Medical Aid in South Africa
The first rule of thumb about medical aid is to grasp a clear understanding of what it is all about. And, in South Africa, this can become quite an onerous task.
That’s because of the wide range of different medical healthcare products that consumers are urged to buy.
What is medical aid?
Medical aid is quite simply another form of health insurance. You buy a product for a monthly premium and, in return, you receive financial cover for any treatment or other medical expenses you may incur. But here’s the rub. That old adage, you get what you pay for, has never been truer than when it’s applied to medical aid. There are so many different medical aid providers. There are so many different levels of benefits. There are so many different scales of monthly premiums. It can be a minefield. Choosing the right product for you and your family can be a minefield. Do your research. Obtain advice from a qualified healthcare insurance broker. These two actions will guide you to the right medical aid cover to suit your personal needs.
How to select the right medical aid
As already stated, finding the right product to suit both your needs and your pocket can be a minefield. Before beginning your selection journey, analyze what healthcare needs will be suitable for you and your family. Carefully examine what medical expenses you have incurred in recent months. Now, you will be in a position to decide on one of two critical options:
- Whether you are prepared to use a network of preferred providers stipulated by the company of your choice.
- Whether you would prefer to choose your own healthcare professionals.
The first option will enable you to reduce your monthly medical aid contribution. The second option will suit those of you who are in a financial position to meet heftier monthly premium payments. Too rich for your blood? If at the end of all your research, you should discover that comprehensive medical aid cover is too rich for your blood, then a hospital plan may be your best alternative. South African medical insurers have devised hospital plans for people who need basic cover that nevertheless encompasses important medical issues. It’s a great product for younger and healthier individuals, or for those who are less cash-flush. Hospital plans generally insure you for in-hospital procedures and treatments, as well as for check-ups. Premiums for hospital plans are far less onerous than full medical aid cover.
Which is the best medical aid scheme?
As we all know, statistics can be tweaked to reach suitable outcomes but two recent surveys give us a clear indication of South Africa’s leading medical aid schemes. According to results of the latest South African Customer Satisfaction Index (SAcsi) by Consulta, an independent market research company, Medihelp has emerged as the leading performer in 2018. They were followed by Discovery, Momentum, Bonitas, and GEMS, a closed medical insurance scheme for government employees. A second survey by financial services company, GTC, reviewed 21 open schemes and one closed scheme, Profmed for professionals, and covered 22 different plans spanning five categories, eight sub-categories, and three micro-categories. According to GTC, the following companies emerged as leading South African medical aid providers based on a family of four.
- Momentum Ingwe Network – comprehensive entry-level medical aid
- Discovery KeyCare Plus – comprehensive entry-level medical aid
- BonitasBonCap – comprehensive entry-level medical aid
- Momentum Ingwe State – medical aid using state facilities (lower income)
- Momentum Ingwe State – medical aid using state facilities (upper income)
- Discovery KeyCare Access – medical aid using state facilities Hospital Plans
Bestmed took the top two positions for both network and non-network hospital plan schemes.
Saver only plans
Bestmed took the top two positions for both network and non-network saver plans. These plans offer affordable in-hospital, chronic and day-to-day cover.
Risk-only plans
Discovery took the top two positions for risk-only comprehensive medical aid plans at both network and non-network service providers.
Complete costs
Discovery took the top two positions for comprehensive complete costs plans at both network and non-network service providers.
Conclusion
There is much debate that the advent of National Health Insurance is putting pressure on private medical aid schemes. The industry believes that the introduction of NHI will force medical aid providers to improve their services. This, in turn, could lead to significant monthly premiums hikes. In the meantime, consumers have to navigate a minefield of healthcare options with more than 270 products on offer in South Africa. On the other hand, medical aid providers face the challenging task of offering top-class services, at reasonable prices, to maintain consumer satisfaction levels.
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NOTES:
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.