Choosing a Medical Aid

With so many medical aid schemes available in South Africa everybody wants to know how to choose a medical aid. Choosing a Medical Aid Before we get to the factors you should consider, let us look at medical aid in general.

What is a medical aid?

Medical aid is a type of insurance that pays for private medical costs. Medical aid can be provided for a family, a couple, or an individual, and will protect the member and dependants from the financial burden of the high costs of private healthcare. Medical insurance will probably be some of the most important insurance you will ever need.

What types of medical aids are there available?

• Comprehensive medical aid: This is full cover plans, where you receive hospital and day to day cover.

• Hospital plans: these plans only provide in hospital cover with no or limited day to day cover.

• Network plans: these plans offer comprehensive or hospital cover at Network service providers.

• Hospital insurance: This is not a medical aid, but insurance taken out on your health, the money goes straight to you to use as you see fit. This is a cheap medical aid form that should not be confused with the real thing.

What questions to ask when you consider a medical aid?

• Is this an affordable medical aid? Can you afford the premiums and still maintain your level of lifestyle?

• What kind of medical aid do I need? This choice should be based on your current medical condition.

• What are the benefits? All medical aid plans have different benefits; find a plan with benefits that suits your personal medical care needs.

• What is the overall annual limit? Make sure you choose a plan with enough overall money in the budget to cover your needs.

• Are there any exclusions? Some medical aids place exclusions on pre-existing medical conditions.

• Are there waiting periods involved? Waiting periods means you do not cover for a certain period of time.

• Are there any co-payments payable? Some schemes require co-payments or deposits on certain procedures, medication, and specialist visits.

• What percentage of suggested medical aid rates does the scheme cover? Some hospitals and specialists can charge up to 300% of the suggested rates, funds cover some part of these but the rest are for you to pay.

• How does the claims process work? Find a fund with a claims process you can adhere to.

• What are the scheme rules? Some medical aids have strict rules and penalties if you do not adhere to these rules.

• Do I have to visit specific service providers? Some schemes and plans have a list of service providers you have to use and are penalized if you use unlisted providers.

• Is a plan with a rewards program really worth it? A plan with a rewards program can be great, but you might find the same benefits for less at a scheme without rewards programs.

• How many medical aid comparisons should I do? As many as possible, that way you will be able to make an informed decision.

• Should I consider the services of a medical aid broker? Definitely yes! A broker will give you the best advice as they know the ins and outs of medical aids.

This list of questions might be long, but it will help you with how to choose a medical aid dilemma. You will find a medical aid that suits you and your pocket, and you will know what you are letting yourself into. © Medical Aid Plan

COMPLETE THIS FORM TO GET YOUR MEDICAL AID QUOTES!

Your medical aid quote will include options to suit your pocket. Please ensure that the cover you select is exactly what you need and that you understand exactly what insurance you are buying. Do not hesitate to ask questions about the medical aid or hospital cover you choose.

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