An Affordable Monthly Medical Scheme Fee Alone is Not Enough
An affordable monthly medical scheme fee is an important consideration for anyone who may be seeking the means to defray much of the high cost incurred by private healthcare. While once the care offered by state-funded institutions was on a par with the best in the world, rising costs, a vastly increased demand for treatment and the lack of funds that is almost inevitable in a non-contributory system under such pressures have seen its steady demise and, in many cases, reduced to the role of a primary care provider. Without the option of private healthcare, the additional burden on its resources would probably sound its death toll.
Maintaining an affordable monthly medical scheme fee requires considerable ingenuity on the part of fund managers, both in the design of products and in maintaining financial discipline. While private clinics are able to offer advanced equipment and facilities now well beyond the scope of the public sector, the associated costs are correspondingly higher. Furthermore, while the schemes responsible for covering those costs are non-profit companies, private clinics, pharmacies and laboratories are definitely not.
This result is that a careful balance has to be struck between the needs of the service providers, those of their patients and the constraints of the insurer, in order to arrive at an affordable monthly medical scheme fee. The precise strategy adopted by each individual medical aid, in its attempt to achieve the required balance can tend to vary quite considerably. Such variations make it necessary for a prospective member to look beyond the price of the premiums and to be quite clear as to just what he or she can be assured of receiving in return for them.
Naturally, there is a limit to what most members are able to afford. So, before attempting to make any detailed comparison between schemes, it is important to select only those products that, in terms of your guaranteed disposable income, appear to charge an affordable monthly medical scheme fee and one that you are able to maintain on a long-term basis. As with vehicle insurance, missed premium payments can result in loss of cover and, although not everyone may agree, your continued good health and that of your family are even more important than the family saloon.
Armed with three or four alternatives, the next step is to examine each one in more detail, in order to determine what is covered and what is not, as well as checking the extent of the related benefits and their annual limits. These must then be evaluated against the known and anticipated needs of everyone to be covered. A truly affordable monthly medical scheme fee should not just fall comfortably within your budget, but should also be able to cover most of your private healthcare costs in both foreseen and unforeseen circumstances.
South African medical aids are compelled to provide certain prescribed minimum benefits, including the full cost of treatment for 25 chronic illnesses, including asthma, diabetes, epilepsy and multiple sclerosis. Cover from KeyHealth, however, extends even further. By eliminating all frills and using a network of preferred service providers, we are able to offer more for less. Valuable extras, including our Easy-ER kids’ facility, guarantee value for an affordable monthly medical scheme fee.
