Find the Best Medical Scheme
There is a wide variety of medical schemes in
South Africa and sometimes all you need is a little help on how to choose the best medical
With all the options available the best option would be medical aid plan
that suits your budget and your personal needs.
In essence you have four kinds of medical
insurance available at medical schemes. In order to choose the best option for you, you have to examine your
medical needs and choose a medical scheme accordingly.
The four options:
Hospital plans: Hospital plans are more suited to
young and healthy families or people that can afford to cover their day to day costs by themselves. Most hospital
plans only provide cover for in-hospital treatment, procedures and surgery, though there are plans available with
medical savings accounts to assist with your day to day medical needs.
Ordinary medical aid: Most employed people belong to
closed medical schemes (for particular companies or industries) or open medical aids, which anyone can join. Most
people have one of the cheaper or medium plans on a medical aid.
Comprehensive plans: A comprehensive plan is the all
rounder plan, with both hospital and day to day cover. This plan either has a medical savings account or added day
to day limits. A comprehensive plan is more suited for persons or families with more advanced medical needs. This
is the most expensive form of medical aid, but well worth the benefits you receive.
Network Options can come in hospital and comprehensive options. The
premiums of these plans are usually related to the income of the member. The main catch with a network plan is that
you have to use the chosen network of medical service providers.
Hospital insurance: Hospital insurance is not a form
of medical aid but rather a booster option to consider. You get paid in cash per day you spend in hospital. You can
use this as additional funds to pay the amounts your medical aid does not cover.
Question you should ask when deciding on what the
best medical scheme is:
- Who has the most affordable medical aid
- Who has the products that suits me needs the
best? It is important that the product suits your lifestyle and preferences.
- Who offers the best benefits? The higher the
benefits you receive the better.
- Who has the highest payment ceiling? The
scheme or option with the highest ceiling will result in you being liable for less additional
- Who covers the most chronic conditions? Some
schemes only cover the prescribed minimum benefits and you will have to cover the rest
- Who has the least co-payments or deposits?
Some schemes require co-payments or deposits for certain procedures where others do not have
- Who has the biggest network of medical
service providers in the area I reside in? Should you choose a network option but reside in a rural area the
chance may be that you do not network cover in that area.
In order to choose the best medical scheme you need to focus on your personal needs and who gives you the best value
for your hard earned money. © Medical Aid
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