What is medical aid?
Hospital and medical bills can be large and hard to predict, and medical aid helps you and your family pay them. Medical aid is membership of a medical scheme: a not-for-profit fund, owned by its members, that pays for health care. Schemes are regulated by the Medical Schemes Act and the Council for Medical Schemes (CMS). Each scheme offers options, from hospital plans to comprehensive cover with day-to-day benefits.
- Open schemes must accept you, whatever your age or health. You can belong to only one scheme at a time.
- Contributions depend on the option you choose, how many dependants you have and, on some options, your income. They cannot depend on your health.
- Prescribed Minimum Benefits (PMBs) must be covered on every option. They include emergencies and a set list of serious conditions, among them 26 chronic conditions such as diabetes, asthma and high blood pressure. Schemes can make you use their chosen providers.
What if you join later?
- Waiting periods. Depending on your previous cover, a scheme can apply a general waiting period of up to three months, and a waiting period of up to 12 months for a specific condition.
- Late-joiner penalties. If you join at 35 or older and have not had continuous cover since before 1 April 2001, the scheme can add a penalty to your contributions.
Waiting periods do not apply to a baby born while you are a member, or when you move to another option in the same scheme (unless you are still serving one).
Is there a tax benefit?
Yes. For the 2026/27 tax year, medical scheme contributions give you a tax credit of R376 a month each for the first two people covered, and R254 a month for each extra dependant.
Things to know
- Plan ahead for pregnancy. A new scheme can apply a waiting period to pregnancy if you had less than two years of cover before joining, or no recent cover.
- Check your broker. Anyone who sells you medical aid should be accredited by the CMS, and you can ask the CMS to confirm a broker’s accreditation.
- Review your option every year, as schemes change their benefits and contributions.
Who it suits
A hospital plan may be enough when you are young and healthy. Families with children, and older people, often need more day-to-day and chronic cover.