Useful guide to medical scheme plans in three different bands

Although there is just no way of providing a comprehensive comparison of all the medical aid plan options across all the different schemes, we have done the next-best thing. We took three of the most popular medical aid schemes and compared three options they offer: a comprehensive plan, a plan that offers hospital cover and medical savings, and a hospital-only plan.

Pensioners do not receive a discount, and if they joined a medical scheme late, they are likely to pay a late-joiner penalty as well. For this example, we used a family of four (two adults and two children).

Fine print that changes the maths

Networks and copayments: Discovery’s Smart, Core and Delta plans and Momentum’s Evolve use hospital networks, whereas Bonitas’ BonEssential Select avoids a 30% co‑pay when you use the network.

Chronic medicines: hospital plans usually cover Chronic Disease List medicines only through designated service providers (DSPs), and these medicines must be on the scheme’s formulary, which is the list of medicines – both generics and the originals – that will be reimbursed by it. Non‑DSPs or non-formulary medicines attract copayments of between 20% and 30%. Comprehensive options add more chronic conditions and higher limits.

Scans and day‑surgery copayments: the typical MRI or CT scan copayment is about R2,800 per scan, unless it’s a prescribed minimum benefit.

Quick steer (who tends to fit what)

Discovery Classic Comprehensive would suit families with heavy day‑to‑day use needing broader specialist cover and above-threshold benefit protection.

BonComprehensive has a clear savings and threshold structure with strong maternity and child add‑ons.

Momentum Summit provides any‑provider flexibility and rich benefits at a premium price. It would also suit a family with high specialist use.

BonEssential is a strong‑value hospital plan if you’re disciplined about DSPs and formularies and cash‑pay day-to-day.

Momentum Evolve offers a low per‑beneficiary hospital pricing with virtual GPs. It is best for digital‑first, network‑comfortable members.

Discovery Core is a hospital‑only option that can be paired with a health‑saver if needed.

Notes on the numbers

Contributions are option- or network‑dependent and subject to the rules of the Council for Medical Schemes rules. Get an official quote for your exact ages and income, as well as network choices.

All figures shown are 2025 public list prices and illustrative totals where per‑beneficiary pricing is published. DM

This story first appeared in our weekly Daily Maverick 168 newspaper, which is available countrywide for R35.