Medical Loans in South Africa: Options to Try Before You Borrow

A medical bill arrives when you are least able to deal with it. Panic leads to expensive choices.

Here is a calmer order of questions, from free to costly, before you take medical loans.

What should you ask first?

1. An itemised quote. Know what each part costs.
2. A payment plan. Many hospitals, doctors and pharmacies accept instalments.
3. A discount for paying upfront or in cash.
4. Your medical aid or hospital plan, if you have one. Confirm what is covered before the procedure.
5. State facilities. Public hospitals and clinics charge fees based on income.
6. Gap cover, if you have it, for what your medical aid does not pay.

How do state and private costs differ?

For an emergency, you are entitled to emergency care. Billing is dealt with later. Do not delay treatment because of cost worries.

What are other funding options?

• Medical aid or hospital plan. Check your benefits and waiting periods. Medical schemes must cover a set of prescribed minimum benefits, so ask your scheme what applies.
• Gap cover. Pays the difference between what your medical aid pays and what the provider charges, for some procedures.
• Employer help. Some employers offer advances. See salary advances.
• Family, community or a stokvel.
• Charity and non-profit support for specific conditions.

What do medical loans cost?

At the legal maximums, a first one-month R5,000 loan costs about R969, and over six months about R1,939. See the working in R5000 loan.

A payment plan from the provider usually costs nothing. That is why the first three questions above matter.

When might medical loans make sense?

When treatment cannot wait and none of the cheaper options works. Even then, borrow only what you need. See emergency loans.

How do you borrow safely?

1. Check the lender on the NCR register.
2. Get the quote in writing. See the guide to the pre-agreement quote.
3. Check affordability with the loan affordability guide.
4. Avoid upfront fees and unsolicited offers. See online loan scams.

Some lenders and scammers target people who need medical money. Never share your PIN, and be careful with anyone who contacts you first.

What if you already owe the provider?

Talk to them before the account is handed to a collector. Offer what you can pay and get the arrangement in writing.

Read debt collectors and what to do when you cannot pay your debts.

How can you prepare for next time?

• Keep an emergency fund, even a small one. See emergency fund.
• Check what your medical aid or gap cover includes.
• Keep your policy details handy.

How do you read a medical quote?

An estimate and an itemised quote are not the same thing. Ask for a written, itemised quote and read it with these lines in mind:

Ask which amounts are fixed and which may change. A quote that is clear on those points gives you something to plan around, and something to take to a payment-plan conversation. If you are unsure, get a second quote from another provider.

What happens if you have medical aid but there is still a shortfall?

Medical aid does not always cover the whole bill. Providers can charge more than the scheme’s rate, and the difference falls to you. Here is a hypothetical example for a procedure.

This is where gap cover may help, if you have it, because it can pay some or all of the shortfall for certain procedures. Check your policy before treatment. Ask your scheme whether the condition is a prescribed minimum benefit.

Generally, these must be covered in full if you use the scheme’s designated providers, but confirm the details with your scheme.

Ask the provider whether it will accept the scheme rate as full payment, or whether a payment plan is possible for the shortfall.

How do you ask for a payment plan?

Providers are more likely to agree when you offer something specific. A short message works well:

“I have a quote of R___ for [procedure]. I can pay R___ now and R___ a month for ___ months. Please confirm in writing that this arrangement is accepted and that the account will not be handed over to a collector while I keep to it.”

Ask for the agreement on the provider’s letterhead or by email, with the monthly amount, the dates and the total. Keep a copy, and set a debit order so that you never miss a payment. If the first answer is no, ask what they would accept.

What if the bill is already with a debt collector?

Do not panic and do not ignore it. Take these steps:

1. Ask the collector for a statement showing the original provider, the amount and how it is made up.
2. Check it against your own records and the itemised quote.
3. Offer a payment you can afford, in writing, and ask for a written confirmation.
4. Do not pay anyone who will not give you details in writing.

Our guide to debt collectors explains what a collector may and may not do. If you cannot pay, talk to a free debt counsellor before the account grows. A payment plan with a provider is nearly always cheaper than medical loans.

How can you cut the cost of medical bills before you borrow?

A few habits shrink the bill itself, which is better than financing it:

• Ask whether a generic medicine is available. It is often cheaper and works the same way.
• Ask whether follow-up visits can happen at a state clinic or a cheaper provider.
• Check whether your medical aid plan has a savings account that can pay for out-of-hospital costs.
• Ask for a discount if you can pay part of the bill upfront.
• Question tests and scans you do not understand, and ask whether they are needed now.

Every rand you remove from the bill is a rand you do not borrow. Medical loans are the last step, and the smaller the amount you need, the lower the cost.

Related guide: Quick loans in South Africa: what they cost and how to read the quote.

Frequently asked questions