Have you made sure you are on the right plan for 2026? You window to change plans is closing fast. Below are some tips to help you decide.

Today we discuss:

• The differences between different types of medical aids
• How to instantly save money on your premium
• Netcare hospitals get smart(er) ....

Reminder: rehealth.co.za helps you get the most out of your medical aid. It's free, it's instant. No registration or pesky sales calls.

Please share!

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🖊️ Eve's notes...

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Before we get into anything medical aid related, I have a cool Black Friday tip for you. Use the Serval tool (free) to track the historical price of any item on Takealot. That means you can see if that toaster that is "50% off today" is a real discount, or if the price was simply increased in October to make today's price look really good.

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Today's is the second-last newsletter of the year. Next week I am going to keep it brief and tell you about three really exciting things happening in the rehealth space next year, but today I want to help you make sure that you are on at least a good enough plan for 2026.

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"Good enough" means the right mix of benefits and affordability. Remember that medical aids are not all the same and there's no such thing as a free lunch. The cheapest non-capitated plan costs R1,350/m. The most expensive costs R19,393/m. We should accept that the benefits on these will be vastly different. I think the reason we have 210 plans is to give diversity and optionality. (Fun fact: when I started thinking about rehealth, there were just under 400 plans. Lots of consolidation since then!) So yes, we'd all love to be on a fully comprehensive plan, but few of can afford to be. (Don't stress: there's no such thing as a "fully comprehensive" plan anyway!)

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My one quick tip: it can often be better (and cheaper) to be on a lower medical aid plan with a gap cover, than a higher medical with no gap cover. (Email me if you have questions on this eved@rehealth.co.za).

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Stay healthy! Stay wise and thanks for reading.

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PS: Questions about your cover? I can't give individual advice, but I can probably point you in the right direction. Email me on eved@rehealth.co.za.

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Our Guides are free and available for instant download.

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🇿🇦 Medical Aid and other cover 101:

Useful and relevant information about medical aid, gap covers, hospital insurance and even pet cover. Goal: to help you know the rules, so you don't overpay.

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What are the differences in medical aid plans?

There are exactly 210 open medical aid plans in the country (!!), and all of them offer some sort of different benefit combination. Luckily, they do all fall into what I see as five broad categories, and a good first step for you is to decide what category best suits you. Remember, you can search rehealth.co.za by price to find an affordable plan. Capitated Plans​ These are interesting plans! They have different premiums depending on how much you earn, but the benefits are identical eg. for Bestmed's Rhythm, a person/household earning less than R9,000/m pays R1,763/m while a person who makes R15,000/m pays R2,024 for exactly the same benefits. All these plans require use of strict networks (for hospitals and doctors). Capitated plans tend to have a lot of the primary benefits (GPs, medicine, x-rays, pathology) paid by the scheme. There are 7 schemes that offer capitated plans: Bestmed (Rhythm), Bonitas (Bncap), Discovery (Keycare), Momentum (Ingwe), Medimed, Profmed, Suremed. (Click on scheme, and go to bottom of page to view the capitated plans). PMB-only plans and/or exclusions and co-payments​ These plans pay mostly for only the 270 PMB conditions (the minimum required by law) and/or require a hefty co-payment for non-PMB treatment. That means any life-endangering situation is covered for some sort of treatment, but electives like C-sections, tonsillectomy and most non-PMB in and out of hospital claims are not fully covered. These are the basic, cheapest plans. Note that some of these plans might require you to get cancer and dialysis treatment at a State hospital and mayAI have very limited preventative benefits (mammograms, etc). All these plans require use of strict networks (for hospitals and doctors). Examples: Medimed Alpha (R1,820), Discovery Active Smart (R1,350) Hospital Plans ​ These plans pay for most in-hospital claims, but they do not cover much out of hospital, aside from PMBs, preventative benefits (mammogram, flu shots) and maternity consults. They can, however, offer very good benefits for in-hospital procedures and cancer cover, and many do pay for scopes and other small procedures in doctors' rooms. You can opt for network-only plans, which are considerably cheaper. Examples: Discovery Core (R2,681) , Momentum Custom (R2,585) Saver/Fund Plans ​ A step above hospital plans, these plans offer you funds for day-to-day benefits like GP consults, specialists, medicine and dentistry. The funds can be a savings account, or a fund that is allocated to you by the scheme, or a combination of both. You can also opt for network-only plans, which are considerably cheaper. Examples: Bonitas BonPrime (R3,255), Keyhealth Equilibrium (R3,296), Medihelp MedAdd (R3,186) Comprehensive Plans​ The top tier plans. They offer a savings account, then when that is depleted you have to pay a certain amount for day-to-day claims out of pocket. Once you pay this "self payment gap", the scheme will again start paying for most day-to-day expenses, up to 100% scheme rate. This "above threshold" benefit can be limited, or unlimited. These plans tend to not have networks, and offer plenty "extra" benefits like refractive surgery, cochlear implants and cover for biological cancer medication. Examples: Discovery Executive (R12,338 ), Bonitas BonComprehensive (R12,509), Medshield Premium Plus (R9,489), Momentum Summit (R16,469) ​

What if your plan is just too expensive?

There are 3 quick ways to possibly lower your medical aid premiums pretty instantly: Check if you are paying a Late Joiner Penalty, and if you are, check that you are not overpaying. (Your policy document will show any penalties). In my experience, more than half of people who ask for my help with this are overpaying, by thousands every month. Review! It's the easiest way to cut a big chunk of your cost. (I'm happy to help: just hit reply to this email). Move to a network plan. You'll probably save 20-25% of your current cost If you have healthy adult children (students) on your plan, think of moving them to a student plan. Medihelp has a student plan for just R804 (!). Discovery's Active Smart is R1,350 (Available to everyone, not just students)

Other news:

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✅ Netcare is introducing a wearable device that will monitor patients' vitals continuously. I love this, because this nonsense of being woken up twice in the middle of the night to have blood pressure checked is ridiculous. Also, doctors will have AI-enabled ambient listening and dictation, freeing them to focus more on you (in theory!).

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✅ Anecdotally, I am noticing many more social media complaints about how medical aids decline seemingly legitimate claims, or just offer poor service. It's a growing trend, and a sign of things to come.

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✅ A reminder: There are 33 plans that cost less than R2,000 per month. The cheapest costs just R589! (Yes, for medical aid, not insurance). The catch is you have to earn less than R1,500/m to qualify. The cheapest unrestricted income plan is from Discovery, at just R1,350. Search for medical aid by price here.

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✅ Don't forget, rehealth,co.za allows you to check all your plan benefits here, and you can also compare any two plans side by side.

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New and/or noteworthy on rehealth:

Medical Aid:

> Check your plan's benefits for 2025 and 2026

> Compare any two medical aid plans

> Check you're not overpaying your late joiner penalty​

> What to do if your medical aid won't pay for a PMB?

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📆 Next week...

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Thank you for reading! I appreciate your attention :-). Next week I will wind down the year, and give you a glimpse into what I'm cooking up for 2026 😉

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See you then!

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PS. If you find value in this newsletter, please forward to a friend! I'll be so happy to see it spread through more medical aid members. Strength in numbers!

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Important side note: I am not a broker or financial advisor, so cannot give individual advice. All info is my own interpretation of how the medical aid etc world works. Always speak to a broker or your insurer before making any decisions about your health cover

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