Best health insurance in South Africa in 2025
- Top-tier chronic and hospital cover
- Full maternity support
- Extensive optical/dental
- Ideal for families with high needs
- Top-tier chronic and hospital cover
- Full maternity support
- Extensive optical/dental
- Ideal for families with high needs
With one of the most comprehensive health coverage options on the South African market, the Platinum plan from KeyHealth stands out for its all-inclusive scope. Although the monthly premium is on the higher end, it justifies the cost with unlimited hospital cover in DSP (Designated Service Provider) networks, extensive chronic condition management (55 conditions), enhanced optical benefits, and full dental support including orthodontics and prosthetics with prior authorization. Day-to-day benefits are generous, and high limits apply to consultations and medication. Complementary care features are also remarkable, with maternity, palliative, and elderly support services included. The plan is designed to align well with South African private healthcare standards, providing peace of mind even for serious or ongoing health needs.
Highly recommended for families, older adults, or individuals with extensive medical needs, chronic illnesses, or expecting children. Also suitable for those who want premium coverage without compromise.
For all these reasons, we recommend KeyHealth’s Platinum Option.
- Unlimited hospital cover in preferred networks
- Extensive dental and optical coverage
- Highest chronic medication benefit range
- Full maternity and palliative care support
- Premium cost may not suit all budgets
- Requires prior approval for many advanced procedures
- Most comprehensive plan
- Elite global and chronic care
- High premiums justified
- Top travel emergency cover
- Strong digital & wellness features
- Most comprehensive plan
- Elite global and chronic care
- High premiums justified
- Top travel emergency cover
- Strong digital & wellness features
Discovery Health offers its Executive Plan as a premium and comprehensive medical aid solution in the South African market. It provides extensive cover across key health domains, including dental, consultations, hospitalisation, optical, and chronic medication—backed by reimbursement rates as high as 300% for specialists and virtually unlimited hospital coverage. Optical benefits up to R10,550 and maternity support make this a standout offer for those seeking maximal protection. However, access to top-tier benefits often comes with significant costs, and out-of-network services can trigger co-payments. Still, this plan aligns seamlessly with South Africa’s high-cost private health sector and caters well to demanding medical needs.
Professionals or families with chronic conditions, frequent specialist visits, or those requiring high-end private healthcare services.
For all these reasons, we recommend Discovery Health's health insurance.
- Most comprehensive plan on the market
- Elite global and chronic care coverage
- Premium pricing may not suit all budgets
- Network restrictions may apply for full benefit access
- Designed for professionals
- Generous specialist & chronic limits
- Strong maternity & trauma support
- High value-for-money
- Designed for professionals
- Generous specialist & chronic limits
- Strong maternity & trauma support
- High value-for-money
Profmed’s ProPinnacle plan stands out with its emphasis on professionals, offering tailored coverage with high limits and flexibility. It includes up to 300% cover for in-hospital consultations, over 50 chronic disease conditions, and wide-ranging maternity, mental health, and global emergency services. Dental and optical benefits are strong and structured with clear annual limits. The Savvy option requires DSPN hospital usage, which can limit provider freedom, but otherwise, the plan is well-calibrated for high-value use. The inclusion of trauma and GBV support makes it particularly progressive in its support for real-life healthcare scenarios.
Ideal for working professionals, especially those with families, who require advanced chronic care or travel cover.
For all these reasons, we recommend Profmed's health insurance.
- High specialist and chronic condition limits
- Global assistance and trauma coverage
- DSPN usage required on some options
- Can be costlier than simpler plans
- Solid family plan
- Good network support
- Balanced cost vs. benefit
- Preventive care prioritized
- Specialist referral needed
- Solid family plan
- Good network support
- Balanced cost vs. benefit
Bonitas’ BonComprehensive plan offers a balanced and family-oriented package that includes solid coverage for dental care, consultations, medications, hospitalisation, and preventive health services. With generous limits for GP and specialist visits, routine and prosthodontic dental treatments, and a user-friendly network structure, it positions itself as a highly dependable option for households. The plan also includes good support for chronic illness and vaccinations. However, co-payments apply for out-of-network services and certain specialist visits require referrals, which may reduce flexibility for some users.
Families or individuals looking for comprehensive benefits, consistent chronic care support, and reliable access to private healthcare within a controlled budget.
For all these reasons, we recommend Bonitas' health insurance.
- Wide coverage across essential health categories
- Good chronic and preventive care support
- Referral system required for specialists
- Co-payments apply outside the provider network
- Very flexible via provider choices
- Unique wellness rewards
- Best for tech-savvy users
- Generous global aid cap
- Complex option structure
- Very flexible via provider choices
- Unique wellness rewards
- Best for tech-savvy users
- Generous global aid cap
Momentum’s Extender Option is a flexible and personalised health plan that allows users to choose their level of provider access and co-payment structure. With coverage for 62 chronic conditions, high medication caps, and solid hospital benefits, it stands out for its customisability. Dental, optical, and maternity benefits are also strong. The wellness-driven interface, including rewards and digital tools, aligns with modern healthcare usage. However, the plan’s complexity and varying co-payment structures might confuse less informed users.
Tech-savvy individuals or families who value wellness incentives and want to customise their benefits around their lifestyle and provider preferences.
For all these reasons, we recommend Momentum's health insurance.
- Strong chronic and maternity care
- High flexibility and personalisation
- Complex benefit tiers and rules
- Co-payments vary widely based on choices
- Strong hospital + dental cover
- Good for families
- Clear plan structure
- Mid-tier outpatient cap
- Encourages DSP use
- Strong hospital + dental cover
- Good for families
- Clear plan structure
Bestmed’s Pace 4 plan offers a high-value and comprehensive solution for users who need consistent access to healthcare providers and medications. Covering general and specialist dentistry, consultations, vaccines, and maternity, it meets most private healthcare needs. Benefits like 200% specialist cover and substantial in-hospital and chronic medication limits make it appealing to families with frequent healthcare usage. However, reliance on designated service providers and specific authorisations may be limiting.
Families or individuals with regular healthcare needs and preference for a predictable, mid-to-high level of coverage.
For all these reasons, we recommend Bestmed's health insurance.
- Extensive hospital and dental cover
- Accessible pricing for high coverage
- Use of DSPs strongly encouraged
- Authorisation needed for many services
- Excellent for medium needs
- Well-rounded maternity & screening
- Broad chronic support
- Strong wellness focus
- Limited outpatient flexibility
- Excellent for medium needs
- Well-rounded maternity & screening
- Broad chronic support
- Strong wellness focus
Medihelp’s MedPlus plan targets users looking for a mid-to-upper-tier medical scheme that covers all essentials including maternity, optical, chronic care, and routine dental. It provides unlimited hospital access, capped out-of-hospital consultations (R4,500/year), and generous medication limits for both acute and chronic cases. The plan’s structured prevention benefits (vaccines, contraception, screenings) make it proactive. However, consultation budgets are limited compared to competitors, and higher-tier options may offer better specialist access.
Mid-income earners or small families seeking a broad medical scheme with solid maternity and outpatient medication support.
For all these reasons, we recommend Medihelp's health insurance.
- Well-rounded maternity and screening benefits
- Good medication cover for chronic and acute
- Lower outpatient consultation limits
- Prior authorisation required frequently
- Low-cost digital hospital plan
- Ideal for young professionals
- Great remote support features
- High value in its bracket
- Limited non-hospital benefits
- Low-cost digital hospital plan
- Ideal for young professionals
- Great remote support features
- High value in its bracket
Fedhealth’s flexiFEDSavvy plan is a budget-conscious, hospital-focused solution tailored to young professionals or digital-first users. It covers unlimited private hospitalisation within a provider network and offers virtual GP consultations, mental health support, and screenings. However, it excludes most dental and optical benefits and limits GP visits to three per year (in-person). It’s highly affordable, but less suitable for families or those needing frequent specialist care.
Young working adults or students in good health who prefer remote consultations and need strong hospital cover without extensive outpatient needs.
For all these reasons, we recommend Fedhealth's health insurance.
- Excellent value for hospital care
- Digital tools and telehealth options included
- Limited physical consultations and no optical/dental cover
- Specialist access restricted unless hospitalised
- Reliable mid-range plan
- Clear dental & optical benefits
- Solid maternity support
- Requires DSP compliance
- Routine limits apply
- Reliable mid-range plan
- Clear dental & optical benefits
- Solid maternity support
Medshield’s MediValue Prime is a moderately priced plan with well-structured benefits for GP and dental services, hospitalisation, and preventive care. It allows for up to 2 specialist visits per family and includes maternity and vaccination support. Routine care is capped, and co-payments may apply out-of-network. The plan rewards adherence to its designated service provider system but may limit freedom for those who prefer a broader range of private facilities.
Budget-conscious families or individuals who seek routine healthcare, moderate chronic coverage, and structured access to private care via networks.
For all these reasons, we recommend Medshield's health insurance.
- Clear and defined benefits for maternity and dental
- Good preventive care inclusions
- Limited out-of-hospital flexibility
- Specialist visits capped and referrals required
- Simple, affordable option
- Good basic optical & GP cover
- Suitable for young professionals
- Lacks depth for chronic cases
- Needs network discipline
- Simple, affordable option
- Good basic optical & GP cover
- Suitable for young professionals
CompCare’s SelfCare Plus plan is a compact and affordable option aimed at individuals seeking basic medical aid with essential benefits. It includes up to six GP visits, chronic medication for approved conditions, dental care capped at R7,000/year, and full hospital coverage. Optical benefits and mental health support are also available. However, coverage depth is limited, with tight caps on consultations and medications, and minimal flexibility for higher medical demands.
Young professionals or freelancers seeking minimal yet structured medical coverage, and comfortable with capped benefits.
For all these reasons, we do not recommend CompCare's health insurance.
- Affordable and straightforward structure
- Includes basic dental and optical
- Very limited outpatient and chronic flexibility
- Not suitable for high healthcare users
- How health insurance works in South Africa
- What does health insurance cover?
- What does health insurance NOT cover?
- The cost of health insurance in South Africa
- How to lower the cost of your health insurance?
- FAQ
Did you know that a standard private hospital stay in South Africa can easily exceed R20,000 per night, with many costs not covered by the public system? Unexpected illnesses, accidents, and the high cost of advanced treatments are real risks for South Africans. The public healthcare system, known as the Department of Health or "public health sector," often struggles with waiting times, limited resources, and restricted access to specialists. This makes a well-chosen private health insurance policy crucial for fast, quality care, covering vital benefits like hospitalisation, specialist consultations, and chronic medication.
Comparing providers is essential, as cover and premiums can vary widely. HelloSafe’s mission is to offer you independent, trustworthy comparisons, backed by in-depth analysis and expertise, so you can choose the best health insurance for your needs in South Africa with confidence.
How health insurance works in South Africa
South Africa's public healthcare system, the National Department of Health, often faces challenges such as long waiting times, overcrowded facilities, and limited access to specialist care.
Private health insurance offers faster access to medical services, elective procedures, and private hospitals, where waiting times are usually much shorter.
It provides wider coverage for outpatient care, chronic conditions, and direct access to specialists without lengthy referral processes.
Additional benefits can include higher reimbursement levels, more comprehensive benefits, and international medical coverage, making private health insurance a valuable choice for those seeking greater security and convenience.
What does health insurance cover?
In South Africa, health insurance commonly includes basic cover for general practitioner visits, prescribed medicines, and in-hospital treatment for accidents or medical emergencies.
Optional extras, such as dental, optical, maternity, and extended hospitalisation, can be added to your plan for broader protection and higher reimbursement limits.
Reimbursement works either by direct payment to the provider or refund to the policyholder, usually based on a set tariff schedule; some plans have deductibles (co-payments) and waiting periods for certain benefits.
This is different from the public healthcare system, managed by the National Department of Health, which provides free or low-cost care but often with long waiting times and limited access to private specialists or facilities.
Private health insurance therefore offers quicker, more flexible, and more comprehensive coverage compared to relying solely on the public system.
| Type of cover | Reimbursement by National Department of Health | Coverage with basic private insurance | Coverage with premium private insurance |
|---|---|---|---|
| 💊 General care | 100% in state hospitals | Yes | Yes |
| 🏥 Hospitalisation | 100% (public) | Yes (emergency only or basic) | Yes (private hospital/private ward) |
| 🦷 Dental | Not covered | Optional/Partially | Yes |
| 👓 Optical | Not covered | Optional/Partially | Yes |
| 🤰 Maternity | 100% (basic care in public clinics) | Optional/Partially | Yes |
| 🌿 Alternative medicine | Not covered | No | Optional/Partially |
| 🛡️ Preventive care | 100% for child immunisations | Yes | Yes |
| 🧠 Psychological care | Not covered | Optional/Partially | Yes |
| 👂 Hearing aids | Not covered | No | Optional |
| ♨️ Thermal spa treatments | Not covered | No | No |
| ♿ Medical equipment and devices | Not covered | No | Optional |
| 🍃 Non-covered alternative treatments (e.g. acupuncture) | Not covered | No | Optional/No |
| ✈️ Medical assistance abroad | Not covered | No | Optional/Yes |
| 💻 Teleconsultation | Not covered | Yes | Yes |
What does health insurance NOT cover?
Most health insurance policies in South Africa exclude pre-existing conditions for a certain period, meaning costs related to illnesses or treatments you had before joining may not be covered right away.
Cosmetic procedures, experimental treatments, and surgeries not considered medically necessary are usually excluded from all policies.
Other frequent exclusions include treatment for self-inflicted injuries, substance abuse without rehabilitation, and care outside South Africa, unless you’ve specifically chosen international cover.
Waiting periods often apply, especially for maternity and dental, and there are also coverage limits for chronic medication and certain expensive procedures.
Read your policy carefully to understand all exclusions and any applicable waiting periods.
| Exclusion type | Example | Good to know |
|---|---|---|
| Medical | Pre-existing condition, cosmetic surgery, experimental cancer drugs | Pre-existing conditions may have waiting periods (often 12 months); elective cosmetic procedures are not reimbursed |
| Administrative | Non-disclosure, missed premium payments | Failure to disclose medical history or missed payments can void coverage |
| Legal | Injuries from illegal acts, self-harm, war-related injuries | Claims related to criminal activity, self-inflicted harm, or war are always excluded |
| Geographic | Treatment outside South Africa | Medical assistance abroad usually requires extra cover |
| Benefit limits | Chronic medicine max capped, expensive prosthetics | Even covered services can have strict financial limits per year |
The cost of health insurance in South Africa
The price of health insurance in South Africa is influenced by factors such as your age, medical history, chosen level of cover, deductible (excess), and the number of people included on the policy.
Younger applicants usually pay lower monthly premiums, while premiums increase as you get older or if you have pre-existing medical conditions.
Selecting a more comprehensive policy with additional benefits or a lower deductible will also increase your monthly cost, whereas choosing a higher excess can reduce it.
Premiums may also rise annually due to inflation, changes in your health status, past claims, or upgrades in your cover.
Each insurer reviews premiums based on these risks, resulting in regular adjustments to the rand (ZAR) amount you pay.
| Age group | Cover type | Monthly premium (basic) | Monthly premium (premium) |
|---|---|---|---|
| 25 years | Basic | R900 | R2.100 |
| 45 years | Basic | R1.400 | R2.850 |
| 65 years | Basic | R2.300 | R4.200 |
How to lower the cost of your health insurance?
| Tip | Explanation |
|---|---|
| Compare offers | Use the HelloSafe comparison tool at the top of the page to easily identify the cheapest coverage that fits your needs. |
| Choose hospital plans only | Selecting a plan that covers hospitalisation only and excludes day-to-day benefits can substantially lower your monthly premium. |
| Increase your deductible | Opting for a higher excess (the amount you pay for claims) reduces your regular premium payments. |
| Limit dependents | Only add essential family members to your health insurance policy to prevent unnecessary additional costs. |
| Review benefits annually | Regularly check and adjust your plan to remove benefits you no longer need, ensuring you are not overpaying. |
| Maintain a healthy lifestyle | Some insurers offer discounts or rewards for healthy living, which can help reduce premium increases. |
| Pay annually | If possible, pay your premium annually rather than monthly, as insurers sometimes offer a discount for lump-sum payments. |
| Consider network providers | Use the insurer’s preferred medical provider network to qualify for lower premiums and reduced out-of-pocket expenses. |
FAQ
What is the difference between health insurance and medical aid in South Africa?
Health insurance usually provides fixed cash benefits for specific health events or hospital stays, while medical aid covers the actual cost of medical treatments, hospitalisation, and doctor visits. Medical aid is regulated under the Medical Schemes Act, while health insurance has fewer mandatory benefits and is often more affordable but with more limited coverage.
Does health insurance cover private hospitals in South Africa?
Some health insurance policies do provide fixed cash payouts if you are treated at private hospitals, but these payouts may not cover the full cost of admission or specialist fees. It is important to read your policy carefully and compare it to medical aid, which pays for services directly at private hospitals under its contract agreements.
Can I have both public healthcare and private health insurance in South Africa?
Yes, you can make use of the public healthcare system operated by the Department of Health and also have private health insurance or medical aid. This allows you to access basic services through public clinics while using insurance for faster, private care or specialist treatment.
How do waiting periods work in South African health insurance?
Waiting periods are specific times after joining, usually ranging from three to twelve months, when certain claims or conditions are not covered. Insurers use them to prevent people from joining only when they expect high-cost treatments, so check your policy for details on waiting times for pre-existing conditions or maternity benefits.
Do health insurance premiums increase every year in South Africa?
Premiums generally rise each year due to factors like inflation, higher medical costs, and increased claims across the industry. You may also see higher premiums as you age or if you upgrade your cover, so it’s a good idea to review your policy annually and shop around for better deals.
Is there a penalty if I do not have health insurance or medical aid in South Africa?
There is currently no legal penalty or mandatory requirement to have private health insurance or medical aid in South Africa. However, without it, you may have to rely solely on the public system which can mean longer waits and less choice in providers.
Does health insurance cover chronic conditions in South Africa?
Basic health insurance plans often exclude chronic conditions or only offer limited benefits for them. Comprehensive medical aid plans are more likely to cover ongoing treatment for chronic diseases, so it’s crucial to compare benefits if you require long-term medication or care.
What is the difference between health insurance and medical aid in South Africa?
Health insurance usually provides fixed cash benefits for specific health events or hospital stays, while medical aid covers the actual cost of medical treatments, hospitalisation, and doctor visits. Medical aid is regulated under the Medical Schemes Act, while health insurance has fewer mandatory benefits and is often more affordable but with more limited coverage.
Does health insurance cover private hospitals in South Africa?
Some health insurance policies do provide fixed cash payouts if you are treated at private hospitals, but these payouts may not cover the full cost of admission or specialist fees. It is important to read your policy carefully and compare it to medical aid, which pays for services directly at private hospitals under its contract agreements.
Can I have both public healthcare and private health insurance in South Africa?
Yes, you can make use of the public healthcare system operated by the Department of Health and also have private health insurance or medical aid. This allows you to access basic services through public clinics while using insurance for faster, private care or specialist treatment.
How do waiting periods work in South African health insurance?
Waiting periods are specific times after joining, usually ranging from three to twelve months, when certain claims or conditions are not covered. Insurers use them to prevent people from joining only when they expect high-cost treatments, so check your policy for details on waiting times for pre-existing conditions or maternity benefits.
Do health insurance premiums increase every year in South Africa?
Premiums generally rise each year due to factors like inflation, higher medical costs, and increased claims across the industry. You may also see higher premiums as you age or if you upgrade your cover, so it’s a good idea to review your policy annually and shop around for better deals.
Is there a penalty if I do not have health insurance or medical aid in South Africa?
There is currently no legal penalty or mandatory requirement to have private health insurance or medical aid in South Africa. However, without it, you may have to rely solely on the public system which can mean longer waits and less choice in providers.
Does health insurance cover chronic conditions in South Africa?
Basic health insurance plans often exclude chronic conditions or only offer limited benefits for them. Comprehensive medical aid plans are more likely to cover ongoing treatment for chronic diseases, so it’s crucial to compare benefits if you require long-term medication or care.
