How to Choose a Medical Scheme – Some Factors to Consider

How to choose a medical scheme is a question a lot of people ask, especially if you lack the knowledge of the medical industry. We will take a look at the type of schemes available and the factors to consider when choosing a scheme.

What is a medical scheme?

A medical scheme is a non-profit organization that helps you pay for your private sector medical costs. They require a monthly premium, all the premiums of all the members are pooled together to have the funds available to pay for claims.

What kinds of medical schemes do we have?

Open Schemes:

Open schemes are schemes that provide medical aid cover to anybody who wants to purchase it. By law, they are not allowed to turn away any prospective member, either based on the medical history or race of the applicant.

Some of the largest open medical aid schemes in South Africa are:

• Discovery Health
• Bonitas
• Fedhealth
• Medihelp
• Momentum health
• Profmed
• Genenis
• Resolution Health
• Keyhealth
• Liberty Health

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Closed Schemes:

Closed schemes provide medical cover for employees of specific companies. People not employed by these companies are not allowed to join these schemes; though some of them make allowance for families should the employee pass away.

How to choose a medical scheme?

• According to the medical schemes act, schemes need a solvency ratio of 25%. Choose a scheme with a higher solvency rate, which will mean that there is enough money available in the scheme to pay for your medical costs.
• Choose a scheme with a high amount of members. A scheme with more members will have more income, meaning more money available to pay for your medical costs.
• Look at the claims payout percentage of the prospective schemes. Pick a scheme with a high claims payout percentage, this means the chance that your claims will get paid is higher.
• All schemes have rules. Make sure you pick a scheme whose rules you can comply and adhere to.
• Look past the glitter. Medical schemes are expensive and the added glitter might cost you more than a scheme that does not have all the added extras.
• The claims process. Some schemes require you to pay the bills first and then claim it back from them. Rather consider a scheme with an easy claims process.
• Search the internet for customer reviews of the schemes, you might just learn more than you expected and this will help you make an informed decision.
• Choose a scheme with a wide range of medical aid options, this way you are sure to receive the best cover available for your money. Read this useful article about the cheapest medical aid in South Africa.

How to choose a Medical scheme summary:

How to choose a medical scheme? Pick a scheme with; a high solvency ratio, high member numbers, a wide range of medical aid plans, a high claims payout percentage, rules you can follow and good customer reviews. © Medical Aid Plan.

To get your medical aid plan quote by email Click Here

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NOTES:

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.