Medical Insurance | Medical Aid & Gap Cover | Sanlam
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What to look for
What is the difference?
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OUR PREFERRED HEALTHCARE PROVIDERS

Find your fit with one of our two preferred medical aid providers

Medical Aid for South Africa

Affordable and benefit-rich, Bonitas offers a wide range of plans to meet the needs of South Africans from all walks of life.

  • Plans that are easy to understand and use – giving you access to quality care when you need it
  • Extensive cover and benefits including wellness, dental and optical, maternity, child care, and preventative care paid from risk
  • A range of plans to meet your needs including hospital, savings, edge, traditional and network plans
Get a Bonitas quote Read more

Create your aid

Fedhealth is all about customisation, choice, flexibility and control, and pays more benefits from Risk than other schemes.

  • Options for every life stage and healthcare need
  • Customisation and control for single people, young couples, or growing families with our flexiFED range
  • Innovative MediVault and Wallet solutions to help flexiFED members save on their monthly contributions, while still having access to funds for day-to-day medical expenses
Get a Fedhealth quote Read more

Not sure which scheme is right for you?

Let us help you choose the right solution to fit your needs.

Help me choose

What about gap cover?

From R219 for individuals, and R385 for families, Sanlam Medical Gap Cover Insurance provides towards the difference between what your medical aid pays and the rates charged by medical specialists.

In certain cases the cost for in-hospital procedures or outpatient treatment may exceed the base medical aid rate by an additional five times. By taking out Sanlam Medical Gap Cover Insurance, you ensure that you and your family aren’t left with a large excess amount to settle.

Apply now Read more
WHAT TO LOOK FOR

Choosing the right medical scheme for you and your family

Although it is impossible to predict future illnesses, you must ensure that the option you decide on will adequately cover you for your current needs. It is important to consult with a Sanlam Financial Adviser who will be able to assist or guide you to a health-accredited specialist to determine the most suitable option for you.

With a wide range of options available, you are able to select between savings, traditional, virtual, hospital and income-based options. You need to choose wisely so that you and your family are covered for everyday medical incidents, as well as those life-changing events such as pregnancy, accidents, or the diagnosis of dread diseases.

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Key things to consider when choosing your medical aid option

  • Your life stage and age: If you’re a single professional, your healthcare needs will be different to the needs of a mom with three young kids, or a mature couple.
  • Your health: Chronic and dread diseases are a reality from which anyone can suffer. However, if there’s a history of certain diseases in your family, there’s a chance that they might become a reality for you. Be prepared and enjoy comprehensive medical cover when you need it.
  • Your pocket: It pays to shop around until you find the right option to suit your own and your family’s needs and budget.

Other things to consider

  • You may have to use a set provider network in order to get full cover for certain treatments
  • Study your product brochure to make sure of what is excluded on your option, or the co-payments on certain in-hospital procedures
  • Find out about the chronic medicine formularies, designated service providers and the maximum amount the scheme is willing to pay
  • Certain waiting periods may apply before you are covered for a specific condition
  • It is crucial to share your full medical history when signing up for a new medical aid to avoid the scheme’s refusal to pay out claims in future due to non-disclosure
  • Make sure you know how the option covers oncology, dialysis and HIV
WHAT IS THE DIFFERENCE?

Differentiating between medical aid and medical insurance

Medical aid schemes are governed by the Medical Schemes Act and have to adhere to a list of very specific rules and regulations that include open enrolment, standard-rate fees and cover for the diagnosis and treatment for a list of Prescribed Minimum Benefits (PMBs). Payments are normally made directly to the hospital or service provider.

Medical insurance products, on the other hand, fall under the Short-term Insurance Act with specified benefits that pay out a defined amount per day or per incident, irrespective of the medical treatment needed. Payments are made directly to the client who stays responsible for payment to service providers.

HELP ME CHOOSE

Let us help you decide on the right solution for you

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