While the thought of medical expenses is enough to give anyone cold shivers, South Africans are in the fortunate position that we don’t only have many talented professionals to provide quality care, but also an array of medical aid schemes and benefit plans to choose from to cover the associated costs. That said, the quality of the cover is completely dependent on the service provider and how suitable the plan you chose is in terms of your specific healthcare needs.
Sounds simple enough, right? That is until you start looking at the options available. While it’s great having many options to choose from, the sheer volume of information can be quite daunting. There is so much to consider, that everything starts blurring into one. Yet, this decision is such an important one that it is essential you pay careful attention and consider all the possibilities when comparing medical aid schemes and benefits.
The complicated nature of this choice often causes people to delay making this vital decision. This is a dangerous game, as it’s your health – and the health of your family – that’s on the line. So, if you’ve been putting off making this very important choice, here are some tips to help you get started. Follow these to break down the process and make the choice a much simpler one:
Always Start with a Budget
This is an important tip for two very good reasons:
First, you should always choose a scheme and benefit option that you can afford. This might mean that you have to review your budget – medical aid should be a priority expense. However, don’t overstretch yourself. Overspending could be more tempting than you might think, as there is a prevalent perception that more expensive always means more and better cover. However, people have different healthcare needs and different usage habits. Choosing carefully will allow you to maximise the benefits that matter to you at an affordable rate.
Second, by setting a price range that you are willing to commit to, you also provide yourself with more focus during the medical aid comparison process. There is a wide variety of medical schemes out there and an even wider range of benefit options. Having a set price range eliminates the fringe options to allow you to focus on understanding the benefits of the qualifying options better.
Take a Close Look at Your Healthcare Needs
This should be the next step to help you whittle down the list of options. You should have a pretty clear idea of what conditions or ailments you or your family may have, and what the biggest risks to your health are. You also know what the typical healthcare service usage of your family is, and how many people in your household needs to be added as beneficiaries. Using this information, make a list of the benefits and features that are important to you. This list will help you keep track of all the benefit options you consider, and to determine which health plan options meet your needs and which ones to discard. This way, you end up with the plans that meet your needs best.
See Whether They Subscribe to a Specific Hospital or Healthcare Network
To secure preferential rates and make monthly premiums more affordable, many medical aid schemes have formed partnerships with certain healthcare networks. This might mean that certain benefit options require you to make use of specific hospitals, clinics, or doctors. While this is generally not a problem, you might just want to check whether any of these conditions are in play and whether the necessary healthcare service providers are within your reach before you sign up. It’s of very little use when you choose the most attractive price option when doing a medical aid scheme comparison, only to find out you can’t access the service.
Check the Financial Wellness of the Scheme
This doesn’t mean you should study their financial reports. However, you can use the scheme’s solvency (also referred to as ‘reserve’) level. The South African law requires all medical aid schemes to have at least 25% of the annual contributions of their entire member base in reserve to pay claims should anything go wrong. If a scheme does not meet this requirement, it could be an indication that their operating model is not as sustainable as it should be in the long run. It also raises the risk that the scheme might increase contribution rates in the near future to make up this shortfall.
Make Sure You Truly Understand the Benefits
If you have followed all the steps above, you should be left with only a handful of best-suited options, at most. For a meaningful comparison between these medical aid schemes, it’s essential to fully understand the benefit structure of each scheme. This might be the toughest part, as many schemes often use language filled with jargon and vague statements. Don’t make the mistake of assuming you know what they mean, only to find out later that you don’t enjoy the cover you thought you did. If anything is unclear, contact the scheme and ask them to explain in detail until you understand.
Making Medical Aid Comparison a Breeze
True to our philosophy of being smart and keeping it simple, KeyHealth avoids jargon as much as possible and makes it as easy as possible to compare medical aid benefit options and find the solution that is right for you. To get started, simply hover over the tab “Join Now” and select “Compare Our Products”. We’ll gladly help you find the ideal plan for you and your family based on your unique needs.
