The Covid-19 pandemic underlined the need for membership in a medical scheme. However, it’s also sensible to choose one that offers additional benefits. Whatever purchase we may be contemplating, it is only natural to look for a product that appears to provide good value for money. However, appearances can often be deceptive. Many South Africans will have been lured into accepting a free product or service only to discover it was a limited-time offer and that continuing to enjoy it will require a monthly subscription.
Some medical aid schemes attempt to attract new members by offering freebies, like shopping discounts, free movie tickets or low-cost gym memberships. Did you really think that shops, cinemas and fitness centres make these concessions available to hundreds or perhaps thousands of scheme members at no charge? That there is no such thing as a free lunch was well-established by patrons of 19th-century taverns in the US who, in exchange for a free lunch, invariably spent more heavily than intended on beer and spirits. Unfortunately, the cost of those apparent freebies must be met somehow and are sure to be reflected in the monthly premiums, reduced benefits or both.
Furthermore, apart from the cheap gym sessions, these so-called free extras are of little benefit to the member’s health. However, they can be an effective means to deflect attention from an inflated premium price. When seeking added value from a medical aid product, your focus should be on core benefits directly relevant to your known and anticipated private healthcare requirements.
How KeyHealth Medical Scheme Enhances our Members’ Cover With Added Benefits
Given the current economic conditions, we are aware that many South Africans risk endangering their health by abandoning medical aid or opting for cheaper but less effective alternatives, like a hospital cash plan from a short-term insurer. At KeyHealth, we have implemented four effective strategies as the cornerstones of our campaign to maximise value for money and peace of mind for all our members. Let’s explore them together:
- A Designated Service Provider Network
Many South Africans may be aware that the price for a given course of treatment can vary substantially depending on the hospital where it is provided. However, they may be less aware of why such variations exist. South Africa’s Department of Health oversees the operation and budgets of the public sector healthcare service based on recommended tariffs for each procedure. However, these recommendations are not binding on private healthcare providers. Instead, private physicians, surgeons, pathologists, radiologists and other medical professionals may charge whatever they wish.
Perhaps this might help you understand why a medical scheme will often undertake to pay up to 200 or 300%. The percentage refers to the DOH base price. Clinic owners, too, are free to set their own fees for accommodation and nursing services.
The KeyHealth solution has been to appoint a network of designated service providers (DSPs) who agree to charge significantly less than their usual tariffs in exchange for our captive business.
- An End to Co-Payments
Subject to our medical scheme rules, members who use our DSPs will receive a significant additional benefit. Network users will not incur co-payments enabling them to save some of their hard-earned cash without skimping on their cover and risking their health. Introducing this measure underscores our determination to redefine the real value of medical aid in South Africa and to raise the industry’s bar.
- A More Inclusive Hospital Plan
Medical aid providers initially launched this option to support young, unmarried members with sound general health but lacking enough income to purchase full-comprehensive cover. It left members to pay for day-to-day needs, like medicines and GP visits but covered the vastly bigger bills arising from accidents and other medical emergencies.
While the overall aim of these products remains unchanged, KeyHealth strives to provide added value with selected out-of-hospital benefits. In addition to the mandatory Prescribed minimum benefits (PMBs), we have included a range of valuable day-to-day extras that vary according to the plan chosen.
- Additional Free Core Benefits
Whether enrolled in our entry-level hospital plan or our top-of-the-range fully comprehensive cover, all KeyHealth members enjoy three valuable core benefits at no charge. Click on Health Booster, Easy-ER or Smart Baby Programme to learn more about these unique gratis add-ons.
