Medical Aid in South
Medical aid in essence is a type of insurance that
pays for private medical costs should you fall ill, require emergency medical treatment in a hospital or are
involved in an accident. (Read the Top 10
facts about Medical Aids in South Africa.)
This form of private heath cover varies from country to country but is called medical aid in South Africa. This
cover 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 is probably be the most vital
insurance you will ever buy.
To get your
medical aid plan quote by email Click
Private medical costs are staggering a birth is a
private hospital will cost up to R100 000, that is more than the average person earns in a
With medical plans you pay a monthly premium to
cover your medical costs and specific medical needs. All these premiums are combined to cover all the scheme’s
member’s projected medical costs.
In essence it is a high level budgeting system
that estimates the annual risk of all the member’s medical expenses. This is calculated by looking at the past
expenses and expected increases of the cost of health care in the future. A financial structure is set up to ensure
that they have enough money available to pay for all the benefits the members receive.
The estimation considers how much the members
claim, what is claimed for and the cost of the medical treatment. This estimation indicates to the medical aid
schemes how high the premiums of the members should be. The more cover you require the higher your premium will
These costs are calculated annually when the next
year’s medical cost structures are published. Thus your premium will increase annually as the medical costs
Some factors to look out for when deciding to
purchase a medical aid plan:
- Exclusions: Some
companies have exclusions on existing conditions; these exclusions can last up to a
- Waiting periods:
When you acquire a medical aid, some companies have a waiting period of three months before they start paying
for certain claims.
- Benefits: Ensure
that all the benefits you receive will suit your needs, an active person participating in sports might have
need of higher radiology and physiotherapy benefits, and a member with a family history of cancer might look
into higher oncology benefits.
- The claims
process: Some companies require the members to pay deposits for procedures where other companies do not
have this deposit requires. As with claims, you do get aids that require you paying the bill and claiming from
them instead of the service provider placing the claim.
- Bonus features: Some companies offer bonus features like
magazines and gym subscriptions, Should these not fit your lifestyle consider something that does not
include these features.
Understanding how it
works and what medical aid in South
Africa is, will help you to make an informed decision should you consider medical insurance in
future. © Medical Aid
To get your medical aid plan quote by email Click Here