What is the average price of medical aid?

Medical aid is calculated using many factors, of which the most important is affordability for the particular individual. There are definitely basic price points and tiers set up by each scheme, but the price per family and member varies. But, on average, what can you expect to pay for a medical aid in South Africa?

As of 2018, 8.8m South Africans are able to afford private healthcare, says Jillian Larkan, head of health consulting at Grant Thornton Capital.

According to the annual report for the 2017/18 year by the Council for Medical Schemes (CMS), combined, all medical aid schemes earned R162.9 billion in contributions and paid out R144.5 billion. After accounting for administration costs, broker fees and other impairments and losses, the industry is left with a net surplus of R8.92 billion.

In a table released by the Council, which shows the average monthly contribution by each scheme in South Africa (both public and private), the lowest contribution in a public medical aid scheme for the end of 2017 was with Makoti Medical Scheme, at R887,95 per member. The highest monthly payment for the same time period is KeyHealth, with R2 231, 02.

For restricted medical aid schemes, the lowest payment per month was R111.04 per member. For a restricted scheme in the same period, the highest payment per month was Parmed Medical Aid Scheme with R3 863.46.

According to data from medical aid companies, the industry generally follows the guideline of CPI+3% when determining price increases every year, but this has not always been the case, Business Tech reports.
Tony Singleton, CEO of Turnberry Risk Management Solutions, explains that medical aid contributions need to form part of your overall financial planning.

“You get what you pay for,” says Singleton. “If you take a low-cost medical aid option, for whatever reason, the chances are that you are going to be exposed to some additional costs. For example, a hospital plan covers in-hospital expenses and is typically cheaper than other options. But you are going to be exposed to the costs of all your GP visits and other incidental costs.”