Discover why young and healthy individuals in South Africa should prioritise healthcare planning, understand the risks of being uninsured, and learn essential tips for securing the right coverage.
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When you're starting out, every rand already has a job. Rent, student debt, transport, the emergency fund you're still trying to build. Healthcare planning quietly slides to the bottom of the list. You're young, you rarely see a doctor, so why pay for cover you'll probably never use?
I understand the thinking, but it's one of the most expensive gambles a young person can make. Crises don't check your age. The flaw in the I'm young and healthy’’ mindset is the assumption that medical emergencies happen to other people, later in life. They don’t, and we see this every day reflected in our claims statistics, and in the lived experiences of our families, friends and colleagues.
These may be tough conversations to have, but understanding the implications of experiencing a serious health event without having the right cover in place is key to the correct decision making. In healthcare terms, an emergency is the thing you didn't plan or prefund for, and it lands on twenty- and thirty-somethings far more often than this generation expects,” says Martin
A sporting injury that ends in surgery and months of rehab. A car accident with multiple fractures. A workplace injury. Being a victim of crime. Or a diagnosis nobody sees coming when they are young - breast cancer, melanoma, lymphoma and certain leukaemia’s are increasingly showing up in younger people, often with no family history at all. We see it in our claims data year after year. When one of these moments arrives, the last thing you want to be doing is working out whether you can afford decent care or worrying that the bill will set you back financially for years.
The South African healthcare reality
For a young adult, the real question isn't ‘Can I afford private cover?’ It's ‘Can I afford to be without it when something goes wrong?’ Access to quality private healthcare shouldn't be left to chance. It should be a cornerstone of your healthcare financial plan from the moment you become financially independent. Above all things, it’s the health priority that should be at the centre and core of all your planning, and this is where the services of an accredited healthcare advisor is extremely important.
The good news is that getting it right isn't about buying the most expensive medical scheme option on the shelf. It's about putting the right protection in place for your stage of life and your budget. There are three essential healthcare financial planning tips that do all the work:
Get proper advice.
Don't DIY this. You are never too young to engage with an independent financial advisor. An independent advisor will pinpoint your actual needs, flag the pitfalls, and stop you paying for cover you don't need while leaving the critical gaps exposed. That relationship also grows with you as your life and income change.
Hospital-only cover forms a foundational base.
Hospital-only cover serves as a foundational option. For a budget-conscious young professional, this type of medical scheme option reflects a balance between cost and protection, providing cover for major in-hospital events such as sudden illness or injury. Scheme structures may include designated network hospitals, oncology benefit provisions, and specific approaches to managing Prescribed Minimum Benefits (PMBs). Day-to-day healthcare expenses such as GP consultations, dental care, and optometry are typically excluded from a core hospital-only option and fall outside its scope.
Close the gap.This is the gap most young people miss. Medical schemes typically pay at a scheme tariff, but specialists often charge 200% to 500% more than this tariff - and on hospital-only plans this shortfall can be significant. Sirago’s average large-loss gap claim now sits between R40,000 and R60,000. This means you may have to fund this shortfall from your own pocket if you don’t have gap cover in place.
Build the safety net while you can
Planning for the worst isn't pessimism, but rather about securing your financial freedom. With the right cover in place, you get to chase the opportunities and adventures of this decade knowing that if life throws you a curveball, your financial protection is solid.
Your strategy will evolve. Single cover becomes family cover. Hospital-only might grow into comprehensive benefits as your income and needs do. But the principle holds: lock in solid healthcare financial protection while you're young, healthy and premiums are low.
Engaging with an independent financial advisor provides insight into one’s specific circumstances. In a country where access to quality healthcare can significantly influence outcomes, this represents a key financial consideration at an early stage.
* Rimmer is the CEO of Sirago Underwriting Managers.
PERSONAL FINANCE