Sanlam and Old Mutual medical aid: gap cover, health insurance and partner schemes

Old Mutual's personal health page lists gap cover and severe illness cover and no medical scheme. Sanlam states that its medical insurance products fall under the Short-term Insurance Act and pay a defined amount per day or per incident, whatever the treatment needed.

• Neither Sanlam nor Old Mutual runs a medical scheme. Sanlam sells Gap Cover (insured by Centriq, FSP 3417) and Primary Care health insurance, and points people wanting medical aid to Fedhealth Medical Scheme as its preferred partner scheme. Old Mutual sells Gap Cover (administered by Kaelo, underwritten by GENRIC, FSP 43638), employer Health Solutions health insurance (underwritten and administered by GENRIC) and, for employer groups only, a Medihelp Medical Scheme collaboration. (oldmutual.co.za)
• Sanlam explains that medical aid schemes are governed by the Medical Schemes Act, while its insurance products fall under the Short-term Insurance Act and pay defined amounts. (sanlamonline.co.za)
• Sanlam Gap Cover is only for people who already belong to a registered medical scheme. (sanlamonline.co.za)
• Sanlam Gap 2026 oncology limit is the statutory maximum of R219,845 per insured per year. (sanlamonline.co.za)
• Sanlam Gap has an automated, paperless claims process for members of preferred partners Fedhealth and Medshield. (sanlamonline.co.za)
• Sanlam's own pages show two different starting prices for gap cover: 'From as little as R321 and R487 for a family under 30 years' on the health-solutions page and 'Individuals from R346/pm, families from R524/pm' on the gap page. (sanlamonline.co.za)
• Old Mutual says Gap Cover requires active membership of a registered South African medical scheme and is 'specifically designed to boost your existing medical aid cover'. (oldmutual.co.za)
• Old Mutual Gap 2026 policy wording is effective 1 January 2026 and is underwritten by GENRIC and distributed by Old Mutual Life Assurance Company (South Africa) Limited. (oldmutual.co.za)
• Old Mutual Health Solutions is an employee-benefit offering: it lists health insurance, medical aid, gap cover, occupational health, executive wellness, onsite clinics and an employee assistance programme. (oldmutual.co.za)
• Old Mutual explains health insurance is for basic day-to-day expenses at lower cost and that employees cannot hold both health insurance and medical aid if the benefit option provides hospital emergency or illness cover. (oldmutual.co.za)
• Reported launch (undated news item): Old Mutual Health Solutions primary care rates start from R260 for a principal insured person and its head of employee benefits stressed the offering 'is not medical aid'. Article date not shown on the fetched page; the official Old Mutual page publishes no price. (cover.co.za)

Sanlam and Old Mutual (what they sell under 'medical aid': partner scheme, gap cover, employer health insurance) publishes 6 products for 2026. Prices are the monthly contribution for a main member as published by Sanlam and Old Mutual. Adult and child dependants pay extra. Checked on 29 September 2026.

Sources: sanlamonline.co.za/personal/health-solutions, sanlamonline.co.za/...l/health-solutions/gap-cover, sanlamonline.co.za/...olutions/retail-primary-care, oldmutual.co.za/...l/solutions/health/gap-cover, oldmutual.co.za/...e/employers/health-solutions.

Sanlam names Fedhealth as its preferred medical scheme, with flexiFED options and Fedhealth Savings, and says Sanlam advisers or its site can refer you. The scheme, its contributions and its rules are Fedhealth's, not Sanlam's. Fedhealth applied a 9.6% average weighted increase for 2026.

If you want the scheme itself, read our Fedhealth page. Sanlam Gap also has an automated, paperless claims process for members of Fedhealth and Medshield, its preferred partner schemes.

Checked on 29 September 2026 against Sanlam and Old Mutual'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: sanlamonline.co.za/personal/health-solutions, sanlamonline.co.za/...l/health-solutions/gap-cover, sanlamonline.co.za/...olutions/retail-primary-care, sanlamonline.co.za/corporate/health-solutions, fedhealth.co.za, oldmutual.co.za/...l/solutions/health/gap-cover, oldmutual.co.za/...e/employers/health-solutions. All schemes' numbers are on our medical aid contact numbers page.

Sanlam describes it as "a plan focused on day-to-day medical needs rather than extensive hospital cover". It offers GP visits at contracted network providers, acute medication, limited specialist access on referral and 24/7 telephonic counselling, with optional accident and emergency cover on the individual page.

No price and no underwriter was published on the page we checked, so ask Sanlam in writing who insures it and what the hospital limits are. It is health insurance, so PMBs do not apply. Read our medical aid versus health insurance guide.

Both are for people who already belong to a registered medical scheme, and neither replaces one.

Sanlam Gap (Comprehensive) pays tariff shortfalls up to an additional six times medical aid rates, sub-limit shortfalls up to R68 500 per event, unlimited co-payments and deductibles subject to the overall annual limit, and a hospital booster up to R29 300 a year. The oncology limit is the statutory maximum of R219 845 per insured person a year. Waiting periods are 3 months general and 12 months condition-specific. Sanlam's own pages show two different starting prices for gap cover, so confirm the price for your age and family.

Old Mutual Gap covers in-hospital and defined out-of-hospital shortfalls, consumables, oncology co-payments and sub-limits, a step-down facility, dental reconstruction and casualty benefits, with a contribution waiver. It has 3-month general and 12-month condition-specific waiting periods, and the 2026 policy wording took effect on 1 January 2026.

See the gap cover guide and the gap cover buying checklist. Kaelo administers Old Mutual Gap: see the Kaelo page.

Old Mutual Health Solutions is an employee-benefit offering that lists health insurance, medical aid, gap cover, occupational health, executive wellness, onsite clinic management and an employee assistance programme. Its health insurance is underwritten and administered by GENRIC, sold through employers and groups, and includes day-to-day needs, accident and illness hospitalisation, a personal health adviser and an accidental death benefit. There is also Student Health Insurance for university students. Old Mutual says employees can hold both health insurance and medical aid, but only for day-to-day cover.

Many people search for "Old Mutual staff medical aid". We did not verify a scheme run for Old Mutual's own staff, so if you work there, ask HR which scheme your employer uses. For everyone else, the employer route to a scheme is Medihelp, offered to employer groups only.

Gap cover is not hospital cover: it needs a scheme with hospital benefits underneath. The primary care and employer health insurance products pay fixed benefits, so a large hospital account can leave a gap and PMB protection does not apply.

If you want medical aid, choose a registered scheme directly. From the 2026 figures: Fedhealth flexiFED Savvy hospital plan at R1 155 for the main member, Medihelp MedVital Elect at R2 412, Bonitas BonCore at R1 275 for every beneficiary, and income-based Discovery KeyCare Start. Compare on hospital plans in South Africa and medical aid contact numbers, and see the Medihelp page.

Use the contact table for Sanlam, Old Mutual and the partner schemes. Ask for the policy wording, waiting periods and the underwriter's name in writing.

For a Sanlam or Old Mutual insurance product, complain to the company or the administrator first, then the National Financial Ombud. For Fedhealth or Medihelp, the scheme comes first and then the Council for Medical Schemes: see the CMS complaints guide.