While you can go direct, a broker works for you, not the medical scheme. We offer impartial, expert advice by comparing multiple schemes and plans to find the one that truly fits your needs and budget. We also save you immense time and hassle by handling the paperwork, queries, and claim disputes on your behalf.

There is no additional cost to you. Our services are free. Brokers are paid a commission by the medical scheme you choose to join. This fee is regulated by the Council for Medical Schemes (CMS) and is already built into the medical aid premium, whether you use a broker or not. You pay the exact same monthly premium.

We are paid a monthly commission by the medical scheme after you become a member. To ensure impartiality, this commission is regulated and capped at a standard rate across the industry (either 3% of the premium or a set maximum amount, whichever is lower). This structure allows us to focus on finding the best solution for you, as our goal is a long-term, satisfied client, not a specific scheme.

Our service doesn’t stop once you’ve signed up. We become your single point of contact for all scheme-related matters, including:

• Assisting with complex claims and resolving disputes.

• Helping with applications for chronic medication benefits.

• Guiding you through hospital pre-authorisation processes.

• Assisting with adding or removing dependants.

• Conducting an annual review to ensure your plan is still the best fit for the following year.

A Hospital Plan is the most affordable type of cover. It covers your in-hospital costs, such as surgeons, anaesthetists, and hospital accommodation. It generally does not cover day-to-day expenses like GP visits, optometry, or dentistry. A Comprehensive Plan covers both in-hospital costs and a portion of your day-to-day medical expenses, often through a Medical Savings Account (MSA).

An MSA is a feature of some medical aid plans where a portion of your monthly premium (25% by law) is set aside for you to use on out-of-hospital expenses like GP visits, medication, and glasses. You manage this money yourself. If you don’t use all the funds by the end of the year, they roll over to the next. If you run out, you’ll have to pay for day-to-day costs yourself until the account is replenished the following year.

A network option is a more affordable plan where the medical scheme has pre-negotiated rates with a specific network of hospitals, doctors, or pharmacies. To receive full cover, you must use the providers within that network. Using a non-network provider might result in significant co-payments or no cover at all.

In South Africa, medical schemes can legally impose a late-joiner penalty on individuals who are 35 years or older and have not been a member of a medical aid for a specified period. The penalty is calculated based on the number of years you have been without cover and is added to your monthly premium. This is designed to encourage people to join medical aid earlier in life.

Our goal is to lift the entire administrative burden from your shoulders. We handle new employee enrolments, terminations, dependant changes, and annual renewals. Instead of your HR team spending hours on the phone with a call centre, they have one direct point of contact—us—for any issue, from complex claim disputes to simple queries.

Absolutely. We encourage it. Providing direct support to your employees is a core part of our service. It empowers them to understand and use their benefits effectively while freeing up your HR department’s time. We can act as the first port of call for any questions they have about their cover.

Yes, in most cases, a corporate group scheme offers more competitive premiums than individual policies for the same level of cover. Schemes view corporate groups as a lower risk, and these savings are passed on to the company and its employees.

Yes. We can help you structure a “multi-option” scheme. This allows you to offer different plans based on seniority or job grade—for example, a comprehensive plan for senior management and a hospital plan or network option for general staff. This provides flexibility and helps manage costs effectively.

While this can vary slightly between medical schemes, a corporate group can typically be started with as few as 5-10 main members. We can advise on the specific requirements for each scheme.

This is a critical part of our annual service. Well before the renewal deadline (typically around this time of year, in October/November), we will:

• Analyse the scheme’s proposed benefit changes and premium increases for the upcoming year.
• Compare these changes against the market to ensure your scheme remains competitive.
• Present you with a clear summary and our professional recommendation on whether to stay with your current plan or explore other options.
• Facilitate any plan changes for the entire group, ensuring a smooth transition for 1 January.

Yes. We believe an educated member is an empowered one. We are happy to arrange and conduct on-site or virtual staff training sessions to help your employees understand their medical aid benefits. We can also assist in coordinating wellness day events with the medical scheme, promoting a healthier workforce.