Find the Best Medical Scheme

There is a wide variety of medical schemes in South Africa, and sometimes all you need is a little help on how to choose the best medical scheme.

With all the options available, the best option would be a medical aid plan that suits your budget and your personal needs.

In essence, you have four kinds of medical insurance available at medical schemes. In order to choose the best option for you, you have to examine your medical needs and choose a medical scheme accordingly.

The four options:

Hospital plans: Hospital plans are more suited to young and healthy families or people that can afford to cover their day to day costs by themselves. Most hospital plans only provide cover for in-hospital treatment, procedures, and surgery, though there are plans available with medical savings accounts to assist with your day to day medical needs.

Ordinary medical aid: Most employed people belong to closed medical schemes (for particular companies or industries) or open medical aids, which anyone can join. Most people have one of the cheaper or medium plans on a medical aid.

Comprehensive plans: A comprehensive plan is the all-rounder plan, with both hospital and day to day cover. This plan either has a medical savings account or added day to day limits. A comprehensive plan is more suited for persons or families with more advanced medical needs. This is the most expensive form of medical aid but well worth the benefits you receive.

Network Options can come in hospital and comprehensive options. The premiums of these plans are usually related to the income of the member. The main catch with a network plan is that you have to use the chosen network of medical service providers.

Hospital insurance: Hospital insurance is not a form of medical aid but rather a booster option to consider. You get paid in cash per day you spend in the hospital. You can use this as additional funds to pay the amounts your medical aid does not cover.

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Questions you should ask when deciding on what the best medical scheme is:

• Who has the most affordable medical aid options?
• Who has the products that suit my needs the best? It is important that the product suits your lifestyle and preferences.
• Who offers the best benefits? The higher the benefits you receive, the better.
• Who has the highest payment ceiling? The scheme or option with the highest ceiling will result in you being liable for fewer additional payments.
• Who covers the most chronic conditions? Some schemes only cover the prescribed minimum benefits, and you will have to cover the rest yourself.
• Who has the least co-payments or deposits? Some schemes require co-payments or deposits for certain procedures where others do not have these.
• Who has the biggest network of medical service providers in the area I reside in? Should you choose a network option but reside in a rural area, the chance may be that you do not have network cover in that area.

In order to find the best medical scheme, you need to focus on your personal needs and who gives you the best value for your hard-earned money. © Medical Aid Plan

 

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