2026 Rules Active
2026 Validated
More kids, capped contributions (where the rules cap child payments).
Actuarial Objective
Optimises for the rule that you pay for only two children under 18, turning the third+ child (under 18) into a near-zero incremental premium strategy while preserving family-level benefits. [file:1]
Running Actuarial Simulation...
More Plan Options
Save R1999 pm
Bestmed
Rhythm2
Strategy: Rhythm2 High Income Optimizer
Upgrade for +R-4101 pm
Momentum
Ingwe Option
Strategy: Ingwe Starter (Connect Network + State day-to-day)
Key Terms for this Strategy
- Network Restriction
- You must use hospitals and doctors listed in the scheme's specific network. Voluntary use of non-network providers will result in a heavy co-payment.
- Medical Savings Account (MSA)
- A fund of R5,688 included in your premium. You use this for day-to-day expenses like GP visits and scripts.
- Elective Procedure Co-payment
- A mandatory upfront fee you must pay to the hospital for specific scheduled surgeries (like hip/knee replacements) that are not emergencies.
People Also Ask
Does this plan cover hip replacements for wear and tear?
No. Hip and knee replacements are only covered if they are required due to an acute injury (e.g. a car accident). Wear and tear is explicitly excluded.
What happens if I use a hospital outside the MedPrime Elect network?
You will be liable for a 35% co-payment on the hospital account. You must use a network hospital to avoid this penalty.
Is the cancer cover unlimited on MedPrime Elect?
No, the oncology benefit is limited to R336,000 per family per year. Once this limit is reached, you may have to self-fund.
Do I have to pay upfront for a gastroscopy or colonoscopy?
Yes, there is a R4,225 co-payment for endoscopic procedures, even if performed in a day clinic.
Is there a limit on my day-to-day medical expenses?
Yes. After your savings are depleted, you have an 'Insured Pooled Benefit' of R7,550 per member. Once this is used, day-to-day cover stops.
What will I pay if I need an MRI scan?
You will be responsible for the first R1,700 of the scan cost as a co-payment.
Are contraceptives covered by the scheme?
Yes, contraceptives are covered up to R2,470 per year under the preventative care benefit.
Do I need a referral to see a specialist?
While you don't strictly need a referral for payment, using the MedPrime Elect Network GPs and Specialists is required to avoid out-of-pocket costs.