Medical Aid Plan - 10 Things

10 Things You Should Know About Medical Aids

Hello. There are dozens of medical aids (also called medical schemes) that South Africans can choose. But how do medical aids work? Why are they so expensive? Which are the best medical schemes? And is there a medical aid plan that’s suitable for you and your family?

Here are the main points about medical aids:

1.       Regulated by government   

The SA government regulates medical schemes in South Africa. So these cash-rich cannot just do as they please. Medical aids register with the Council for Medical Schemes, which makes them official. A Registrar is in charge of the Council. Operationally medical schemes must adhere to certain regulations, which include holding 25% of all incoming funds in reserve to pay out benefits and weather any unexpected financial storms. Also, every plan from every medical scheme must offer Prescribed Minimum Benefits (PMBs).

2.       Not-for-profit organisations 

The members of medical aids “own” the medical aid. These organisations do not make money. However, the management companies that operate the medical aids do make a profit – vast profits. Some medical aid members feel this is unfair. And yet the medical schemes work well and most of them are financially sound. Sometimes medical aids merge if one gets into difficulties.

3.       “Open” and “Restricted” Schemes 

There are two types of medical schemes:  The “open” schemes are open to every South African citizen – if they can afford the premiums. Most well-known are giants like Bonitas, Fedhealth, Momentum and Discovery. Then there are “restricted” schemes, which are open only to employees of certain companies or certain industries. Some examples are Bankmed for the banking industry, the Government Employees’ Medical Scheme (GEMS) for government workers and Moto Health Care for employees in South Africa’s automotive industry. Obviously the “restricted” schemes are less well-known than the “open” schemes.

4.       Sole providers of hospital plans 

Did you know that only registered medical aids may LEGALLY offer hospital plans? Sometimes what South Africans THINK are hospital plans are not hospital plans at all. Take for instance the offerings of Clientele Health. People think if they take out a Clientele policy they are taking out a hospital plan.
But all that Clientele provides is health insurance, which is a set payout if you legitimately land in hospital. They pay a set amount per day under strict conditions. All the cash is enough for is to pay airtime, groceries, transport and so on while you are in care. Hospital and medical professional bills don’t come into it. But payouts from a medical aid’s hospital plan does pay healthcare bills – although often they don’t pay ALL the bills. Bottom line: only registered medical aids may provide hospital plans.

5.       Cheap medical aid available here 

Medical aids in South Africa are aware that most South Africans suffer financial stress. Additionally, the vast majority of people do not earn very much. Therefore they have come up with affordable plans for everyone – from individuals to families, businesses to students. Leaders in cheap medical aid are Fedhealth and Discovery. (When you apply for a medical aid quote on this page, we will make sure to supply you with the cheapest medical aid there is, as long as it complies with your requirements.

6.       The biggest medical aids in South Africa 

Discovery Health is the winner here, with billions in reserves and hundreds and thousands of members. It also has the largest variety of plans to choose from. No wonder Discovery has moved into the life insurance game, the short-term insurance market and now has set up its own bank. Discovery’s Vitality rewards programme is a great attraction for South Africans.
Hot on the heels of Discovery is Bonitas – another “open” scheme – and then comes Momentum Health. That might come as a surprise to you because Momentum does not engage in heavy advertising campaign like Discovery, for example. However Momentum garners its huge membership via group schemes for companies. Among the “restricted” schemes, GEMS is by far the largest.

7.       Compare, compare, compare 

Medical aid experts agree that South African medical aids offer way too many plans. They offer so many, in fact, that consumers (ordinary folk like you and me) find it difficult to make sense of what each plan offers and how these plans compare with others. That’s where we come to the rescue. Complete and submit the form on this page so we can do the legwork for you. You will receive comparative quotes from several medical aids – plans that match your particular circumstances.

8.       Don’t fall for the glitter 

Medical aid experts agree too that often people are drawn into medical aids for the wrong reasons. Having good medical scheme membership does not mean gym membership or Voyager miles. What it means is reliable and predictable health care cover for you and your family. The extras are neither here nor there – nice to have but they should not be the main priority.

9.       Don’t cancel your medical aid 

When times are tough, South Africans consider cutting out their medical aid membership altogether. That is not a good idea – ever. It means that when you re-enter the medical scheme market later your will be penalised. And, obviously, you won’t have cover if something happens and you land in hospital. You DO NOT want to land up in a state hospital. You might as well sign your death warrant in most cases. Get gap cover if you think that medical aid won't cover all your expenses.

10.   Get your quote here 

Below you will find a form for you to fill in. Our experts at Medquote will immediately get to work finding the best medical aid option for you. No matter if you are a senior, an individual, a family, a student or a business, we can supply you with medical aid quotes. So act now before it is too late and you find yourself lying in a government hospital without the health care you need. Rest assured that we will not use your details for any other purpose than to send you a quote.





Medical Aid QuoteNOTES:

Your medical aid quote will include options to suit your pocket. Please ensure that the cover you select is exactly what you need and that you understand exactly what insurance you are buying. Do not hesitate to ask questions about the medical aid or hospital cover you choose.