The Importance of Finding Affordable Medical Aid in 2016
Clearly there can be marked differences in the way a given individual may interpret the word “affordable” and, in most cases, this is likely to have an equally marked influence on their choice of a suitable medical aid scheme. According to the latest count, the total number of these schemes registered in 2016 stands at ninety-nine and, of these, just twenty-six are of the type described as open or unrestricted schemes that are free to accept anyone as a member. Membership of closed schemes is reserved for those employed by specific companies, for members of a particular professional body or for those working in certain industry sectors and similar groups.
For those in these latter categories, membership of the related scheme is often a condition of employment and employees are generally subject to premiums commensurate with the number of their dependents and their income. For the self-employed and for those working for companies that offer no group scheme, it is therefore important to find a medical aid that is affordable. You should not, however, be influenced by price alone. The ease with which you may be able to meet the monthly premiums is actually far less important than the absolute assurance that you have also purchased adequate cover to meet the private healthcare expenses of yourself and your family in 2016, or whichever year may be appropriate, as fully as possible.
It may be tempting, for instance, to sign up for a hospital plan, as these are generally the cheapest option by far. However, the products offered by insurance companies that pay a fixed daily sum while hospitalised cannot come close to covering the actual healthcare expenses incurred. By contrast, those offered by dedicated medical aid schemes are designed to cover most, if not all of the actual costs.
Once again, unfortunately, it is necessary to exercise a little caution. In practice, these products are intended for young, single people who are in good health and whose main concern is meeting the crippling costs of hospitalisation due to an accident or unexpected surgical emergency. It is also expected that they will pay for any out-of-hospital, medical contingencies out of their own pockets. This is therefore not the best choice for a family or for someone with a chronic illness and who’s prescribed minimum benefits will normally cease once he or she is discharged.
In all cases, the ideal product therefore will therefore not only need to be affordable, but also sufficiently comprehensive in terms of the various benefits that it provides. Families with young children will be concerned about paediatric services and dentistry, while others may be more concerned about emergency cover. Of benefit to those who may suffer from a chronic condition, all of a medical aid scheme’s products are now legally obliged to meet all related costs in full for the duration of cover agreed and, of course, providing the premium obligations have been met.
The good news is that one scheme in South Africa now offers a range of products that, between them, should meet the needs of more South Africans than most competing schemes. At KeyHealth, we offer our members in 2016, an entry level option that is every bit as comprehensive as it is affordable.
