Choosing a Medical Aid
With so many medical aid schemes available in South Africa everybody wants
to know how to choose a medical aid. Before we get the factors you should consider let us look at medical aid in
What is a medical aid?
Medical aid is a type of insurance that pays for private medical costs.
Medical aid 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 will probably be some of the most important insurance you will ever
To get your medical
aid plan quote by email Click
What types of medical aids are there
• Comprehensive medical aid: This is full cover plans, where you receive
hospital and day to day cover.
• Hospital plans: these plans only provide in hospital cover with no or
limited day to day cover.
• Network plans: these plans offer comprehensive or hospital cover at
Network service providers.
• Hospital insurance: This is not a medical aid, but insurance taken out
on your health, the money goes straight to you to use as you see fit. This is cheap medical aid form that should
not be confused with the real thing.
What questions to ask when you consider a medical
• Is this an affordable medical aid? Can you afford the premiums and still
maintain your level of lifestyle?
•What kind of medical aid do I need? This choice should be based on your
current medical condition.
• What are the benefits? All medical aid plans have different benefits;
find a plan with benefits that suits your personal medical care needs.
• What is the overall annual limit? Make sure you choose a plan with
enough overall money in the budget to cover your needs.
• Are there any exclusions? Some medical aids place exclusions on
pre-existing medical conditions.
• Are there waiting periods involved? Waiting periods means you do not
cover for a certain period of time.
• Are there any co-payments payable? Some schemes require co-payments or
deposits on certain procedures, medication and specialist visits.
•What percentage of suggested medical aid rates does the scheme cover?
Some hospitals and specialists can charge up to 300% of the suggested rates, funds cover some part of these but the
rest are for you to pay.
• How does the claims process work? Find a fund with a claims process you
can adhere to.
• What are the scheme rules? Some medical aids have strict rules and
penalties if you do not adhere to these rules.
• Do I have to visit specific service providers? Some schemes and plans
have a list of service providers you have to use and are penalised if you use unlisted
• Is a plan with a rewards program really worth it? A plan with a rewards
program can be great but you might find the same benefits for less at a scheme without rewards
• How many medical aid comparisons should I do? As many as possible, that
way you will be able to make an informed decision.
• Should I consider the services of a medical aid broker? Definitely yes!
A broker will give you the best advice as they know the ins and outs of medical aids.
This list of questions might be
long, but it will help you with the how to choose a medical aid dilemma. You will find a medical aid that suits you and your packet and you will
know what you are letting yourself into. © Medical Aid
To get your medical aid plan quote by