Updated 04.11.2022

Medical Aid for Pensioners

As people grow older, they need more care and support. However, the resources they have also dwindles because they no longer have the energy to work as they did before. Sadly it is also at this advanced age that most people suffer from medical conditions such as chronic illnesses that require a lot of finances to take care of. This means that seniors need to access good medical care continuously. 

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Unfortunately, due to incapacity to work, most seniors loose their ability to generate income to pay for regular monthly premiums needed to cater for the medical health insurance or Medicare premium fees. As such, many end up becoming a burden to their kids and loved ones who have to pay for their medical care out of pocket, something that can be quite expensive. 

However, it helps to note that all South Africans, including those of pensionable age have access to South African medical facilities. Unfortunately, the standard of medical care in public facilities may not be very appealing, hence preferred by people who have no alternatives. 

To avoid having to rely on medical facilities that you do not approve or fancy, it helps to plan and prepare early. Anyone approaching retirement or pensionable age can consider a number of alternative medical care providers and plans that can help take care of their medical needs when their age advances.

What it Takes to Find the Right Pensioners Medical Aid?

When trying to answer this question, one of the most important concerns is about which medical aid is affordable for pensioners. Affordability is key, especially considering the fact that your funds may be dwindling. You definitely do not want something that will be crippling in terms of monthly premiums. 

The good news is that there are several options you can settle for in South Africa. There are a number of service providers who have rather lucrative packages for pensioners in South Africa. Before looking at the different service providers you will find in South Africa, below is a look at some of the things you ought to learn about the process of selecting a pensioner’s medical aid.

It Helps to Have a Plan

Medical aid schemes in South Africa are mandated by law not to discriminate customers based on age limit. Therefore, a company one is interested in applying to cannot refuse the application based on age,. What’s more, the basic monthly contributions remain uniform regardless of the applicant’s age or their pre-existing conditions. What matters is that they are able to pay the required premiums for the exact plan they choose.

The only thing pensioners and older applicants need to know is that they may have to pay a specific fee. Medical insurers are allowed to charge a late joiner fee for applicants that are 35 years and above. This fee is often included in the applicants’ monthly contribution and only applies to new applicants. It will not be applied to members that may be changing from one plan to another.

Expected Waiting Period

The standard condition across all the medical aid providers and plans requires that a new member waits for a minimum of three months before they begin making any claims. The same applies to members who are changing from one plan to another. However, in this case, previous members who want to swap to other plans can have some of the items covered during the three months waiting period.

How are Pre-existing Conditions Handled?

Usually, whenever you joining a medical aid with pre-existing conditions, you may have to wait for a year to elapse before any of these conditions are covered by your cover. This only means that it is reasonable not to wait until one gets to their old age before applying. The one year wait should happen when you are still energetic and in a position to pay for the payments out of pocket. Joining the medical aid scheme earlier is a great way of minimizing the risk of not accessing the right medical care when you need it because you joined late.

How to Choose the Best Medical Aid for Pensioners Plan

In most cases, ideal plans for pensioners are that that require them to pay the least amount of monthly contributions. However, the comprehensive cover tends to be more useful because they cover chronic conditions. 

When getting into retirement, a lot of things may have to change. For instance, you should consider downgrading your medical aid plan and look into the possibility of changing hospitals plans as well. The idea is to find one that suits your needs, especially if you have a chronic condition. Hospitals plans are great and can match the comprehensive cover in terms of chronic care giving even though they don’t cover day-to-day medical needs, consultations and other tests and medication.

It helps to compare different plans as you advance in age. Choose a plan that works for your current needs as you age and move into pension bracket. If you are unsure how to proceed, you should consider getting in touch with professionals or experts that deal with this kind of insurance. Below are some pretty good options pensioners can consider as they plan for their future medical needs.

Sizwe medical aid for pensioners 

This is one of the most affordable and reliable medical scheme in South Africa. It is known to increase annual premiums by 6.9 percent while the rest of the competitors increase by 8 to 9 percent annually. Besides that, it is also one of the few schemes that have an interest earned on the premiums, considering that your premiums will earn 6.2 percent annually. The scheme come with 5 different plans, all costing differently and accommodating everyone’s budget and capabilities. These are:

  • Primary care at R427
  • Gomomo Care at R845
  • Hospital care at R1500
  • Affordable car at R2870
  • Full Benefit care at R4421

Choose a package that best fits your pocket. Pensioners are free to consider a plan that works for them, depending on their specific needs at this age as well as their income.

Gems medical aid for pensioners 

This is the government employees medical scheme which is an affordable but restricted medical care for public service employees and their chosen beneficiaries. This scheme happens to be one of the largest with over 700,000 members and over 2 million beneficiaries. 

There are several options offered in this medical aid scheme namely the Tanzanite One, Beryl, Ruby, Emerald value, and Onyx. These come with different provisions and at varied price caps. As a pensioner that worked for the government before, you can choose a GEMS plan that works best for you without straining your pockets.

Momentum medical aid for pensioners 

Momentum medical aid has been known for its affordable packages over the years. It offers a wide range of options and caters to the needs of a diverse population and ages. Its covers range from entry-level packages to comprehensive medical aid cover, depending on your ability to afford the services. Common options with their monthly costs include:

  • Evolve Option which costs R1345
  • Custom Option costing R1706
  • Incentive option that costs R2224
  • Extender Option costing R5231
  • Summit Option costing R10642
  • Ingwe Option costing R445

With different packages offering varied services, you need to take time to compare the options available vs. your needs. This way you can conveniently pick a choice that works best for you.

Bonitas medical aid plans for pensioners 

Like all the other medical aid covers, Bonitas also has a range of options for its customers. This means that pensioners can opt for a package that best suits their needs. The common plans in this medical scheme are:

  • Edge plan starting from R1338
  • Traditional plan starting from R2322
  • Saving plans starting from R2230
  • Hospital plans starting from R1784

Each of these plans has specific offers. Choose one that best accommodates your current financial situation as a pensioner and enjoy great medical cover in your old age.

Medshield medical aid for pensioners 

This is the other option for pensioners who want a medical scheme that is affordable. It offers high quality medical services at a rate most people can afford. All you have to do is find your ideal package. This include:

  • Premium plus brochure  at R6747
  • Medibonus brochure at R6528
  • Mediplus brochure at R3531
  • Medisaver brochure at R3894
  • Medicore brochure at R2961
  • Medivalue brochure at R2139
  • Mediphila brochure at R1596

Each of these packages has a lot to offer. It is important to check out what works for you before opting for it.


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Job is a seasoned writer with a good understanding of the emerging markets, Africa to be specific.