Dis-Chem medical aid: what Dis-Chem Health covers and what it does not

Dis-Chem is a pharmacy retailer. Its health cover is sold under the Dis-Chem Health brand, and the website carries the statement "This is not a Medical Scheme and the cover is not the same as that of a Medical Scheme". The same site also says Dis-Chem Health is neither a medical scheme nor an insurer: the insurer is Centriq, and Kaelo Risk runs the administration and claims (see our Kaelo page).

Health insurance is exempt from the Medical Schemes Act and does not have to cover Prescribed Minimum Benefits (PMBs). It also does not carry the medical scheme tax credit. Read medical aid versus health insurance if the difference is new to you.

• Dis-Chem does not run a medical scheme. Dis-Chem Health sells health insurance (MyHealth Core and MyHealth Plus day-to-day cover), Accident Cover and Gap Cover, insured by Centriq Insurance Company Limited (FSP 3417) and administered by Kaelo Risk (Pty) Ltd (FSP 36931). Dis-Chem Health itself says it is neither a medical scheme nor an insurer. (dischemhealth.co.za)
• Dis-Chem's medical insurance does not cover hospital admissions for illness, only trauma or accident events. (dischemhealth.co.za)
• Accident Cover does not pay for planned hospital admissions. (dischemhealth.co.za)
• Day-to-day cover works through the Prime Cure network, which Kaelo says is owned wholly by Kaelo and has more than 9,500 providers. (dischemhealth.co.za)
• Gap Cover is only for existing members of a registered medical aid and cannot be bought by Medical Insurance policyholders. (dischemhealth.co.za)
• MyHealth Plus covers chronic medication for 27 conditions and MyHealth Core for 7 conditions, both on a defined list. (dischemhealth.co.za)
• MyHealth Core covers only 4 in-person GP visits a year; Plus is unlimited on the Prime Cure network. (dischemhealth.co.za)
• Kaelo's Health FAQ (the administrator) says new day-to-day policies carry a one-month general waiting period, with a six-month condition-specific wait for chronic medication for HIV, type 2 diabetes and dentures. (kaelo.co.za)
• Dis-Chem Better Rewards gives 20% off instantly on a basket of brands at Dis-Chem for policyholders; the savings are marketed as offsetting the premium. (dischemhealth.co.za)
• Health insurance products such as these are exempt from the Medical Schemes Act and do not have to cover Prescribed Minimum Benefits. (dischemhealth.co.za)

Dis-Chem Health (Dis-Chem medical insurance, accident cover and gap cover) publishes 8 products for 2026. Prices are the monthly contribution for a main member as published by Dis-Chem Health. Adult and child dependants pay extra. Checked on 29 September 2026.

Sources: dischemhealth.co.za/medical-insurance/myhealth-core, dischemhealth.co.za/medical-insurance/myhealth-plus, dischemhealth.co.za/...cal-insurance/accident-cover, dischemhealth.co.za/gap-cover.

The price tables are added below. Note that the Lifestyle Benefits are included in the Medical Insurance and Gap plans and are an optional extra on Accident Cover.

Checked on 29 September 2026 against Dis-Chem Health's official website. Numbers change, so confirm on the linked page before you call. A scheme will not ask you to pay into a new bank account over the phone: hang up and call the official number if anything feels off.

Sources: dischemhealth.co.za/contact, kaelo.co.za/contact. All schemes' numbers are on our medical aid contact numbers page.

This is where most people are caught out. Dis-Chem's own FAQ says it does not cover hospital admissions unless the cause is trauma or an accident, and Accident Cover does not pay for a planned admission.

• Accident Cover pays up to R380 000 per event and R1.5m per insured person a year, for accidental harm only.
• Extended Accident Cover pays up to R1.5m per event and R2.5m per insured person a year.
• The Illness Buy-Up adds a list of 12 qualifying emergency illnesses, for example acute appendicitis and pulmonary embolism. It cannot be bought alone.

Any illness outside those 12, any planned operation and any long-term hospital stay is not covered. A hospital stay for an illness that is not on the list, or a planned operation, would be your cost. Ask Kaelo in writing about a planned delivery before you rely on the product for maternity, since planned admissions are excluded.

Day-to-day cover works through the Prime Cure network, which Kaelo says it owns wholly and which has more than 9,500 providers. Check that your doctor is on the network before you rely on the benefits.

MyHealth Core: 4 GP visits and 4 telephonic or virtual GP consultations a year, 8 network pharmacy clinic visits, 8 scripts a year for short-term medication, chronic medication for 7 conditions, basic dentistry, 1 eye test and 1 pair of glasses every 24 months, an HIV programme, 2 x 2D pregnancy scans and health screenings.

MyHealth Plus: everything in Core, plus unlimited GP visits and virtual consultations on the network, 1 specialist visit per person a year (2 per family, up to R2 000 a visit), and chronic medication for 27 conditions.

Both cover chronic medicine only for a defined list of conditions, so check that yours is on it. See our chronic disease guide.

Waiting periods. Kaelo's FAQ says new day-to-day policies carry a one-month general waiting period, with a six-month wait for chronic medication for HIV, type 2 diabetes and dentures.

Rewards. Policyholders get access to Dis-Chem Better Rewards, with 20% off on a basket of brands. Whether that offsets your premium depends entirely on what you buy at Dis-Chem.

Gap Cover is available to existing members of a registered medical aid only. It is not available to Medical Insurance policyholders. Base pays tariff shortfalls up to an additional 500% of medical scheme rates and sub-limit shortfalls up to R34 450 per event. Summit goes up to an additional 600% and R68 370 per event and adds out-of-hospital procedures, co-payments and deductibles, oncology cover and accidental and child casualty.

Gap cover sits on top of a medical scheme. It does not replace one. Read our gap cover guide and the gap cover buying checklist.

It can suit a healthy adult or family who mostly need GPs, acute medicine, chronic medication for a listed condition and basic dentistry at a low monthly cost, and who accept that a major illness would not be covered.

It does not suit anyone who needs hospital cover for illness, planned surgery, specialists beyond one visit, or PMB protection.

Scheme alternatives. An entry hospital plan on a registered scheme covers what Dis-Chem cannot. From the 2026 figures: Bonitas BonCore at R1 275 for every beneficiary, Fedhealth flexiFED Savvy hospital plan at R1 155 for the main member, and income-based Discovery KeyCare Start from R1 436 for the lowest income band. Network limits apply. Compare on hospital plans in South Africa and cheapest medical aid. Similar products include Oneplan and Affinity Health.

We found no announced 2026 or 2027 increase. Kaelo says premiums are rated annually, with adjustments taking effect on 1 January, and the price pages carry no year, so confirm the current price when you apply.

Join through dischemhealth.co.za or the sales line in the contact table. Read the policy wording first, particularly the waiting periods and the list of conditions.

If you have a complaint, use the escalations contact in the table and keep records. If you are not satisfied, complaints about insurance go to the National Financial Ombud, not the Council for Medical Schemes.