Medical Aid

 

 

Medical aid ensures that you and your family are protected in the event that the worst should happen. If you or a family member gets sick, medical aid will ensure you can get the medical support you need.

Purchasing medical aid can be a really challenging experience. Here are some tips to ensure that you choose the right cover at the right price for you and your family.

Before Choosing a Cover: What do you Need?

Before you choose a medical aid scheme, you need to first decide what sort of cover you want. Different types of medical aid schemes cover different types of things. Some might cover GP visits and hospital stays, while others might only cover hospital stays. The more your medical aid covers, the more expensive it will be, so it’s important to balance your needs with the cost of a policy.

For those who have specific medical conditions, you need to make sure that your medical aid will cover those conditions.

Rate Of Cover

When you sign up for a policy, you might see that a medical aid provides 100%, 200% or even 400% cover, but what does this mean?

Medical costs in South Africa aren’t regulated, so doctors, hospitals and other facilities can charge whatever they want. The Department of Health has published a guide recommending how much these facilities should charge and this is usually what medical aid schemes use to decide on their rates.

So, if a doctor charges R1 000 for a consultation, but the Department of Health (and the medical aid) suggest they should charge R500, then you’ll have to pay in the extra R500 if you only have 100% cover. If you have 200% cover, you won’t have to pay anything. Of course, the higher the rate of cover, the more you’ll end up paying for your medical aid.

Annual Thresholds

Most medical aid schemes will have some type of annual threshold and the more affordable the plan, the lower these thresholds will be. A threshold is the maximum amount the medical aid scheme will pay out for a specific service, and it can apply to visits to the GP and to your medication. If your threshold is set at R1 000, for example, one visit to the GP could use up your allowance for the whole year.

Affordability

Medical aid plans range from somewhere around R1 000 to R10 000 per month, depending on the type of cover you want or need. Make sure that you can afford your monthly premiums – after all, if you start missing payments, you won’t be covered.

The Medical Aid’s Payment Record

Before choosing a medical aid, take some time to look at their payment record. Some medical aids might have developed a reputation for delaying payments or looking for ways not to pay out at all – steer clear of these.

What Hospitals and GPs are you Allowed to Use?

With certain medical aid schemes, you might be restricted to certain doctors or hospitals, so make sure that you know which ones are included in their scheme. If the GPs or hospitals are not convenient for you, you might want to consider an alternative medical aid.

If You’re Unsure, Get Professional Support

A professional, independent broker is someone who will be able to take the time to understand what you need and then find you a plan that considers your financial situation. If you’re finding the process of choosing medical insurance a little overwhelming, simply contact an independent broker and have them help you out.

Get In Touch

082 345 2101

learn@lifegap.org

gauteng, south africa

LifeGap teaches you what you need to know to be prepared for the “Real World”. The book is divided into three sections; Personal, Financial and Governmental.