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Medical Aid | Company Medical Aid | KeyHealth Medical Scheme


Medical Aid Provides an Essential Benefit

“Company medical aid” or “normal fringe benefits” often appears in job vacancy advertisements and included in the latter benefit, membership of a medical scheme is implied. Make no mistake; it is a benefit and a very important one too.

Depending on the employer, they may co-fund the staff members’ monthly contributions; with the ever increasing cost of living, this is a very attractive benefit. There are income tax benefits too. Medical aid contributions are reflected on tax returns after being confirmed via the employee’s IRP 5.

Parliament established the Council for Medical Schemes through the Medical Schemes Act (Act 131 of 1998), which regulates and supervises private health financing via medical aids. Certain prescribed minimum health services must be accessible to all fund members, irrespective of which medical plan they have chosen.

The aim is to ensure that as many people as possible have access to healthcare for a minimum of 270 specified conditions in the most affordable way. Belonging to a hospital plan usually costs considerably less than membership of a medical option with comprehensive cover, choices of service providers and full payment for non-formulary medicines.

The latter two choices are excluded from hospital plans, where members must make use of designated service providers and formulary drugs where they exist. Non-formulary or generic drugs are covered, providing that an equivalent has not yet been developed. Should the member consult someone not on the list, they will be responsible for the difference between the two rates charged.

Our company’s medical aid offers a selection of five plans, all of which are competitively priced. The cover for PMB chronic conditions is incorporated in all options, once the application and approval process has been completed. This has been excluded from the many of competitors’ affordable funds.

Extensively promoted cash-back hospital plans fall under the Insurance Act, because these products are strictly insurance related. You pay premiums, not contributions, in the hope that some medical crisis or illness will occur, but should this happen you are paid a set amount per day of hospitalisation.

Anything else, such as treatments, drugs, procedures and consultations and other day-to-day expenses are all for your own account. The daily in-hospital payments normally only commence after two or three days, so you need cash or a large credit facility on hand when you’re to be admitted to a private hospital, or they’ll probably tell you to go elsewhere.

It has been said that anyone who drives around the block without having car insurance or medical aid is crazy. A high percentage of motor vehicle accidents actually do happen a short distance from home. One assumes that this might be due to the fact that the driver knows he or she is almost there, in the safety and sanctuary of their own home, so they start relaxing and let their guard down.

Homeowners spend money insuring their dwelling and possessions contained therein. Specified items like jewellery, sunglasses, computers and cell phones are generally covered by insurance, should they be lost or stolen when worn or carried outside of the home where they are usually kept; this increases the monthly premium.

Strange, if you pause to think about it; we take ourselves out daily at possible risk to health and well-being, yet some of us appear to be less concerned about ensuring that we can afford good care and treatment in the case of some unfortunate occurrence.

Don’t neglect such a vital aspect of caring for yourself and your loved ones. Decide what is affordable for you, keeping in mind that medicines, surgery and disease treatment or management cost a lot more.

Think of your current situation regarding age, health and resulting requirements; then have a look at our five medical aid plans and get cover and peace of mind.