South Africans are no strangers to financial pressure, but 2025 has brought new levels of belt-tightening.
After three rounds of budget revisions and rising costs across the board, households and businesses are reassessing how they spend every rand. And all too often, one of the first expenses to go is medical aid.
A shifting health landscape
Yes, financial pressure is real. South Africans are cutting back on everything from groceries to medical cover, but skipping healthcare isn’t without risk.
While 77% of households earn less than R12 000 a month and fuel prices are expected to rise, a more worrying trend is emerging: serious illnesses are increasingly affecting younger people.
- Lung and heart conditions, cancer, and stroke are no longer limited to older adults. Cardiovascular disease accounts for more than half of deaths before age 65 in South Africa, with premature deaths in the working-age group (35-64 years) projected to increase by 41% by 2030.
- Early-onset cancers are rising. Although age remains a key risk factor, recent data shows a growing number of younger adults being diagnosed with breast, colon, and cervical cancer. A major South African insurer recently reported that 26% of all cancer claims were from clients under 45, mirroring global trends.
- Mental health challenges are increasingly common among young adults. A 2023 UNICEF South Africa report found that 70% of young people needed mental health support, citing stress, anxiety, and burnout as key concerns.
These are no longer your parents’ conditions. Long hours in front of screens, poor diet, chronic stress, and inactivity are placing younger working adults at risk.
Cutting medical cover might save you money today but cost you far more later
If you’re relatively healthy and earning a decent income, delaying medical cover might seem like a reasonable decision. Whether you’re in your 20s, 30s, or 40s, it can be tempting to prioritise lifestyle upgrades, big purchases, or debt repayments — and assume that medical aid can wait.
After all, if you eat your vegetables (most days), stay active, and feel fine, why not spend your cash on something more exciting than a medical plan?
The truth about life is that it happens, no matter your age
Accidents, sudden illness, injuries, or even a toothache can derail your finances if you haven’t planned for financial curveballs. If you haven’t saved up for medical emergencies, the cost of treatment could leave you with years of debt.
“In our experience, young people – and even individuals in their thirties and forties – often have two main reasons for not taking out medical aid: firstly, the cost, and secondly, because they think they don’t need it,” says Werner van Deventer, Head of Product and Business Development at Medihelp Medical Aid. “However, the longer you wait to get onto the medical aid ladder, the more expensive it becomes, and the longer you potentially have to wait before you can claim.”
Before deciding not to invest in your health long-term, consider these facts:
- Affordability: Some medical cover is better than none. Even a hospital plan is a smart start.
- Underwriting rules: If you haven’t been on medical aid for 90 days or more when joining, you may face waiting periods. Late-joiner penalties may also be added to your monthly contribution when.
- Treatment costs vs medical aid contribution: Medical care is expensive, especially hospital stays and specialised tests such as CT scans. One event could leave you with debt the size of a home loan. The monthly contribution for medical aid is often a fraction of the cost of medical treatment.
- Public vs private care: Public hospitals in South Africa are under immense strain. Medical aid gives you access to timely, quality care.
- Prevention matters: Most medical aids cover preventive services such as screenings, vaccines, and psychological counselling.
- Lifestyle illnesses are rising: Sedentary habits, stress, and poor nutrition are contributing to more serious health problems in younger adults.
- Mortality risk: A study in the Annals of Internal Medicine found that people without medical insurance have lower survival rates, often due to undiagnosed or untreated conditions.
Other reasons to prioritise medical aid
- Peace of mind: Having medical aid gives you the assurance that you’re covered when unexpected medical emergencies arise.
- Health maintenance: Regular check-ups and early intervention can prevent more serious health issues down the line, making medical aid crucial for maintaining overall health.
- Financial protection: Medical aid cushions you from the financial burden of unexpected medical costs and helps manage chronic conditions with chronic medicine benefits and disease management programmes.
- Access to better healthcare: Medical aid members typically have access to a broad network of healthcare providers, private hospitals, and specialists.
- Comprehensive benefits: Many medical aid plans include cover for dental care, optometry, and mental health services, ensuring a holistic approach to protecting your health and well-being.