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Are you confident your medical aid will protect you?

Medical Aids are becoming complicated. In attempting to remain solvent, many are constantly increasing contributions and reducing benefits. Medical aids offer a number of options within their schemes.

Medical aid is like car insurance – you insure against the major costs, not the minor ones. Therefore, you must be certain that you are covered for hospital, chronic medication and costly out of hospital procedures like MRI and CAT scans. If you are funding your own plan, or are part of a company scheme, you need to know just what you are not covered for!

Day to day costs are increasingly being funded by way of savings accounts, where you pay for the expenses through a fund built from your contributions. Various schemes offer a “risk pool” from which some of your day to day costs are paid. These are normally limited and ultimately your savings will be used to pay costs.

Other schemes offer “threshold cover” whereby your savings pay out first and when a defined limit of payment is reached, the scheme steps in and covers you further. Either way, you pay an “excess” on your day to day costs.

Comprehensive schemes are still available, however they are expensive. Some schemes also offer lower cost plans whereby you are restricted to networks of hospitals and clinics. They can be extremely attractive – but, read the fine print!

An important point to note is that penalties may be levied if you have not been a member of a medical aid for a period of time. So, if you are delaying joining – the sooner you do the better!

Some schemes also offer additional benefits like discounts on holidays, car hire, subsidized gym membership, movies etc. these are designed to attract members to the scheme and to help control expenses by rewarding members who use certain beneficial services. They may be compulsory.

We are accredited with the Council of Medical Schemes and are in a position to give you comprehensive advice.