Medical Aid Enhancers Available in 2025

Bonitas Medical Fund: A Holistic Care Approach
The Benefit Booster, available on most plans except BonComprehensive, Hospital Standard, and BonCap, offers additional day-to-day benefits. It covers acute medicines, GP visits, and non-surgical procedures, with annual amounts per family ranging from R1,160 to R4,000 by plan. Claims are first paid from scheme risk to protect member savings.
Casualty Benefit Enhancement allows two emergency room visits per family without pre-authorisation, with extra consultations for children under six on select plans.
A Mental Health Programme with a digital platform offers members consultations, medication at chronic-disease coverage levels, and access to online mental health resources like assessments, peer support, and virtual therapy sessions.
Maternity and Childcare Programmes support from early pregnancy through postnatal care, with benefits or boosters covering antenatal vitamins, infant vision screenings, and developmental milestone reminders.
Geriatric Home Screening provides members over 70 with home-based wellness and preventative screenings.
These enhancements aim to assist families, individuals with chronic illnesses, and seniors in obtaining comprehensive care.

Discovery Health: Personalised Coverage Options

Discovery Health's 2025 plans see an average 9.3% premium increase alongside benefit upgrades.
The Active Smart Plan, designed for young professionals, starts at around R1,350 per month, focusing on lifestyle and preventive measures.
The Personal Health Fund, an evolution of the WELLTH fund, provides a personalised pool for preventive and day-to-day care, including a one-time joining benefit for more flexibility.
This approach integrates preventive healthcare with personalised benefit pools, suitable for those wanting to manage day-to-day benefits effectively.

Genesis Medical Scheme and Sizwe Hosmed: Expanded Cover and Savings Flexibility

Genesis implements a 5.4% premium increase and extends limits for dental care, consultations, dialysis, and cancer treatment. This may appeal to those seeking better specialist care and chronic illness support.
Sizwe Hosmed introduces Medical Savings Accounts (MSA) with an average 13.7% premium increase, allocating up to 22.7% of contributions for out-of-hospital services like optical and dental care. MSA funds are released quarterly to manage expenses throughout the year.
These plans might draw members interested in higher benefit limits and flexible fund usage.

Momentum Medical Scheme and Bestmed: Focus on Networks and Preventive Care

Momentum's premiums increased by 9.4%, with the launch of the Ingwe Connect network providing accessible care through negotiated rates for consultations and procedures. Benefits have been adjusted for inflation to maintain value.
Bestmed's premiums rose by 12.75%, expanding preventive coverage including mammograms and pap smears across all plans. Child dependents can remain on the plan until age 24 without needing to prove student status. Diagnostic and medication allowances have also been updated.
These schemes offer network-based cost control and enhanced preventive screening options.

FedHealth: Emphasis on Prevention and Technological Integration

FedHealth's premiums increased by 12.4%, whereas the myFED option decreased by 18%, simplifying plan choices. Key 2025 upgrades include:

AI-powered retinal screenings for diabetes patients.
Retinopathy screenings for newborns.
Annual weight management programs covering GP visits and pathology tests.
Expanded HPV PCR testing for women living with HIV.
These enhancements aim to merge technology and personalized care within streamlined plans.

KeyHealth: Digital Solutions and Care for High-Risk Members

KeyHealth raised premiums by 11.9% and introduced digital and clinical initiatives, such as:

A Rewards Programme encouraging preventive screenings.
Expanded virtual consultations via the Clicks Udok platform.
Cardiac Monitoring and Geri-Care Programs for members over 65, focusing on medication adherence and coordinated care.
In-hospital and post-discharge pathways managing chronic and acute conditions.
These improvements cater to members valuing digital healthcare access and proactive health management.

Medshield: Specialist Networks and Emergency Care Improvements

Medshield's contributions increased by 9.6%, with upgrades including:

A Specialist Network covering 15 essential specialties for better access and tariff negotiations.
Coverage for two annual emergency room visits per family without pre-authorisation.
Reduced or eliminated co-payments for certain treatments, including oncology medications.
Medshield phased out the MediSwift option, transitioning members to plans with extended maternity and chronic care pathways.

Considerations to Help Choose an Appropriate Enhancer

Choosing the right enhancer involves evaluating personal health needs, financial circumstances, and preferences. Key factors include:

Healthcare Needs: Prioritise maternity benefits if planning for childbirth or focus on management programs and medication coverage for chronic diseases.
Benefit Structure: Review daily benefit limits and features like Benefit Boosters or Medical Savings Accounts for spending flexibility.
Access to Emergency and Specialist Care: Check emergency consultation coverage and specialist networks.
Preventive and Wellness Programs: Consider mental health, weight management, screenings, and elderly care programs for long-term health support.
Premium Changes and Affordability: Balance premium hikes against benefit enhancements to evaluate value.
Co-Payments and Service Providers: Check co-payments and access to preferred providers to avoid surprise expenses.
Digital and Support Services: Digital platforms for consultations, assessments, and rewards improve healthcare engagement.

Guidance for Reviewing Your Medical Aid Plan Enhancements

Use the Medical Aid Review Period from October to December 2024 to explore options and enhancements, effective January 1, 2025.
Seek Professional Advice: Consult healthcare advisors to assess health needs, compare benefits, and clarify costs.
Assess Current and Future Health Needs: Consider factors like adding dependents, chronic condition management, or family planning.
Understand Plan Updates: Familiarise yourself with enhancements, premium changes, and provider networks.
Weigh Benefits Against Costs: Consider that higher premiums might be offset by valuable benefit improvements.
In 2025, South Africa’s medical schemes, including Bonitas, Discovery Health, Genesis, Sizwe Hosmed, Momentum, Bestmed, FedHealth, KeyHealth, and Medshield, have introduced diverse benefit enhancements to address members’ healthcare needs. Selecting the right enhancer is based on personal health profiles, preferences, and financial conditions. An in-depth review and expert guidance during the review period can assist in making informed decisions aligning coverage with health and budget requirements.

Understanding Enhancements to Medical Aid Plans in South Africa for 2025