How To Choose a Medical Aid

What to Look Out For When Choosing a Medical Aid

It should come as no surprise to you that a huge chunk of your income is spent on paying for your medical aid. How do you go about making the smart choice of not overspending and ensuring that you are with a medical aid that has the right cover for you and your family? It all comes down to selecting a scheme, not just a medical aid, which has options that will look after your needs for every stage of your life.

Where Do You Start?

You should start by considering the following:

1. Do you require a scheme that will cover GP visits and other day-to-day medical expenses or would you be happy with a more affordable hospital plan?
2. Are you or any of your family members suffering from any chronic medical condition, e.g. diabetes or arthritis?
3. Do you require spectacles or have dental problems?
4. What can you afford? Don’t be scared to shop around or to scrutinise the table of benefits - you don’t want a nasty surprise and major co-payments when visiting your closest hospital or normal GP
5. What do prospective medical aids offer? We recommend that you check out the solvency ratio for the scheme (a measure of an enterprise’s ability to meet its debt and other obligations). Find out about exclusions and overall hospital limits.
6. Use social media and ask your friends about payment records for the schemes that you’re interested in
7. It’s very important to confirm the cover offered for major medical conditions like Cancer and HIV

When Should You Consider Changing Your Scheme?

If you are currently on a medical aid, you should look at your expenditure for the previous year; confirm what your scheme paid and what out-of-pocket expenses you had. Analyse these and consider if you can expect similar expenses for the upcoming year. Look for an option on your current scheme that will cover these out-of-pocket expenses and weigh up the additional monthly contributions to see if you will save. If not, then shop around for alternative medical aids that will be more suitable to your needs. Keep in mind the aforementioned considerations about scheme solvency and payments.

As you get older, your medical needs change and more comprehensive benefits will become necessary. If there is potential for unexpected future expenses, e.g. maternity benefits, then elect to move to a plan that will assist you with these expenses. By taking the time and doing an analysis you may realise that you need to upgrade to a better plan or if you are paying for unnecessary benefits. This may end up costing you more monthly, but will save you out-of-pocket expenses over the next year.

The most important consideration is to know the cover you are getting with your particular scheme and plan, and to understand that you can change your scheme lan once a year according to your changing needs.