SA Topsites ::

Choosing a Medical Aid in South Africa


 

  

  

A Comparison of Medical Aids

It is always difficult to find the medical aid suited to your needs. With all the different types of medical aids available it is good to have the medical aids compared.A Comparison of Medical Aids

Below you will find a list of the different types of medical aid schemes and how their drawbacks and benefits compare.

The comprehensive medical aid plans:

A comprehensive plan is the chocolate cake of medical aid in South Africa; this plan covers most of your medical costs, unlimited hospitalization and has generous day to day cover included.

Benefits:

  • You will have a higher level of medical cover than in the other plans.
  • Most comprehensive medical aid plans provide unlimited GP visits, basic dentistry, and optometry. 
  • Comprehensive plans provide chronic medication cover for all diseases as specified by the specific scheme.
  • Additional benefits for in-hospital treatment, depending on the plan you have selected. These may include; use of the emergency facilities as an outpatient, post hospitalization cover, medication you can take home after you leave the hospital.
  • Possible additional cover includes; alcohol and drug rehabilitation, terminal care, oncology, dialysis, hearing aids, organ transplants, physiotherapy, prosthesis, psychiatry, specialized rehabilitation and medicine, step down facilities, private nursing and hospice.

Drawbacks:

• It is more expensive than the other options.

• Benefits can be depleted, due to high hospital and specialist charges and you will have to cover the rests of the costs yourself.

• Limited cover on certain specialities.

• Co payments on medicine and doctors visits that exceeds the specified cost levels of the fund.

Hospital Plans:

This is an entry level affordable medical aid that covers you in-hospital needs, but only have limited day to cover.

Benefits:

  • More affordable than comprehensive cover.
  • You are covered for in-hospital procedures and hospitalization.
  • Some plans offer limited day to day benefits or include a savings option to assist in day to day medical cover.

Drawbacks:

• You are only covered in hospital.

• Cover is only available up to a certain percentage of medical cost rates.

• Some plans offer no day to day cover, and you will have to pay for these in addition to your premium.

Network or Capitation medical aid plans:

Network options provide the most cost effective options for medical care, but it is limited to selected service providers.

Benefits:

  • This is a very cost effective alternative; you can find adequate cover for a fraction of a comprehensive plan premium.
  • There are no annual limits to in- hospital benefits, depending on the plan you have chosen.
  • Chronic medication is provided for 25 chronic conditions.
  • You have access to network GP’s, limited access to specialists and additional cover for basic dentistry.
  • Some of the schemes have additional in- hospital benefits to cover terminal care, drug and alcohol rehabilitation and other health care emergencies.

Drawbacks:

• Your premiums are based on your income, the more you earn the higher your premiums will be.

• You can only visit specific doctors listed in the network’s list of service providers. 

With this comparison of medical aids you will be able to make a more informed decision regarding the choice of medical cover you need. © Medical Aid Plan

* Read this interesting article about medical aid comparisons in South Africa.

 
To get your medical aid plan quote by email Click Here