The joke Cape Town comedian Nik Rabinowitz makes about growing up directionally confused is a hit, but it's not entirely new. His mother's trick of giving their family doctor the wrong address was a way to avoid being overcharged. 'That depends on what kind of car you drove or where you resided,' he says was the price of a doctor's visit back then.

But things have changed. Medical aid schemes demand thousands from their members, and every year, they increase the fees, typically by double digits. South Africans are choosing another way: self-funded healthcare. This decision isn't taken lightly, especially for those with families. Most healthy adults who don't have children wouldn't spend more than R10 000 a year on private healthcare.

However, this cost can fluctuate. In one year, you may spend more if you have several medical emergencies. In another year, you might spend R3 000.

The cost of individual care is what matters most. Paying cash saves you 20% on blood tests, but that could be a payment above R5 000. Dental care is also expensive. Expect to pay at least R550 in consultation fees when you visit the dentist. Dental x-rays range from R400, but this isn't a full X-ray – it's for one of the four jaw quadrants.

Fillings start at R600, temporary fillings are R750, and simple extractions cost roughly R350 per tooth. For wisdom teeth, the cost increases to R600, and impacted and surgical tooth extractions cost R1 500.

The decision to move away from medical aid schemes isn't taken spontaneously. There's a process and a transition period. You'll have to start by calculating the cost of your health care from the prior year and contrast it with what you're paying for medical aid. Then, to build up savings to avoid going into debt if you choose self-funded healthcare, you'll need to downgrade your medical aid. Finally, for a year before you cancel your plan, you'll begin saving the difference between your previous medical aid package and your downgraded one.

After 12 months, you should have enough in savings to cancel your medical aid membership.

For those who choose to self-fund their expenses, there are options. Dischem and Discovery offer healthcare plans for roughly R600 a month. The key is to save every month what you would expect to spend on a healthcare plan or medical aid. You'll also need to subsidise your savings with a hospital plan. If you're not experiencing a medical emergency, use the options at your disposal for free care.

Then, do your checkups at scheduled intervals when you know you have money, rather than waiting until you feel sick. You can use a tax refund or your bonus payment to cover these costs.

In fact, cancelling your medical aid membership isn't something you can do spontaneously, especially if you have children.

Cancelling your medical aid membership isn't something you can do spontaneously, especially if you have children. There's a process, a transition period. You'll have to start by calculating the cost of your health care from the prior year and contrast that with what you're paying for medical aid.

The greatest perk will be saving thousands a year. If you're spending R2 800 a month on medical aid, that's R33 600 a year. Setting this money aside develops a healthy saving habit. Besides, you can spend the money on other things, as Nik Rabinowitz said, 'you can spend the money on other things, that's the beauty of self-funded healthcare.'

#### Key Facts

  • Most healthy adults who don't have children wouldn't spend more than R10 000 a year on private healthcare.
  • Paying cash saves you 20% on blood tests, but that could be a payment above R5 000.
  • Dental x-rays range from R400, but this isn't a full X-ray – it's for one of the four jaw quadrants.
  • Fillings start at R600, temporary fillings are R750, and simple extractions cost roughly R350 per tooth.
  • The cost of individual care is what matters most.
  • The greatest perk will be saving thousands a year if you're spending R2 800 a month on medical aid.