For a long time, having access to private healthcare belonged only to a privileged few. According to data released by Statistics South Africa in 2018, this was approximately 9.4 million South Africans. Without a doubt, having medical aid to take care of your health is necessary, but what about those who cannot afford it? Well, we’ve got good news for you. There is another option.

The emergence of medical insurance in the last few years has drastically shifted the dynamics, allowing many more South Africans access to medical cover for their most essential medical needs. In summary, medical insurance, also known as health insurance, is a form of insurance cover that focuses on your essential healthcare needs and covers those medical expenses or part thereof. The benefit of medical insurance is that it allows you to take care of your healthcare needs without worrying about high medical costs. It has provided more South Africans with the opportunity to access private medical care in a much more affordable way. Medical insurance is not a medical aid nor a substitute for medical aid, but it is an alternative option to both medical aid and public health facilities.

The difference between medical aid and medical insurance.

To help you understand the difference between medical aid cover and health insurance, the Council for Medical Schemes explains that there are three main areas where they differ:

Types of cover

Medical aid schemes cover a wide range of medical expenses such as in-hospital benefits according to the National Recommended Price List and Prescribed Minimum Benefits (PMBs).

Medical Insurance, on the other hand, covers your essential needs such as your day-to-day medical expenses or covers the cost of a specific medical procedure but does not have to provide for PMBs.

Hospital & Chronic Benefits

Medical aid schemes, depending on the plan type, provide comprehensive coverage for dreaded diseases and are accepted by most private hospitals for both elective and emergency procedures.

Medical insurance provides cover for your day-to-day healthcare needs, which include chronic diseases but does not cover hospitalisation.


Medical insurance is typically more affordable than most medical aid options as medical insurance does not cover hospitalisation for Prescribed Minimum Benefit conditions.

What can Kaelo Health offer you?

Kaelo Health in partnership with Centriq Insurance Company Limited (a licensed non-life insurer), offers affordable Medical Insurance plans for every South African family. We deliver solutions that are simple, cost-effective and structured to ensure that you get exactly what you need. We offer an extensive product selection and cover options that are aimed at every income bracket in South Africa. These plans provide access to private medical care, which helps to weather any of life’s unforeseen accidents and unfortunate health issues.

Skip to content