When it comes to healthcare, South Africa is a country of extremes. We have some of the best healthcare facilities and talent to be found anywhere in the world. However, a large percentage of people do not have access to this care. This is often due to exorbitant rates charged by private healthcare providers. While there is a state-run healthcare service, this is often underfunded and mismanaged, leading to poor service delivery and major backlogs.
This landscape has necessitated the need for medical aid schemes to provide the necessary support structure to allow the public to access and afford the medical care that is available. However, this has resulted in a multitude of medical aid schemes – currently, there are 26 open medical aid schemes in South Africa that offer healthcare coverage to all members of the public, in addition to a number of closed medical aid schemes that are tied to specific industries or companies. Each of these medical aid schemes offers a wide range of plan options, which makes comparing medical aid options in South Africa a rather daunting task. It is often overwhelming for individuals to navigate this glut of information in order to choose the option that is best suited to their needs.
Daunting or not, it is a task that needs to be done, and it is essential that this decision is taken with great care. So, where do you start when comparing medical aid options in South Africa?
Before you rush in and compare benefits, there are a few important things to take note of before you start your research on medical aid options:
- Medical aid and health insurance are not the same
This is a common misperception that can lead to insufficient cover when you need it most. Medical aid schemes in South Africa are governed by the Medical Scheme Act. This act dictates that, no matter which medical aid option you choose, it needs to provide Prescribed Minimum Benefits related to a list of 270 life-threatening conditions and 26 chronic conditions, including emergencies and conditions such as diabetes, hypertension, epilepsy, asthma, and coronary artery disease.
Health insurance, on the other hand, provides ancillary financial support often related to issues such as gap cover, hospital cash plans, medical travel insurance, and so forth. While certainly important and addressing a need, this does not cover the basic medical needs that people often mistakenly think it does.
- Some medical aid schemes are too preoccupied with fringe benefits
We’ve all seen the attractive benefits offered by some medical aid schemes. These include anything from cashback on grocery shopping, to gym memberships, loyalty points, discounted movie tickets, travel benefits, and much more. Now, these added-value features can certainly be meaningful, supportive, and beneficial to members. However, it’s not the reason why one takes out a medical aid membership, and can sometimes get in the way of a service provider delivering the actual service you need since they are preoccupied with fringe benefits rather than the service they are meant to deliver.
Don’t be tempted to such an extent by fringe benefits that you make a choice that does not give you the actual healthcare benefits you need when you need it.
- Some medical aid scheme options are too complicated, leaving you confused… and ultimately out of pocket
Always make sure you understand exactly what is offered before choosing a medical aid plan. Medical aid options in South Africa are often shrouded in mystery due to the overzealous use of jargon. This makes it difficult to read, challenging to understand, and virtually impossible to compare. The risk here is, of course, that you might very well end up with a plan that does not actually provide the benefits or cover that you need, or that excludes certain cover due to a clause that was unclear. Ask questions, and don’t hesitate to keep on asking until you are comfortable that you understand what you are signing up for.
- It can be scary to commit to partial cover
It’s completely understandable that all of us would wish to sign up for the medical aid option that provides the most comprehensive cover. After all, we are talking about looking after our health. However, the top comprehensive medical aid plans can be very expensive and do not fit into the budget of most South Africans. Don’t despair – this is why different medical aid options exist: to make sure that there is some form of cover for every member.
We all have different medical ailments, needs and usage habits. It’s absolutely fine to choose a more affordable medical aid option that does not provide cover for every single scenario, but that does, for example, protect you against exorbitant hospital costs in case of an emergency. Your choice should be based on your needs and what you can afford.
- The number of options available can be overwhelming – you need a plan to guide you through the process
With so much choice and so little clarity, where do you start? It’s virtually impossible to compare every single medical aid plan available in South Africa, so the best thing to do is to start with your needs:
- See what monthly amount you can afford.
- List your medical requirements that you need financial assistance with.
- Start looking at options that fall within your budget that addresses your unique medical needs and ignore the ones that don’t.
The KeyHealth Solution
At KeyHealth Medical Scheme, we are aware of how daunting the process of comparing medical aid options in South Africa can be. This is why we keep it as simple as possible. We stay away from jargon where possible and make the comparison of medical aid options as easy as possible. Get in touch with us today for medical aid that cares.