Why the Cost of Medical Cover is so High
The cost of medical
cover is a nightmare for all of us, and sometimes we wonder if it really is
Today medical cover is a necessity, to ensure you receive proper health care. You may
go without it, but that means either paying the costs yourself or going to a government institution with a
lack of space and resources.
Why do medical aid schemes charge so much for medical
The cost of private medicine is extremely
expensive, an uncomplicated birth for instance can cost up to R100 000. A back operation can cost up to R400 000.
Imagine the costs involved should you be in an accident and have to be hospitalised for a
Without any treatment the accommodation alone can
be close to R500 000 in a general ward. The major costs of medical care these days are hospitals and specialists.
Cancer and cardiac related procedures can be exorbitantly expensive.
• Medical aids are in essence risk insurance
against your health, where accidents, dread diseases and cancer are the biggest risks and also have the biggest
costs to cover.
• The insurance against these risks is actually
what makes the cost of medical cover so
• Part of your premium also covers
admininistration fees, and the salaries of the employees of the scheme. As a scheme is a non-profit organization
the members have to help cover these costs.
• Your contributions are also sometimes used to
fund sponsorships, community projects and sports teams.
Why do medical schemes have capped or scheme
• Some medical practitioner’s especially super
specialists can sometimes charge up to 300% of the suggested medical rates.
• To ensure that the schemes have the funds
available to pay the claims they have to limit the rates they pay.
• These rates are called scheme rates. Some
medical aid schemes in South Africa pay up to 300% of the scheme rates though this is normally on the more
expensive medical aid plans.
• Due to the incidence of the high fees the
service providers charge most schemes have network practitioners where set fees are discussed with the service
providers and set in place.
Is it really worth it to pay the cost of medical
Yes it is. Without the medical cover you purchase
you will either be forced to use government institutions or pay for these high medical costs out of your
You will have peace of mind that when you are in
an accident or need the best medical care available that you and your family will be
Your best option to find affordable medical aid is
to do your homework, study all the schemes plans and benefits and find a product that both suit your needs and
won’t leave you bankrupt. Another option to consider as well, is purchasing gap cover, for the instances where the
service providers do charge more than the scheme rates. © Medical Aid