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- Our products
- Medical aid vs. insurance
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Health solutions that fit your lifestyle
- Products
Fedhealth Medical Aid
More choice, flexibility and control, and more risk benefits than other schemes.
Options for every life stage and healthcare need.
Customisation and control for single people, young couples, or growing families with our flexiFED range.
Innovative Fedhealth Savings, powered by MediVault, helps flexiFED members save on their monthly contributions, while still having access to funds for day-to-day medical expenses.
Sanlam Primary Care
A great way to either complement your existing hospital plan or an affordable way to access quality private primary health care benefits.
Comes with a range of day-to-day benefits
Core Benefits - Day-to-day: Visits to GPs, dentists, optometrists and specialists, as well as benefits for radiology, pathology, acute and chronic medication
Additional Benefits - Accident and Emergency (A&E): Hospital expenses that result from an accident, emergency casualty room visits after hours, and emergency transportation
Sanlam Gap Cover
An insurance product that provides protection for shortfalls between what you medical aid pays and what hospitals and service providers charge when hospitalised.
From as little as R321 and R487 for a family under 30 years.
Hospital Tariff Shortfalls: Covered at 600% over the medical scheme rate for procedures, includes shortfalls for Prescribed Minimum Benefits and mental health institution stays.
Co-payments and Deductibles: Covered for all diagnostic procedures in and out of hospital if funded by your medical scheme from risk.
Penalty Co-payments: Assists with up to two penalty co-payments a year, up to R18,550 per event.
What’s the difference?
Medical aid vs. medical insurance
Medical aid schemes
Medical aid schemes are governed by the Medical Schemes Act and have to adhere to a list of very specific rules and regulations. This includes open enrolment, standard-rate fees, and cover for the diagnosis and treatment for a list of Prescribed Minimum Benefits (PMBs). Payments are normally made directly to the hospital or service provider.
Medical insurance products
Medical insurance products fall under the Short-term Insurance Act with specified benefits that pay out a defined amount per day or per incident, irrespective of the medical treatment needed. Payments are made directly to the client who stays responsible for payment to service providers.
Rewards
Get rewarded for staying healthy
Fedhealth members enjoy a free digital platform to take part in health activities, track progress, earn exciting rewards and enjoy discounts on Sanlam financial products.
Get rewarded with vouchers from industry leading brands by completing activities such as personalised health challenges and assessments.
You have access to Always On benefits, wellness content, instant weekly rewards and exclusive lifestyle perks that support a balanced and healthy life.
Larger rewards can also be earned if you engage with the Annual Health Rewards.
Questions to ask
Choosing a medical aid plan
- What are my medical scheme options?
There are a wide range of medical scheme options available including: savings, traditional, virtual, hospital and income-based options. When choosing an option, consider one that will provide you and your family with cover for everyday medical incidents, as well as life-changing events such as pregnancy, accidents, or the diagnosis of dread diseases. A Sanlam financial adviser can guide you to a health-accredited specialist to determine the most suitable option for you.
- What are the key things to consider?
Life stage and age You may have to use a set provider network in order to get full cover for certain treatments.
Health Chronic and dread diseases can affect anyone. If there’s a history of certain diseases in your family, there’s a greater chance that it might become a reality for you. Be prepared with comprehensive medical cover when you need it.
Your pocket Shop around until you find the right option to suit your needs and budget.
- Is there more to consider before choosing?
You may have to use a set provider network in order to get full cover for certain treatments.
Study your product brochure to make sure of what is excluded on your option, or the co-payments on certain in-hospital procedures.
Find out about the chronic medicine formularies, designated service providers and the maximum amount the scheme is willing to pay.
Certain waiting periods may apply before you are covered for a specific condition.
It is crucial to share your full medical history when signing up for a new medical aid to avoid the scheme’s refusal to pay out claims in future due to non-disclosure.
Make sure you know how the option covers oncology, dialysis, and HIV.
More Products
Your health journey starts here
From disability cover, to severe illness cover, Sanlam is here to help protect what matters most to you.
- More Products
Disability cover
Manage the financial impact of a permanent or temporary disability.
Cancer cover
Fight cancer, not your finances with this comprehensive solution. Supplement existing cover and take care of unexpected costs.
Severe illness cover
Focus on your health, and not the unexpected costs of a dread disease, with cover that helps you as you recover.