What Is a Medical Aid?
The short answer to the question What is a Medical Aid is that a medical aid ensures that members of the medical aid scheme can rest assured that they will receive the best possible treatment when they become involved in accidents, experience medical emergencies or when they become ill.
What is a medical aid?
There is a myriad of schemes that offer medical aid. All these schemes are strictly governed and regardless of the specific plan chosen, they all have to cover the conditions listed as Minimum Prescribed Benefits, as defined in the law governing these schemes.
Medical aids provide private care in privately owned medical facilities and by independent medical professionals. All South Africans have access to the public health system but it is an unfortunate fact that government clinic and hospitals are overburdened and underfunded. Most people are of the opinion that they will receive better care at private facilities and they are willing to pay for that privilege.
Choosing a Medical Aid
What is a medical aid? It is important to keep in mind that the various companies operating in this market all offer various plans. The benefits offered by each plan differ. In some cases cover is offered only if the member is hospitalized while other plans are comprehensive and make provision for day-to-day medical expenses as well.
Before choosing a specific scheme or plan it is vital to consider your own needs and those of your family. Young, fit and healthy people may need no more than a hospital plan, but families with children and members that suffer from chronic disease may need a more comprehensive plan. It is also vital to consider your budget. Medical plans can be expensive, but it is certainly worthwhile to get the best plan that can be afforded. After all, when accidents happen or when disease strikes one realizes that nothing in life is more important that one’s health and wellbeing.
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Some schemes require that their members make use of an approved network of service providers and hospitals. Most schemes also require their members to obtain prior approval for specialist treatment or admittance to a hospital. If these conditions are not kept the member may be liable for the cost of the treatment or the hospitalization.
What is a medical aid?
It is also important to keep in mind that some plans will only pay the approved medical rates. In many cases treatment cost exceeds this rate and members are liable to pay the difference. It is very important to carefully study the terms and conditions of any plan and to make sure that cover is available before requesting treatment.
Some schemes offer hospital cash plans. These plans do not pay the medical bills but rather pay members a specified amount of money for each day spent in hospital. The member may do whatever he will with that money. He may, for example, decide to use it to settle debts or to buy groceries.
Other plans feature a medical savings account. These accounts help members to manage their day-to-day medical expenses. In most cases unused funds are carried over to the following financial year. Read this article entitled What Does Medical Aid Cover? for more information.
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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.