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Medical Aid – Importance of Reliable Medical Aid


Bonuses have their Appeal but Reliable Medical Aid is More Important

Regardless of just how reliable it may prove to be, medical aid is a product and, as such, it is subject to much the same market forces as any other product. While some authorities claim other numbers, according to the Council for Medical Schemes (CMS), there are currently 87 such schemes operating in South Africa. Of these, the majority are of the closed variety and aimed at very specific groups of individuals such as the employees of a large company or those that are employed within a specific industry or profession. As such, these closed schemes benefit from a captive membership source leaving around 25 or so open schemes that must compete against one another to attract their members from among those to whom no closed scheme is available or who are self-employed.

However, the cost of private healthcare is already high and subject to further escalation every year. This means that any attempt by a scheme to achieve and to maintain the volume of members needed to ensure reliable medical aid on the basis of price alone requires either finding some way in which to cut costs or simply limiting member benefits. An adequate membership is essential to any scheme to ensure that the total income from its premiums is always sufficient to cover all the claims upon it in strict accordance with the agreed terms and conditions.

Rather than freezing or discounting the monthly premiums, instead, some schemes have chosen to offer various forms of incentive to attract new members. These commonly include options, such as free or discounted entertainment or concessions at selected retail outlets, and perhaps rewards for successful referrals. While such methods have proved to be a very effective marketing tool for certain of the country’s schemes, it remains true that nothing is truly free. For each of these so-called freebies there is a cost that is frequently met by adjustments to benefits.

A reliable medical aid is one that not only meets its member’s claims as agreed, but that also ensures it can do so on time, every time. In practice, such assurances are of far greater value to a member and their dependents than loyalty points or cheap movie tickets. Such qualities are the legacy of lengthy experience within the industry and a solid reputation earned through good governance and an understanding of what is most important to a member when faced with meeting the high cost of private healthcare.

Firstly, a member needs to fully understand the terms and conditions governing the promised benefits. For this, only a “what you see is what you get” approach and not reams of incomprehensible legalese ensures that understanding. When a member, their spouse, or one of their children is faced with a life-threatening illness, it is core benefits and not freebies that determine how reliable their medical aid actually is.

These are the same principles on which the KeyHealth scheme chooses to operate. Our goal is to provide members with straightforward, competitively-priced priced products that, above all, offer comprehensive and relevant core benefits. All our products also include certain additional benefits that are unique and genuinely carry no extra charge.