Cape Medical Aid
Cape Medical Aid offers its services to everyone
in South Africa, not just in the Cape.
Cape Medical Scheme has three plans to choose
from, the HealthPact Premium Plan, HealthPact Silver Plan and the comprehensive HealthPact Select
Founded in 1961, this medical scheme has regional
offices in various cities throughout South Africa. The head office is based in Cape Town. Good communication with
members is very important, and they promise to react promptly on any enquiries made. They also keep you up to date
with information of what is happening in healthcare in South Africa.
The medical aid offers three plans, formulated in
such a way that it covers medical needs and is seen as an affordable medical aid.
HealthPact Premium Plan
The Healthpact Premium Plan is the basic health
plan for the healthy individuals who are not diagnosed with chronic diseases. Hospital cover has not limits and
200% above medical tariff rate are covered when visiting specialists. Certain procedures require approval prior to
the operation or procedure. There are no limitations to which hospital to go to, you can go the hospital you
A slightly unique edge to the hospital plan is the
coverage of certain medical treatment and procedures out of the hospital. It is however recommended that you check
first to ensure whether the treatment you need, is covered by this plan. Pathological services have no limits and
the scheme is generous with benefits to maternity patients. It also covers emergency ambulance
HealthPact Silver Plan
The HealthPact Silver Plan includes a medical
savings plan. This gives members the opportunity to manage their out-of-hospital expenses for medical treatment.
Included are visits to a dentist, a general practitioner, optometrist and the over-the-counter medicine required.
This plan also requires approval prior to the specific hospital treatment or operation.However hospitalisation is
HealthPact Select Plan
The HealthPact Select
Plan is the top of the range of medical aid schemesproviding comprehensive and outstanding cover. This plan includes the hospital plan and
also benefits for patients diagnosed with chronic illnesses. You can go to the doctor of your choice as well
as the hospital you prefer. The expenses for medical and health care out-of-hospital are managed by you, the
member by using the savings account.
Medical Savings Account
The medical savings account provides cover for
out-of-hospital, day-to-day medical and health care. At the beginning of the year the account is funded with the
amount you are allowed to use. As you draw from the account for these medical expenses the account depletes. Should
your medical savings account run out of funds before the end of the year, you as a member will be liable for the
costs. However, if you don’t use much of the funds during the year, the savings that are still in your account will
be carried over to the next year.
Keep in mind medical aids such as Cape Medical Aid and Discover Medical Aid have
certain limits what you can spend in each of the categories. For example, you can run out of funds for optometry,
but have enough founds for a general practitioner. This is an important factor to take into consideration when
choosing your medical aid.