What Medical Schemes
Medical schemes are basically insurance companies
that prove you with the necessary medical cover to ensure you receive the best possible medical care available.
You will have a choice between different plans and
All schemes are regulated by the Council of
Medical Schemes. The council is government appointed body that can assist you should you have any disputes with a
scheme. They also have a list available of all the medical service providers in South
Some of the biggest medical aid schemes in South
We have a dual health care system in South Africa
that includes a public and private health system. Medical care at the public system are free but very expensive in
the private system, you need a medical aid to cover the costs of private healthcare.
With medical aid you pay a premium that insures
your health, this premium then covers your medical expenses. Be aware that schemes do have claims limits based on
their benefit schemes and the plan you purchase.
To get your medical aid plan quote by
You need to be aware of the words "payment in
full" in particular. This usually means "payment in full" at the rates set by the medical aid in question, and not
payment of the actual medical bill in full.
Medical schemes vary a lot in relation to the
plans and options they offer, and
with all these variation it is sometimes difficult to find a scheme that suits your personal and family’s
Factors you should take into consideration when
acquiring medical insurance are:
- The costs involved, medical plans can be
expensive find something that suits your pocket.
- Your current health status, if you have
chronic illness you might need a bigger plan.
- The specific benefits you need, these can be
based on pre-existing conditions and the lifestyle you follow.
- Exclusions and waiting
- Medical scheme rates; this is the rate the
scheme are willing to pay the service provider.
- Are comfortable with supporting only a
certain chain of service providers.
- Will you be able to abide by the rules the
- There is a wide range of medical options
- Comprehensive or traditional plans: Covers
both day to day and hospital needs.
- Hospital plans: Covers only in-hospital
medical costs and some chronic conditions.
- Medical savings accounts: An
additional option to some plans, this can cover above threshold rates or your day to day medical
- Network options: This plan offers cover at a
selected network of service provides. Cover are for both hospital and day to day medical needs. These plans are
mostly income related, and the premiums are decided accordingly.
With all these options, choosing a medical plan that is suited to your needs could be a
difficult choice to make. Most medical schemes have
websites or call centres you can visit to assist with your choice, but a medical broker can be of assistance as
well. © Medical Aid
To get your medical aid plan quote by email Click Here