It is very tempting to give up your medical aid and use the money to stretch your budget. But what if you get sick or hurt and cannot work?
Everything is getting more expensive and even people in higher income brackets are struggling to make ends meet according to surveys.
You have followed the advice of countless advisers who suggest you draw up a budget to stay in control of your finances and cut your budget when you need to. Should you cut your medical aid because it is too expensive?
There have been calls for the past two years to have another look at the cost of private medical care and medical aids because it has become so expensive.
Many medical aids are also reporting that they have lost members, especially from the higher-level plans that are more expensive.
Thoneshan Naidoo, CEO of the Health Funders Association (HFA), says with the cost of living rising, it is tempting to look at your monthly medical aid contribution and wonder if you can do without it.
“But before you cancel, consider this: medical schemes are designed to protect you from catastrophic health costs, give you access to quality care and help you stay healthier for longer.”
He gives these five reasons why keeping your medical aid is one of the smartest financial and health decisions you can make.
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1. Protection against financial ruin
Unexpected illness or accident can be devastating, physically and financially. Without medical aid, you may face massive bills for hospital stays, surgery and specialist treatment, Naidoo points out.
The alternative is to rely on an overstretched public system, where long waiting times for care are common. Medical aid shields you from these shocks, ensuring you get the right care when you need it most.
2. Guaranteed cover for essential conditions with medical aid
By law, all medical schemes must fully cover Prescribed Minimum Benefits (PMBs). These include emergency care, 271 medical conditions such as cancers and 26 chronic illnesses like diabetes, asthma and high blood pressure.
Naidoo says this legal protection means you will not face crippling out-of-pocket costs for essential treatment, especially when using your scheme’s trusted provider networks.
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3. Medical aid is more than just cover – added value and tax relief
Your contributions come with benefits beyond medical protection. The Medical Tax Credit reduces the tax you pay. In 2025/26, the fixed credit is R364 per month each for the first two members and R246 for every additional dependent. Out-of-pocket medical expenses may also qualify for further tax relief.
On top of this, Naidoo points out, many schemes offer reward programmes with discounts on gyms, incentives for healthy living and savings on travel or entertainment, all designed to keep you engaged and reward you for maintaining and improving your health.
“Long-term membership is also important. Cancelling now could mean costly late-joiner penalties or waiting periods if you try to rejoin later.”
4. Smarter, healthier living through innovation
Medical schemes are investing in digital health tools and artificial intelligence to improve care and keep costs down. From apps that track your health to programmes that detect risks early, prevention is becoming a core focus.
Many schemes also cover vaccines, screenings and routine health checks, benefits that not only save money but also help you live a healthier, longer life, Naidoo says.
ALSO READ: How to make the most of your medical aid scheme
5. Medical insurance is not the same as medical aid
Naidoo warns that consumers must not be lulled into a false sense of security by ‘cheaper’ alternatives such as health insurance.
“Hospital cash plans or health insurance products may seem more affordable, but they are not substitutes for medical aid. They pay fixed amounts per day in hospital, regardless of your actual bills.
“A single hospital stay can involve costs for doctors, anaesthetists, scans and medicines which can run into millions of Rands that far exceed what health insurance products cover. Without medical aid, you may face hundreds of thousands of rands in unpaid bills.”
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How to make your medical aid rands go further
- Use your scheme’s hospital network or Designated Service Providers (DSPs) to keep costs low.
- Choose generic medicines where possible.
- Pre-authorise hospital admissions and ask for quotes to avoid surprises.
- Register your chronic condition so your medication is fully covered.
- Use your savings account wisely for genuine medical needs.
Naidoo says medical aid is more than a monthly expense.
“It is a safety net. Rising contributions reflect increasing healthcare costs, longer lifespans and more people needing treatment.
“But schemes are also adapting, using innovation and preventive care to give you better value. Before you cut your cover, think carefully. The short-term savings could cost you far more overall.”
The HFA was established in 2015 as a non-profit organisation representing key stakeholders in South Africa’s private healthcare funding sector.
It represents 20 medical schemes and three administrators, collectively covering 46% of the private healthcare market, equivalent to approximately 4.1 million beneficiaries.
