Discover the best medical insurance plans in South Africa

With rising medical costs in South Africa, it’s imperative to have the right health insurance to ensure you have access to top-quality healthcare services when you need them. However, we’re aware that there are many options available, which can be quite overwhelming for those trying to navigate the complex landscape of health insurance.  Allow Bloom Financial Services to step in and provide a guiding hand. We offer clarity in deciphering the policy jargon so you can better understand areas like coverage, limits, exclusions and benefits. With the right knowledge and guidance, we’re confident that you will be able to find the best health insurance in South Africa for your needs. So, whether you’re embarking on this journey for the first time or are reevaluating your current coverage, let this be your roadmap to finding the best health insurance in South Africa for you. 

What does health insurance cover?

Health insurance typically covers a wide range of medical expenses, which provides you and your loved ones with financial protection against the high costs of healthcare in this country. The exact extent of your coverage will vary depending on your specific plan and insurance provider, but there are common elements across most health insurance policies.

  1. Day-to-day benefits. The specifics of each benefit may vary depending on your plan and its terms. However, our coverage typically includes:
  • GP visits and in-room procedures within the Momentum CareCross Network
  • Specialist benefits, with allowances of up to R2,580 per member
  • Acute medication following the Momentum CareCross Network guidelines
  • Basic pathology and radiology services
  • Coverage for acute and over-the-counter medications
  • Basic dental and optometry services, with emergency dentistry available to Gold plan members
  • Maternity benefits encompassing antenatal GP visits, scans, support, and prenatal care
  • Health assessments, flu vaccinations, and access to emergency telephonic services for counselling
  • Hello Doctor. Access expert medical advice remotely without the need for in-person consultations. Hello Doctor offers unlimited telephonic consultations and access to medical information via mobile or online platforms, making healthcare more convenient and accessible for you.
  • HIV Benefits. We provide antiretroviral medication through the Momentum CareCross Network’s prescribed HIV medication formulary, subject to pre-authorisations and waiting periods.
  1. Major Medical Events

While health insurance offers less in-hospital coverage compared to medical aid plans, it still includes essential benefits for major medical events:

  • Accident and emergency cover, including transportation, stabilisation, and treatment costs
  • Hospital cash benefit and maternity lump sum benefit for hospital stays of up to 48 hours, with a maximum annual payout of R20,000 per member

How to compare the best health insurance in South Africa

To choose the best health insurance plan for your needs, start by assessing your healthcare requirements and financial situation. Compare plans based on key factors such as:

  • Coverage options. Evaluate the scope of coverage for medical services, prescription drugs, preventive care, and specialist visits.
  • Network providers. Check if the medical practitioners you need, like doctors, hospitals, optometrists and other healthcare facilities or services are within the plan’s network to minimise out-of-pocket costs.
  • Costs: Consider premiums, deductibles and copayments to determine the overall affordability of the plan.
  • Medication: Review the formulary to ensure your chronic medications are covered at a reasonable cost.
  • Additional benefits: Consider any extra perks like wellness programmes, telemedicine services, such as Hello Doctor, or tax rebates are offered to members. 
  • Flexibility: Assess the plan’s flexibility in accessing care, including out-of-network coverage and options for changing plans or providers.

Bloom Financial Services offers three health insurance options under the Momentum Health4Me range. These include:

  • Health4Me Gold. Starting at R658 per month. This is our most comprehensive option that covers all the benefits offered on the Bronze and Silver options, plus specialist visits.
  • Health4Me Silver. Starting at R610 per month. Our balanced option covers the essentials as well as additional benefits such as maternity benefits, dentistry, optometry and more.
  • Health4Me Bronze. Starting at just R570 per month. Our entry-level option is designed to cover day-to-day needs and includes unlimited GP visits, acute medication, maternity benefits and more.

Factors that affect your health insurance premiums 

Several factors may affect your health insurance premiums. These include:

  • Age. Older individuals typically face higher premiums due to increased healthcare needs and a greater likelihood of declining health and chronic conditions.
  • Location: Premiums can vary based on where you live due to differences in healthcare costs and provider availability.
  • Coverage level: Plans with more comprehensive coverage and lower deductibles generally have higher premiums.
  • Deductibles and copayments: Plans with lower deductibles and copayments typically have higher premiums, while high-deductible plans often offer lower premiums but higher out-of-pocket costs.
  • Plan type: Premiums can vary between different types of plans you choose. Different plans will offer different levels of coverage and benefits. 

Get one of the best health insurance in South Africa

Health insurance protects you from the overwhelming costs of good quality medical care. Health insurance plans offer a cost-effective alternative to medical aid and Momentum’s Health4Me offers one of the best medical insurance in South Africa. Get covered with health insurance by contacting our team of trained consultants. Contact us for more information or a free quote.

Your journey to quality healthcare starts here.

Health Insurance

Health4Me Bronze

Health4Me Silver

Health4Me Gold

Gap Cover

Gap Core

Gap Max


About Bloom

Frequently Asked Questions


Contact Us

Momentum Health4Me is not a medical scheme product, and is not a substitute for medical scheme membership. The information provided on this website does not constitute advice in terms of the Financial Advisory and Intermediary Services Act. Momentum is a division of Momentum Metropolitan Life Limited, an authorised financial services provider (FSP 6406) and a wholly owned subsidiary of Momentum Metropolitan Holdings Limited.

Bloom Gap Cover is not a medical Scheme. Products that are offered are not the same as that of a medical scheme.

© Bloom Financial Services 2023. Bloom Financial Services (Pty) Ltd is an authorised financial services provider (FSP 50140). Bloom Gap is underwritten by Infiniti Insurance Limited a licensed non-life insurer and an authorised financial services provider (FSP No.35914)

Privacy Policy