk → annually) | 1 every 5 years; or 1 every 3 years if on HIV programme | 1 every 2 years (for average risk) | Additional imaging (e.g. MRI, ultrasound) for high-risk members; cover of breast biopsy following positive findings |
| Bonitas (Be Better / Preventative Care) | 1 Pap smear every 3 years (women aged 21–65) | 1 HPV PCR test every 5 years (as alternative) | 1 mammogram every 2 years (women 40+) | N/A |
| Fedhealth (Screening Benefit) | 1 Pap smear every 3 years (female beneficiaries, aged 21–65) | HPV PCR: 1 in 5 years (female beneficiaries 21–65) | Included under “Women’s health” screening benefit (option dependent) | N/A |
By the time these signs appear, the cancer may be advanced — regular screening is essential.
Routine exam for people without symptoms; funded from each scheme’s preventative/screening benefit on a set cadence (typically every 2–3 years, age-banded).
Done when there are symptoms/abnormal findings (lump, nipple discharge, recall after screening, etc.). Usually funded from radiology/day-to-day or hospital benefits, often with GP/specialist referral and sometimes pre-authorisation. No fixed “frequency”; it’s funded when clinically indicated. In SA PMB guidance, diagnostic mammography is PMB level of care in breast-cancer workups.
Medical aid helps cover the cost of vital cancer screenings. In that way, it can be a lifesaver. If you're struggling to pay your medical aid premiums or haven't taken out medical aid yet, Hippo can help.
Get clear answers about Pap smears, mammograms, and medical aid coverage.
Most medical aids cover Pap smears once every year and screening mammograms every three years. However, frequency limits vary between medical aid schemes and plans. These screening tests usually don’t come from your Medical Savings Account but from a separate day-to-day or preventative benefit. Some medical aids also cover additional tests like bone density scans, TB checks, and HIV/AIDS assessments.
A screening mammogram is a routine X-ray for people without symptoms to detect early breast cancer. A diagnostic mammogram is used when symptoms or abnormal findings need investigation (e.g., a lump or recall after screening). Medical aids prefer to fund screening because early detection costs less than treating advanced cancer, and screening can detect cancer up to three years before it can be physically felt.
If a Pap smear shows unusual cells, an HPV (human papillomavirus) test is often performed to check for high-risk strains that can cause cervical cancer. While coverage varies, most medical aids that fund Pap smears typically cover follow-up HPV testing when medically indicated as part of standard cervical screening.
Early detection saves lives and costs. It’s significantly cheaper for schemes to fund regular screenings (Pap smears and mammograms) than to pay for prolonged cancer treatment. Screening catches cancer earlier, when it’s more treatable and less expensive to manage—benefiting both members and medical aids.
Beyond Pap smears and mammograms, many medical aids cover bone density scans, tuberculosis checks, and HIV/AIDS assessments, as well as general screenings like BMI, cholesterol, and blood pressure. The specific tests and frequencies depend on your scheme and plan; these are usually funded from preventative/day-to-day benefits rather than your Medical Savings Account.
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