Medical Aid Plan - Clientele is it a medical aid

Clientele Health – Is it a medical aid?

Hello. The short answer is no, absolutely not!

Clientele is NOT a medical aid!

So what is it then?

Allow us to explain.

Clientele Health is health insurance, not medical aid

It will be useful, though, for us first to outline the attributes of a medical aid (also called a medical scheme).

Main Points About Medical Aids

  • Medical schemes are not-for-profit
  • Official schemes must register with the Council for Medical Schemes. (Here is the list of registered medical schemes in South Africa.)
  • The members “own” the medical aid
  • Government controls medical aids
  • Medical aids are not-for-profit
  • Medical schemes must, by law, hold huge funds in reserve to pay benefits
  • By law there are dozens upon dozens of benefits that medical aids must cover. These are called PMBs (or prescribed minimum benefits).

Why Clientele Health is not a Medical Aid

  • It is run for profit
  • Clientele is a company, not a registered medical scheme
  • By law Clientele may not call itself a medical aid or medical scheme
  • Clientele Health may NOT pretend it offers hospital plans. All it offers is health insurance
  • The benefits it pays are not meant to cover the cost of hospitals or doctors or specialists. Clientele never sees a hospital bill or a doctor’s bill and does not care about them.
  • All that Clientele pays out is a fixed sum per day you are in hospital.
  • Clientele pays out benefits only after a certain number of days the insured patient has been in hospital.
  • It stops the benefits after a fixed number of days.
  • The cash that Clientele pays out is meant for expenses BUT NOT direct hospital and specialist expenses. All the cash is meant to cover is expenses like transport, airtime, school fees, groceries, etc.

Clientele is Not the Only One

One Life is another insurance company that offers health insurance and there are several others.

If the institution involved is an insurance firm, then you can be sure you are getting health insurance and NOT medical aid.

Why You Should Opt for Medical Aid as Your Main Health Cover

It is obvious: you get hospital cover related to

  • Your income
  • Your requirements
  • The actual hospital and specialist bills you will receive

In addition, if you opt for a comprehensive medical aid membership, you will have a savings account attached for day-to-day expenses.

Hot Tip #1 

Opt for a hospital plan from a registered medical aid and save!

Here’s how:

  1. Apply for the most appropriate hospital plan from a medical scheme (use the form below or go here).
  2. Then buy some medical gap cover from a company such as Zestlife, Sanlam or Turnberry. That will insure the “gap” between what the medical scheme will pay out for hospital and other expenses and what the bill actually says. So doing you say goodbye to co-payments
  3. If you have any monthly budget over, take out health insurance from a firm such as Clientele to cover other, indirect expenses associated with hospitalisation – expenses such as transport, airtime, school fees, groceries, etc.

Put in another way: do not rely on health insurance to cover anything directly related to the expenses you could incur by landing in hospital!

Which Medical Aid Should I Choose?

Hot Tip #2 

Which medical scheme you select, and what plan from that particular medical aid you should opt for, is something you are unlikely to figure out on your own.

South African medical aid experts agree that there are far too many genuine medical scheme plans available in South Africa (around 200 in fact), making it difficult to choose.

That’s why we at Medical-Aid-Plan have set up the form on this page – so we can do the legwork for you.

Just complete and submit the form here and we will do the rest. You will receive quotes from a number of medical aids, with advice about which plans suit you and your family the best.

A List of Some Top Medical Aids in SA

Here is a list of some of the many medical schemes in South Africa that we might send you quotes from:

Discovery Health – This is the largest medical aid in South Africa and open to all. FYI some medical aids, such as GEMS (which is for government workers only) cater to specific industries, organisations or companies. Bankmed is another, serving the banking industry. Discovery’s KeyCare series is popular with low-income earners. It’s top-level comprehensive medical aid plans are favoured by top executives who opt for private membership of a scheme, rather than group membership.

Genesis – Genesis is a favourite of Medical-Aid-Plan.co.za because it is small, powerful, robust and nimble. Genesis is based in the Western Cape. Take a look at their website here. You will see that they have just four plans (good idea!). Two of them are comprehensive plans and the other two are hospital plans. Definitely take a look at these when comparing the various offerings.

Bonitas – Bonitas members swear by this medical aid and believe that it offers generous benefits. It is the second largest “open” medical scheme (as opposed to “restricted” scheme – see above).

Momentum Health – You might not see the Momentum registered medical scheme mentioned in the media much. That is because Momentum caters largely to large companies where it implements group medical aid schemes. Despite its low profile, this MMI-operated registered medical scheme is the third largest in South Africa.

Fedhealth – Fedhealth registered medical scheme has made work of it to cater to the lower income earners e.g. people who earn a small salary, students, pensioners, etc. Definitely make sure your comparative quote includes an option from this scheme. Fedhealth regularly upgrades and alters its plans. There is bound to be something for you at Fedhealth.

Sizwe Medical Fund – Sizwe has an interesting history. It started in the 1970’s during apartheid. Black doctors got together to form a fund for black patients. Today the fund covers thousands of South Africans without regard to race, gender, age or any other limiting factor. Those who joing Sizwe medical aid ten to stay there forever.

Hot Tip #3 

Complete and submit the form below to receive your complimentary comparative medical aid quote.   

 

 

COMPLETE THIS FORM TO GET YOUR MEDICAL AID QUOTES!

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.