What to Think About When Choosing Your Medical Aid Option For Next Year
Consider these questions
Each year, you have the chance to pick your plan. So, what are the things to consider?
- What are the benefit limits? Do these look reasonable for your current age and state of health? Pay particular attention to the limits on cancer treatment, as this can affect anyone and the costs can be extreme.
- What are the in-hospital rates? Will you only be covered for 100% of the scheme rate? Most specialists charge well above that, up to as much as 500% of the rate. Do you need higher cover? Should you take out gap cover as a way to manage a potential shortfall?
- How much are you contributing to a medical savings account, and what will be paid for from this money? Usually all visits to doctors outside of hospital, and all medication will come from this pool. Does it look sufficient, and do you have above-threshold benefits if your savings are used up? Alternatively, you may not have used your savings in the past year and this may be an unnecessary extra. Perhaps a hospital plan is sufficient for you.
- Do you have access to managed care options for treating chronic conditions like diabetes? Will the scheme cover visits to the likes of physiotherapists, occupational therapists and dieticians, if you are likely to need them?
- Understand how your medical aid covers Covid-19 as a prescribed minimum benefit (PMB) so that you know where you stand should you contract the virus.
Stretching your benefits
Also look at the ways that you may be able to stretch your benefits, and effectively get the same level of cover while paying less.
- Network options restrict which hospitals, doctors and pharmacies you may be able to use, but can be cheaper and still provide all you need if you live in a well-covered area.
- Does your medical aid offer online or telephonic consultations that give you advice without the need to necessarily pay for a trip to a doctor?
- How might your medical aid’s rewards programmes benefit you? It may be worth signing up to earn these advantages.
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