We know how overwhelming it can feel choosing a Medical Aid option for you and your family. There are so many things to consider, and often industry jargon can cause a lot of extra confusion. This is why we recommend working with an Independent Medical Aid Adviser who will bring a lot of ease and clarity to this process.
If you are not working with a Medical Aid Adviser, it’s important that you make informed decisions for your unique needs, here are some questions you can ask yourself to best ensure those needs are met.
1. What is my affordability?
Opt for the best Medical Aid Plan available in your price range to ensure that you’re adequately covered health-wise and are not financially strained. Planning and budgeting for your Medical Aid is critical to ensuring that you have medical cover when you need it most.
Here are two important points to consider before deciding on your Medical Aid:
- Monthly contributions: A general rule of thumb is that contributions should not exceed 10% of your monthly income.
- Consider your dependants and how they will fit into your budget.
2. What are my actual medical needs?
No two people are the same, and everyone’s medical needs are unique. You need to decide exactly what you want your Medical Aid Plan to do for you. Your health, age and stage of life are of primary importance when you’re answering this question.
Consider the below needs when looking for a Medical Aid:
- Over-the-counter medication or chronic medication required
- Doctors and specialist visits
- How much you spend on dentistry or optometry
Provision should also be made for any unexpected medical curve balls that life may throw your way.
3. Does the plan have co-payments?
Each plan comes with co-payments, ensure you read through how many co-payments are paid for when you are looking for a Medical Aid. Depending on the plan you’re on or the healthcare provider you use, your Medical Aid Plan may not cover your entire medical expense. In this case, you may be responsible for a co-payment, which is the amount that you must pay from your own pocket for a particular treatment or procedure as determined by your Medical Aid Plan.
4. Do I have chronic conditions?
Chronic conditions A chronic condition is a health condition or disease that is persistent or otherwise long-lasting in its effects or a disease that comes with time. You need to make sure that your medication forms part of the formulary of the medical aid scheme to avoid any co-payments on your medication.
Here are 7 of the most common chronic conditions:
- High blood pressure (Hypertension)
- High cholesterol
- Arthritis
- Coronary heart disease
- Diabetes
- Chronic kidney disease (CKD)
- Heart failure
If you have any chronic conditions, make sure you research which chronic conditions are covered by the Medical Aid Plans you are looking into. All schemes have a Chronic Illness Benefit, click here to read more info on this benefit from Discovery.
5. Have I considered the waiting periods and how they might affect me?
According to the Medical Schemes Act, Medical Schemes may apply waiting periods when members join a new scheme. During waiting periods, members pay full contributions to the medical scheme, but cannot claim for full benefits from the scheme. When choosing a Medical Aid for you and your family, it’s important to know which waiting periods and exclusions apply
Medical schemes in South Africa, can apply a 3 month waiting period and/or a 12-month condition-specific waiting period.
We always recommend having an Independent Medical Aid Adviser on your side, trained in understanding various Medical Aid products from multiple providers and finding you the option that best suits your unique needs. It does not cost you additional money and together with your Adviser, you can work your way through the different options and choose the medical aid plan best suited to you and your family’s needs.
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Get in touch with us:
Gauteng: 080 028 76 33 | Western Cape: 086 010 5154 | KZN: 086 010 9920 | hello@curemed.co.za
