Above Threshold Cover (ATC) & Benefits
Ever wondered what happens when your medical savings run out halfway through the year? That’s where Above Threshold Cover (ATC) steps in — it’s your backup for continued medical support, especially when you have ongoing or unexpected expenses.
Comparative Overview of Medical Aid Providers
Compare ATC availability, treatment limits, and what costs qualify for post-threshold benefits from leading South African medical schemes.
Provider | Plan Name | Monthly Premium (± 2024) | ATC Benefits & Covered Expenses |
Discovery | Classic Delta Comprehensive | ±R6,300 | Extensive post-threshold cover including specialists and scans |
Momentum | Custom Option | ±R4,500 | Day-to-day benefits after MSA exhaustion, subject to a gap |
Bonitas | BonComprehensive | ±R6,800 | Full ATC with generous limits and limited self-payment gap |
Best Plans for Different Profiles
Families with High Medical Expenses
Recommended Plan:
Bonitas BonComprehensive
Why? Includes broad ATC benefits, perfect for families managing regular health check-ups and specialist visits.
Chronic Patients
Recommended Plan:
Discovery Classic Delta Comprehensive
Why? Offers complete specialist, bloodwork, and scan coverage once savings are depleted — ideal for ongoing care needs.
Key Considerations Before Choosing a Plan
- What medical services qualify for ATC?
- Is there a self-payment gap you must meet before ATC activates?
- Are all expenses covered, or are only specific services included post-threshold?
- Does the plan include limits for services like dentistry or optometry, even under ATC?
FAQs
You qualify once your annual medical savings are used and any self-payment gap is met.
No – it’s typically included in mid to high-tier options with day-to-day coverage.
Cosmetic procedures, excluded medicines, and certain lifestyle services may not qualify even under ATC.