Choosing a plan
Network vs traditional medical aid plans: what you save and what you give up
By MedicalAidZA editorial team · 6 min read · Updated 29 September 2026
A network plan is a medical aid option that costs less because you agree to use the scheme's chosen hospitals, and sometimes its doctors, pharmacies or chronic medicine providers. A traditional plan, sometimes called a full-list or any-hospital plan, lets you use a wider range of private hospitals for a higher contribution.
The saving is real. Medihelp's MedVital Elect, a network hospital plan, lists R2 412 a month for a main member, while the non-network MedVital lists R3 096. The price of the saving is a co-payment, or worse, if you go outside the list for planned care. Bestmed's Beat1 Network charges R15 025 in that case.
This guide compares prices, explains what happens out of network, and shows how to check a network before you commit.
What a network plan is
The scheme agrees rates with a defined set of providers and passes the saving on as a lower contribution. Depending on the plan, the network can apply to:
- Hospitals. The most common form. Planned admissions must be at listed hospitals.
- Doctors and specialists. Some plans steer you to contracted providers.
- Pharmacies and chronic medicine. A designated pharmacy or a state chronic medicine option.
- Primary care. Discovery's Smart series, for example, gives limited day-to-day cover if you use providers in a specified network.
Fedhealth says its GRID hospital network is the second largest in South Africa, with Mediclinic and Netcare prominent, and that GRID options save 10% a month on contributions. Ask any scheme for the current list and how often it changes.
What the saving looks like in 2026
Several schemes sell a network and a non-network version of the same option. These are 2026 main member contributions as published.
| Scheme | Option | Non-network or full list | Network version |
|---|---|---|---|
| Bestmed | Beat1 (hospital plan) | R2 523 | R2 269 |
| Bestmed | Beat2 (with savings) | R3 084 | R2 775 |
| Bestmed | Beat3 (with savings) | R4 514 | R4 062 |
| Medihelp | MedVital (hospital plan) | R3 096 | R2 412 |
| Medihelp | MedAdd (savings plan) | R4 038 | R3 186 |
| Medihelp | MedPrime (comprehensive with savings) | R5 790 | R4 746 |
| Sizwe Hosmed | Gold Ascend (comprehensive) | R4 468 | R4 249 |
Momentum prices its Custom hospital plan by your choices: R2 585 a month if you pick its Associated hospitals and State chronic medicine, and R4 472 if you choose Any hospital and Any chronic. The network choice is the difference between the two prices.
The saving varies a lot. On the Medihelp examples it is larger than on Sizwe Hosmed's. For more hospital plans see hospital plan prices.
What happens when you go out of network
For a planned admission at a non-network hospital, a network plan usually charges a co-payment or pays less. Bestmed's Beat1 Network charges a R15 025 co-payment for voluntary use of a non-network hospital. Bonitas' Hospital Standard applies a 30% co-payment. Other plans set their own amounts, so ask for yours in writing.
For Prescribed Minimum Benefits (PMBs) the rules are tighter. A scheme may require a designated service provider (DSP) and charge a co-payment if you choose someone else voluntarily. No co-payment applies if you had to use a non-DSP involuntarily, which the Regulations treat as the case when:
- the DSP could not provide the service without unreasonable delay
- you needed immediate treatment where a DSP could not be reached
- there was no DSP within reasonable proximity of your home or work
Keep records of why the DSP could not be used. The CMS says that where a DSP cannot treat you, the scheme remains liable for the cost at a non-DSP. See designated service providers and co-payments and sub-limits.
Emergencies on a network plan
In a true emergency, go to the nearest facility. The CMS says you may use a facility that is not a DSP and the scheme must cover the costs, and the Regulations say a scheme may not stop a provider starting appropriate emergency treatment before authorisation.
Tell your scheme as soon as you can. You may be asked to transfer to a network hospital once you are stable, so confirm your scheme's rule. Read emergency and ambulance cover for the steps.
How to check a network before you join
- Get the scheme's list of network hospitals for your plan and check it against a map of where you live and work.
- Check that your usual GP, specialist and pharmacy are covered, if the plan applies networks to them.
- Ask which hospital you would use for a baby, a broken bone or a heart problem, and how far it is.
- Ask for the co-payment on using a non-network hospital, in writing.
- Ask how the scheme handles chronic medicine, and whether there is a state or designated option that changes the price.
- Ask how often the network can change, and what notice you get.
Networks are thinnest outside the big cities. If the nearest network hospital is a long drive away, a traditional plan may cost you less in the end. Use the checklist in questions to ask before joining a scheme.
Who each type suits
A network plan suits you if you want the lowest contribution, live near a network hospital and are happy to use the scheme's providers for planned care.
A traditional plan suits you if you want free choice of private hospital and specialist, value that more than price, or live where network coverage is limited.
The choice is not final. Members can move options at the scheme's yearly window. The CMS says to finalise decisions by late November or early December and to check waiting periods and penalties first. Within the same scheme, the Medical Schemes Act allows no new waiting period when you change options, unless one is still running on your current option. See how to change medical aid.
Networks apply to hospital plans and to comprehensive plans alike. To decide between plan types, read hospital plan vs comprehensive.
Frequently asked questions
What is a network medical aid plan?
A network plan is a medical aid option where you agree to use the scheme's chosen hospitals, and sometimes doctors or pharmacies, in exchange for a lower contribution. Using providers outside the network for planned care can mean a co-payment.
What is the difference between network and traditional plans?
A network plan restricts planned care to a defined list and costs less. A traditional plan gives wider hospital choice for a higher contribution. On Medihelp's MedVital, R2 412 is the network price and R3 096 the non-network price.
Do I pay extra for using a non-network hospital?
Usually, yes, for planned care. Bestmed's Beat1 Network charges a R15 025 co-payment for voluntary use of a non-network hospital, and Bonitas' Hospital Standard applies 30%. Emergencies and involuntary use are treated differently.
What happens in an emergency on a network plan?
Go to the nearest facility. The CMS says the scheme must cover the cost of emergency treatment even if the provider is not a DSP. You may be transferred to a network hospital once stable.
Are network plans worth it?
They are good value if a network hospital is close to you and you are happy to use it. They suit you less if your preferred hospital or specialist is outside the list, or if you live far from network providers.
Are PMBs covered at a non-network hospital?
PMBs must be paid in full, but a scheme can require its DSP and charge a co-payment for voluntary use of another provider. No co-payment applies where use of a non-DSP was involuntary, as the Regulations define it.
Can I switch from a network to a traditional plan?
Yes, usually at the scheme's yearly window. The contribution will be higher. Within one scheme, the Medical Schemes Act allows no new waiting period when you change options, unless one is still running on your current option.
Are network plans only for hospital plans?
No. Network versions exist for hospital, savings and comprehensive options. Medihelp's MedPrime, for example, has a network version, MedPrime Elect, that costs less than MedPrime.
