Hospital plans in South Africa in 2026: prices compared

Read the last column before you compare prices. A network plan is cheaper than a plan that lets you use any hospital, and a lower price often means a lower rate for doctors or a co-payment if you step outside the network.

Only open schemes are listed, because anyone can apply to them. Sizwe Hosmed is under provisional curatorship and CompCare reported solvency below the 25% minimum for 2024, so check the scheme as well as the plan. Where a plan's 2026 price could not be verified, we have left it out.

A hospital plan pays for a covered admission: ward or theatre costs, and doctors and specialists treating you in hospital, at a percentage of the scheme tariff. That percentage differs by plan. Genesis MED-100 pays doctors at 100% of scheme tariff and Genesis MED-200 at 200%, and Medshield MediCore pays in-hospital practitioners at 200% of the Medshield Private Tariff.

• PMBs are paid in full. Every benefit option must pay the diagnosis, treatment and care costs of the PMBs without a co-payment or deductible. The CMS lists 271 PMB conditions, plus emergencies and the chronic conditions on the Chronic Disease List.
• Network rules apply. A scheme may require you to use a designated service provider (DSP) and charge a co-payment if you choose a non-DSP voluntarily. No co-payment is payable if the non-DSP was involuntary, for example in an emergency or when no DSP is within reasonable distance.
• Emergencies. You may go to the nearest facility in an emergency, and a provider may start appropriate treatment before authorisation.
• Planned admissions need pre-authorisation. Ask the scheme before you book. See our pre-authorisation guide.

Our hospital plan explained and designated service providers guides go further.

• Day-to-day costs are yours. GP visits, dentistry, glasses and acute medicine are not covered on most hospital plans. Some add a little: Bonitas BonCore funds GP consultations, and Medihelp MedVital Elect has limited day-to-day benefits.
• Doctors can charge more than the scheme pays. If a specialist bills above the scheme tariff rate, you carry the difference. Gap cover exists for this.
• Co-payments. Check for a co-payment per admission or for non-network hospitals. Bestmed Beat1 Network charges R15 025 for a voluntary non-network hospital, and Bonitas Hospital Standard charges 30%.
• Non-PMB chronic conditions. Cover beyond the PMB chronic list is limited or absent on most hospital plans.
• Waiting periods. If you have had no cover for 90 days or more, a scheme may impose up to three months general and up to 12 months condition-specific waiting periods, but not for PMB treatment.

Read our co-payments and sub-limits guide and waiting periods guide.

Gap cover is insurance, not a medical scheme, and it only works alongside a scheme. It pays some or all of the shortfall when a doctor charges above the scheme rate, and some products also cover co-payments. The annual limit for a shortfall contract is R226 881.03 per insured person from 1 April 2026.

Gap products have their own waiting periods, for example three months general and 12 months condition-specific on Sanlam and Old Mutual gap cover. Our gap cover guide explains what to compare.

Some products offer hospital benefits but are health insurance. They pay stated amounts rather than the actual bill, and the PMB rules that bind medical schemes do not apply. Complaints about them go to the National Financial Ombud, not the Council for Medical Schemes (CMS).

Read our medical aid vs health insurance guide before you choose one.

Restricted schemes are open only to particular employer groups, professions or industries. The chartered accountants scheme (CAMAF) sells hospital plans with no day-to-day benefits.

If you belong to a group with a restricted scheme, compare it with the open-scheme plans above.

1. Check which hospitals the plan uses and whether they are close to your home and work.
2. Compare the rate for in-hospital doctors, not only the premium.
3. Add the co-payments you could face.
4. Decide whether you want gap cover, and price it.
5. Keep a cash buffer for GP visits and medicine, since the plan will not pay them.
6. Compare with a comprehensive plan if you claim day-to-day costs often, and see the cheapest medical aid guide for network trade-offs.

For 2027, Medshield has announced MediCore at R4 701 and Fedhealth flexiFED Savvy at R1 252. Most other schemes had not announced by 29 September 2026. See the 2027 increases guide.