Often, seeing a general practitioner (GP) or specialist can be extremely costly for just a simple check up or examination. If you need more in-depth treatment or care, the costs rise quickly, and hospitalizations are financially catastrophic.
Often, this financial burden is too much to bear, and can lead to missed appointments, neglected medications, complicated illnesses, and making the entire health concern significantly more complicated.
By having Medical Aid, a patient can protect against these complications with their plan’s coverage.
The choice of which Medical Aid program to use depends on your needs. You should evaluate the current state of health of yourself as well as any of your dependents.
When doing this evaluation, be sure to consider family medical histories and any past records of disease or illness that you may have to face in the future.
Once you have an understanding of your own needs, you’ll have to consider your budget. What can you afford? If you pay less each month, you’ll have to pay more if and when you need treatment, but you don’t want to strain your monthly resources to get that coverage.
Different companies offer different perks, such as medical savings accounts, network options, comprehensive plans, and more. These options, which are discussed in detail below, need to be considered when making your purchase.
Medical Aid can be purchased by anyone, no matter their age or health, but these factors may influence how much you have to pay for different types of coverage. There may also be delays in getting coverage started, such as for cancer treatments or pregnancies. Be sure to get your coverage BEFORE you need it!Medical Aid schemes and the companies that provide them do not get to decline you based on your age or condition, but they can terminate your scheme membership if you do not meet the requirements, such as missing payments or loss of eligibility through changes in employment. Your employer may grant you access to a Medical Aid Scheme that is only open to certain job fields, or pay levels, or even only open to that company, and Medical Aid packages are often part of the benefits of working for a given company. Some employers may offer special discounted rates for your Medical Aid coverage, while others might contribute towards the cost of your plan. Keep in mind that these are voluntary options for the employers, and they do not have to subsidize your scheme in any way. Part of the complication of Medical Aid stems from coverage periods. If you are new to a program, you may not actually get coverage until the start of the next period, and in some cases you’ll have to wait for up to three months (longer for preexisting conditions) before coverage begins. If you decide to terminate your coverage, or switch to a different scheme, you will typically be protected by your old provider through the end of that notice period or billing cycle. Decisions to change your coverage should include the same considerations you make when first selecting a Medical Aid Scheme. What are your needs and how have they changed? How will they change? What can you afford? The Late Joiner Penalty must also be considered. The Medical Schemes Act includes a provision for a penalty to be assessed if you start coverage after turning 35 years old. This penalty is based on the number of years you have not been covered since turning 21 years old, and is assessed as a percentage on your monthly contribution. This makes it important to start your coverage earlier in your life. Get protection before you need it!
A medical savings account is a pool of money set aside from your monthly contribution that is used to cover any costs as they emerge, with unused amounts being rolled over into the next period, and the total being repaid to you when you terminate your scheme.
A network option gives you discounted access to a group of hospitals and doctors, while out-of-network services are much more costly. This smaller network allows your coverage plan to maintain lower costs.
A comprehensive plan covers more services at a higher percentage, including hospital stays, prescription medications, specialist visits, and more.