Medical aid in South Africa allows any person of any income level to sign up for cover. However, it is important to have a stable income in order to afford the premiums every month. If your monthly income is low and you are on a very tight budget then there is no need to write off the possibility of sign up for medical aid cover. Many schemes have special plans in place for low income workers and families. The benefits may be lower, access to hospitals restricted to certain groups and all the extra frills may be trimmed but you can still rest assured of access to at least some private health services.

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In a country where the public health sector is so overburdened, even low income earners should look at medical aid if they can spare a few hundred rands per month. Without medical aid you have to opt for the government hospitals and clinics unless you have large amounts of cash at your disposal. Medical aid ensures that you will be admitted to a private hospital and receive treatment from private doctors and specialists even if your do not have cash to pay for these services upfront.

Network Restricted Hospitalisation

Hospital bills are probably the most expensive private medical costs. Each day is hospital starts from over R2,000 for the hospital bed alone without considering the cost of doctors, tests and surgery. Most South Africans would prefer private hospitalisation but it is often unaffordable without medical aid cover. Surgery in particular can be very expensive. Medical aid for low income earners provides access to certain private hospitals within the schemes selected network.

This means that you can receive in-hospital treatment and have the medical aid pay for it provided that visit specific hospitals in your city. Should you wish to go to a private hospital out of the network, then you will be liable for all the bills. However, in the event of an emergency, most low income medical aids will still allow you to be hospitalised in any private hospital even out of the network for a period of time. It is important to discuss these terms and policies with your medical aid so you understand the implications when you fall ill.

Outpatient Medical Care

Depending on the plan that you choose, there will also be out of hospital benefits. Most low income medical aid plans restrict you to clinics or doctors with a network. In the past, clinics like Prime Cure were favoured by low cost medical aids. However, these schemes have expanded the network to include private doctors like GPs (general practitioners) who are contracted into their low cost medical aid plans. This means that the doctor has agreed to accept a slightly lower rate for patients who belong to these lost cost medical aids.

Medication and basic diagnostic investigation may also be included within the benefits but you are restricted to the number of times you can visit a doctor in the year.  Chronic medication is covered as well but to a lower limit although with Prescribed Minimum Benefits, you can rest assure of cover throughout the year for 25 life-threatening ailments. Only approved doctors can provide you with prescriptions for these chronic medicines.

Lowest Cost Medical Aid Plans

Different medical aids have different low income plans. One of the most well known of these is the Discovery Health KeyCare series. It starts from as little as R465 per month for the main member and adult dependents with children being covered for as little as R117 per month. These are the 2012 rates and increases every year. With Discovery Health being the biggest open medical aid in the country, the Keycare series is often the preferred choice for low cost medical aid.

However, there are several other popular low cost medical aid plans offered by other schemes like Bonitas, Momentum Health and Medihelp. It is best to discuss your needs and budget with a medical aid broker who can help you find the best plan that suits you. You should also discuss your wish for medical aid cover with your employer. Although employer contributions to a medical aid is not mandatory in South Africa, many employers are keen to work with their employees to ensure their health.

Medical Aid for Low Income Earners, Workers and Families
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