When it comes to choosing the best affordable Medical Aid in South Africa, here a few things to know.
What is Medical Aid?
Medical aid is a form of insurance where you pay a monthly contribution or premium in return for the financial support you may need for medical treatment, as well as any related medical expenses.
You have far more coverage and benefits with Medical Aid when it comes to daily health appointments and medication, depending on the option you choose. Medical Aid provides coverage in-hospital and pays for treatment according to the specific tariff of the medical scheme.
The legislation governing the medical aid scheme industry states that all registered medical schemes must accept any person wishing to join the scheme; their income and family sizes should be the only differentiating factor between prospective users. The scheme must accept any person and may impose a general three-month waiting period, a 12-month exclusion clause from cover for any existing medical condition and a late joiner penalty for any person over 35 based on the previous membership of the South African medical scheme for the person.
Medical help, which is governed by the Medical Schemes Act, is protected by tariff codes and procedures and is frequently deficient due to the disparity between the National Recommended Price List and the prices of the South African Medical. Association.
Prescribed Minimum Benefits
The scheme can not exclude any illness that has not been diagnosed or treated during the 12 months preceding application to join the scheme. This includes any disease that occurs within the three-month waiting period, and any disease that occurs after the 12-month exclusion period has lapsed. The scheme must also cover 270 life-threatening emergencies and 26 chronic conditions irrespective of the cover one chooses.
Cost of Medical Aid in South Africa
Payment for medical treatment is usually made to the hospital and/or service providers directly with Medical Aid. Some companies expect you to pay directly for the day-to-day services and then claim back from the Medical Aid. When looking for affordable medical assistance, one package may seem better in some ways but fail in others in comparison to other schemes.
Many policies may be fully covered in-hospital procedures, but then you will have to pay for essential medicines and doctor visits out of pocket. Medical help plans which fully cover the client are usually very expensive. If you are older and prone to health problems, you may be a better fit for Medical Aid.
Schemes are unable to charge different members contributions for the same plan and family size, the only time the scheme can charge different contributions is if the member has a late joiner penalty or if the plan has income bands (the monthly income then plays a role).
List of Medical Aids in South Africa
Medical aids cover prescribed minimum benefits, has specified annual limitations for procedures and health events need not be specified specifically, does not include any personal accident disability and loss of limb cover, is not permitted to include death and/or funeral cover as part of the Medical Aid Scheme; and pays in-hospital benefits under the National Recommended Price List limiting benefits as outlined in the Plan. Medical aid schemes directly reimburse all providers, even hospitals and specialists. This has the benefit of taking care of all the administration while the patient is focusing on their recovery.
It should be noted that some medical schemes are non-profit organisations that work for the benefit of members like charitable organizations and are governed by a board of trustees elected by members. As such they aim to serve their members by providing them with the best possible healthcare coverage in the most cost-effective manner possible. The Act requires medical schemes to maintain minimum solvency ratios, which provides assurance to members that the medical said will remain sustainable should the client need the care.
Best Affordable Medical Aid in South Africa
Generally, Medical Aid can cost anywhere between R1500 – R5000 per month.
Medical Aid Scheme More Information:
Best Med www.bestmed.co.za
FedHealth Medical Scheme www.fedhealth.co.za
Genesis Medical Scheme www.genesismedical.co.za
Liberty Medical Scheme www.liberty.co.za
Sizwe Medical Fund www.sizwe.co.za
Bonitas Medical Fund www.bonitas.co.za
Best medical aid in South Africa for students
After much comparison here are some of the best companies to contact for a quote for the best medical aid in South Africa for students:
Best medical aid for pensioners South Africa
Having medical aid as a pensioner is essential. While some can foot the bill, in most cases children have to add their parents as dependents. If your parent(s) previously had medical aid, you need to contact the company and get a certificate to prove that they’ve had medical aid coverage for over 20 years, this helps decrease the premium rate.
After much comparison here are some of the best companies to contact for a quote for the best medical aid for pensioners South Africa:
Difference between Medical Aid and Medical Insurance
Health insurance usually provides little coverage for regular costs, so you’ll have to pay most of those medical expenses yourself. Whether you’re relatively healthy or chronically ill, health insurance can provide both routine and unexpected health care needs with the financial protection you need. Health insurance can help with co-payments and coinsurance to protect you from high medical costs.
Traditionally, medical insurance pays a set amount for each day spent in hospital or a set maximum amount per incident, regardless of the type of treatment required. Medical insurance can be taken out as a stand-alone product or can be used as a supplementary product when your savings in Medical Aid have run out. Usually, payment is made directly to you with Medical Insurance, and you must settle your own accounts. The refund may be used to pay for medical care costs or to pay for other regular expenditures incurred while in hospital.
Health insurance is more focused on major incidents in life. It does not cover pre-existing conditions but is useful in the event of serious accidents, paralysis or diseases that may arise after you have taken out the policies (strokes and heart attacks). Older people, or those with pre-existing health conditions, are likely to pay more for health insurance. A health insurance company may sometimes even refuse to cover the individual if they consider the risk of claiming to be too high. Consumers should be wary of statements that they have extensive coverage for any costs that could be incurred as a result of a health care crisis. You are covered for a certain amount with medical insurance, and all the more you’ll need to pay for. Many providers have created health insurance solutions through a network of private providers that exclude or limit private hospital coverage and cater for basic day-to-day medical services. Top of the range plans can include extensive day-to-day benefits and stabilization benefits for private emergency hospitals. Entry-level plans typically only provide basic day-to-day benefits.
The cost of taking out Medical Insurance is lower than that of Medical Aid since it offers fewer benefits. Medical insurance is the best option for individuals who are generally healthy and who are unlikely to incur ongoing daily medical costs. Medical insurance has much more affordable premiums making them affordable for anyone. Medical insurance payments start from R150 a month. Medical insurance products are currently registered under either long-term or short-term (sometimes under both) insurance acts.
Medical Insurance is regulated by the Long-term Insurance Act, which stipulates that: Medical insurance may be used as a gap cover in conjunction with your coverage medical aid where your medical aid scheme may be short protects your financial assets and promotes health and well-being, covers certain accidental injuries such as disability resulting from accidental injury can cover your income if you are unable to work, provide you with the option to provide death and/or funeral coverage in your contract, cover fixed or specified health incidents amount paid directly to the member as opposed to the medical service provider, and offers the stated benefits and an official list of medicinal products which may be prescribed.
On the other hand, insurance products can include a range of products such as hospital cash benefits, distance cover, medical travel insurance and primary healthcare. Hospital cash plans (not hospital plans for medical aid) tend to pay out fixed lump sums regardless of service rendered by health services. While the lump sums paid by an insurance product may seem a cost-effective alternative at first glance and provide adequate levels of hospitalization and treatment coverage, we advise those who rely solely on these products to ensure that a major health event requiring hospitalization should occur. And/or long-term chronic treatment will occur, and the cover provided will prove appropriate. Short- and long-term insurers are sometimes for-profit business-driven companies and are generally owned by shareholders.