Medical aid, PMBs & gap cover guide 2026
For members of a medical scheme in South Africa, or people choosing one: prescribed minimum benefits, hospital plans, gap cover, the tax credit and where the NHI stands.
No sign-up, no form: nothing about you is collected.
Who this guide is for
- You are choosing a medical aid or a hospital plan
- Your scheme refused to pay and you think it is a PMB
- You want gap cover or your medical tax credit
What is inside: table of contents
The PDF puts together 6 guides of Tulinde South Africa, word for word: each chapter opens with its short answer, then the full sections, the frequently asked questions and the date it was last reviewed. All 16 sources — the laws, the regulator and the official documents each fact comes from — are listed at the end, with their links.
- Medical aid in South Africa: the 16 open schemes, what it costs and how to compare
Medical aid is a medical scheme, not an insurance policy · Open schemes and restricted schemes · The 16 open medical schemes (CMS list, 31 March 2026) · What medical aid costs in 2026: the official averages · Cheapest medical aid: the options the law allows · Waiting periods: what a scheme may and may not impose · Late-joiner penalties: the exact bands · How to compare medical aid cost honestly · If your scheme refuses to pay
Reviewed 28 October 2026 · 8 questions · 4 sources
- Prescribed Minimum Benefits (PMBs): what every medical aid must pay
What the law says · The three parts of the PMB package · Designated service providers and co-payments · How to get a PMB claim paid · What PMBs do not do
Reviewed 28 October 2026 · 8 questions · 4 sources
- Hospital plan vs comprehensive medical aid vs hospital cash plan
The three products side by side · A hospital plan is still medical aid · Hospital cash plans: the limits for 2026 · Which one fits you?
Reviewed 28 October 2026 · 6 questions · 6 sources
- Gap cover in South Africa: what it pays, its 2026 limit and when it is worth it
What gap cover is in law · The annual limit for 2026 · Rules that protect you · Is gap cover worth it? What the official figures show · What gap cover cannot do · Complaints about a gap cover claim
Reviewed 28 October 2026 · 6 questions · 5 sources
- Medical aid tax credit 2026/27: the amounts, who gets them and the additional credit
The monthly amounts · Who gets the credit · The additional medical expenses tax credit (section 6B) · How to claim it
Reviewed 28 October 2026 · 6 questions · 3 sources
- NHI in South Africa: where the National Health Insurance Act stands in October 2026
The Act · Commencement status in October 2026 · What changes for medical aid members — and what does not yet · What to do now
Reviewed 28 October 2026 · 5 questions · 6 sources
Look inside
Two pages of the PDF exactly as you will get it: the contents page and the first page of chapter 1.
Who writes it
Tulinde is an independent guide run by Takat AI. It is not an insurer, a broker or an agent, and it does not rank or rate insurers. Every fact comes from a primary source listed in the guide. Read how we check facts.