Medical Aid Calculator
Compare South African medical aid plans from Discovery, Momentum, Bonitas, and GEMS. Calculate family premiums and gap cover requirements.
Understanding Medical Aid Costs
Medical aid premiums are calculated per member. The main member pays full rate; additional adults pay a dependent rate (typically 80–90% of main). Children pay approximately 40% of the adult rate. All registered schemes must cover Prescribed Minimum Benefits (PMBs) — 270 conditions including emergency care and 26 chronic diseases.
| Scheme | Plan | Type | Monthly | % Income |
|---|---|---|---|---|
| Bonitas | BonCap | Hospital | R 2 738 | 11.0% |
| Momentum | Ingwe | Hospital | R 2 812 | 11.2% |
| Discovery | KeyCare Start | Hospital | R 3 053 | 12.2% |
| GEMS | Sapphire | Comprehensive | R 3 515 | 14.1% |
| Momentum | Evolve | Comprehensive | R 4 995 | 20.0% |
| Discovery | Coastal Core | Comprehensive | R 5 273 | 21.1% |
| Bonitas | Standard | Comprehensive | R 5 735 | 22.9% |
| GEMS | Emerald | Comprehensive | R 7 030 | 28.1% |
| Momentum | Custom Series | Comprehensive | R 7 770 | 31.1% |
| Bonitas | Primary | Comprehensive | R 8 140 | 32.6% |
| Discovery | Classic Saver | Comprehensive | R 9 620 | 38.5% |
Medical Aid Tax Credits (2024/25)
| Beneficiary | Monthly Tax Credit |
|---|---|
| Main member | R 364 |
| First adult dependant | R 364 |
| Each additional dependant (adult or child) | R 246 |
These credits reduce your actual income tax payable — a family of 4 saves R 1,220/month (R 14,640/year) in tax.
Add Gap Cover
Prescribed Minimum Benefits (PMBs)
All registered SA medical schemes must cover PMBs in full at designated service providers — even hospital plans. PMBs include:
- Emergency medical conditions
- Chronic disease list (CDL) — 26 conditions incl. diabetes, hypertension, HIV/AIDS, asthma
- Diagnosis, treatment and care of any emergency
- Cancer treatment (at designated service providers)
- Mental health conditions (acute episodes)
- Maternity and confinement
- Neonatal care
Using a non-designated service provider (DSP) may result in co-payments even for PMB conditions.
Total Cost of Care
| Cost Component | Annual Amount |
|---|---|
| Medical Aid Premium | R 34 200 |
| Specialist Shortfall (uncovered) | R 1 600 |
| Total Annual Cost | R 35 800 |