Choosing a Medical Aid in South Africa


 

  

  

 

Cape Medical Aid

 

South African consumers are fortunate to be able to choose between a number of excellent medical schemes and the Cape Medical Aid is just one of those.

 

Cape Medical AidThe general public often struggles to compare the various schemes with each other. The terms and conditions of the various plans are often complicated and riddled with technical language.

 

The Cape Medical Plan takes pride in providing their members with accurate, easy-to-understand information and in helping members to choose the plan that will best suit their needs. Here are a few basic facts about the scheme:

 

·           Despite its name, the scheme operates throughout South Africa. Its head office is in Cape Town but they have regional offices in all the major centres.

·           The Cape scheme was found in 1961 and has a long and roud record of providing medical cover to all and sundry.

·           The company places a heavy emphasis on client communication and they strive to answer questions promptly and comprehensively. That is one of the reasons why the enjoy a high customer satisfaction rate.

 

What Plans does Cape Medical Aid Offer?

 

The medical scheme offers three basic plans, each one specifically formulated to suit well defined needs and budgets.

 

1.   The HealthPact Premium Plan is a no-nonsense hospital plan designed for people that have no chronic diseases and that live a healthy lifestyle. The plan offers unrestricted cover for hospital treatment and access to specialists at double the approved medical aid rate. Members may choose any hospital but for some procedures it is necessary to obtain prior approval from the scheme. The plan, other that most other hospital plans, also offer some out-of-hospital cover for certain procedures but members will be well advised to check with the scheme before undergoing any treatment. There are generous maternity benefits and members have unlimited access to pathological services. In cases of emergencies transport to a suitable treatment facility is also fully covered.

2.  The HealthPact Silver Plan is offered with a medical savings plan that allows members to manage their out-of-hospital medical expenses. This includes visits to a general practitioner. dental treatment, optometry and over-the-counter medication. The plan also makes provision for unlimited hospitalization, although there are limits and in many instances members must get approval from the scheme before undergoing treatment.

3.  The HealthPact Select Plan is the most expensive package in the range offered by the Cape medical aid, but it provides excellent and comprehensive cover. It provides all the benefits of a hospital plan with additional benefits for the treatment of chronic conditions. Members are free to use the hospital or medical practitioner of their choice. Out-of-hospital medical expenses are managed by the members themselves by means of a medical savings account.

 

How does the Medical Savings Account Work?

 

The purpose of a medical savings account is to make provision for everyday medical care. The account is pre-funded at the beginning of each year and as the member incurs medical expenses, it is paid from this account. If there is any money left at the end of the year, it is carried over to the next year.

 

However, if the account runs dry the member will be liable for paying the cost of treatment. It is also important to keep in mind that most schemes, such as Cape medical aid and Discovery medical aid categorize the savings plan and there are limits regarding the maximum that may be spent from each category.

 

In this way it is possible, for example, to drain the funds that are available for dental treatment even though there are still funds available for optometry.

 

Read this excellent article on what a medical aid is.  © Medical Aid Plan

 

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