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Medical Schemes


South Africa has about 105 medical schemes totalling around 8 million beneficiaries.  The total annual contribution to medical schemes is around R85-billion (according to the Council for Medical Schemes - 2009).  Take into account that South Africa have a population of more than 49 million people! Less than 17% of SA citizens belong to a medical scheme.


Not all medical aid schemes are open to the public.  In fact, of the 105 schemes, only about 33 are open to the public.  This number might decrease over the years as the larger schemes take over the smaller ones.


So how do you choose a medical scheme or hospital plan, a specific option of the scheme, which benefits to include or exclude?  In this ever-changing environment, you need the services and advice of an independent intermediary.  Someone who doesn't only have the interests of a specific medical scheme at heart, but one who can guide you to ensure your needs is met.


An organisation specialising in the healthcare industry and will assist you with:


-  choosing the "most suitable" medical aid option in the market

-  investigating more than 30 medical schemes and options

-  providing pro-active advice on your present medical aid

-  assist you with claims and query resolution


Examples of medical schemes used when analysing your needs:


-  Discovery Health

-  Fedhealth

-  Resolution Health

-  Momentum Health

-  Genesis

-  Medihelp

-  Oxygen

-  Profmed

-  Bonitas

-  Libmed


You can also appoint Optivest Health Services as your healthcare consultant.  They will assist with claims and query resolutions at your present medical aid.


Also see

Council for Medical Schemes

Medical Scheme Complaints

Insurance Fraudline

Gap Cover


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