Schemes use co-payments to encourage cost-conscious choices. They come in several forms: (1) fixed-rand co-payments per service (e.g. R2,500 on a defined list of procedures); (2) percentage co-payments (e.g. 20% on certain non-PMB treatments); (3) out-of-network co-payments (go outside the DSP, you pay the difference); (4) procedure-specific co-pays on scopes, MRI/CT scans, and day surgery. Reading the schedule of co-payments before choosing a plan is essential; they can add thousands per event.
SA example: Discovery Classic Smart Comprehensive: R12,650 upfront co-payment if you use a hospital outside the Smart Network. Bonitas BonClassic: R2,800 co-pay for specialised radiology if you don't pre-authorise.