Medical Aid is a Must for Most Parents Today

Medical Aid is a Must for Most Parents Today

While we all tend to worry about our children’s health and how best to protect them, if we are to give them all of the care they need, it is just as essential that we look after our own health. Given the difficulties currently being experienced by the nation’s public healthcare service and the high cost of treatment within the private sector, medical aid for parents is becoming more and more essential both for themselves and for their kids.

Throughout the course of a pregnancy, as well as during and following the birth of a child, there is a heightened risk of health issues. As a consequence, there is a need for careful monitoring and, in some cases, professional intervention may be required. For example, complications with a normal birth might make it necessary to perform a Caesarean section, adding even further to a substantial hospital bill, so medical aid can be especially important for new parents.

Post-partum complications, though a relatively rare occurrence today, could lead to more expenses. However, it is the needs of the newborn that tend to create the most concern. An infant’s rhesus blood type may be incompatible with that of the mother, resulting in jaundice and the need for an exchange transfusion. Alternatively, it may be born prematurely and may need to be kept in an incubator in a paediatric intensive care unit.

It is, however, during the first two or three years of a child’s life that the importance of medical aid for parents will often become the most apparent. Statistically, ear infections rank as one of the most common reasons for a child to visit a doctor. What may begin as a GP visit could quite possibly progress to a referral to an ENT specialist that could perhaps even entail performing surgery to fit grommets or to remove the tonsils.

Though these early years can be difficult enough, it is often when a child starts to attend school that the true value of medical aid for parents is likely to be most appreciated. In addition to lessons, school days are an opportunity to indulge in some of the exploits a mother or father would have considered too unsafe. Quite apart from the risk of cuts, bruises, sprains and, worst-case scenario, a fracture, schools are also the perfect environment for the transmission of infectious diseases, such as measles and mumps, among the uninoculated, and coughs and colds among everyone.

Throughout secondary and tertiary education, until children start earning, medical aid for parents will remain a necessity. Although cover for them will normally cease on their 21st birthday, it can normally be extended to continue helping those who are still engaged in full-time study. Only when they graduate and are employed does it become necessary for them to seek their own cover. In many cases, they will be unable to afford fully comprehensive healthcare cover for a year or two and so, to assist them, most schemes have a hospital plan that covers only costly emergencies, such as an injury. 

Once mom and dad are relieved of the responsibility for insuring their children’s’ healthcare expenses, further medical aid will be solely for the benefit of their parents and should even cost a little less.

Medical Aid - The Importance of Medical Aid for Your Family

The Importance of Medical Aid for Your Family

One should never underestimate the value of good health, yet many of us fail to do so until the day that illness strikes. For minor conditions like colds and flu, we can manage with some fairly inexpensive over-the-counter remedy from a local pharmacy, a hot drink, and a good night’s sleep. However, the importance of medical aid for your family and yourself could quickly become only too apparent in the wake of a motor vehicle accident or a heart attack. Imagine you have no such protection. Could you afford to pay a large sum in order to cover the cost of hospitalisation and surgery?

It is not only to help them deal with such costly emergencies that it is necessary for South Africans to invest in some form of private healthcare insurance. In this respect, one should not underestimate the importance of medical aid for your family if one of them happens to suffer from a chronic illness. The cost of regular treatment, monitoring, and medication can, in many cases, amount to a substantial sum over the course of a year, and this could place a severe strain on the average monthly budget. Since 1998, all schemes in South Africa are required to provide certain prescribed minimum benefits. These include covering the full cost of the diagnosis, treatment, and care of 25 named chronic illnesses, such as diabetes, haemophilia, and multiple sclerosis.

Consequently, the importance of understanding the difference between genuine medical aid for your family and the kind of cover provided by the hospital cash plans available from insurance companies cannot be overemphasised. Firstly, the insurers are under no obligation to offer their clients any of the minimum prescribed benefits. More importantly, however, a hospital cash plan pays a fixed sum for each day the insured is hospitalised and falls far short of meeting the actual cost of accommodation and treatment. For the rest of the year, these plans provide no benefits.

Unless you are independently wealthy, the importance of medical aid for your family is a given. Nevertheless, to maintain the cover it provides, you must be able to meet the monthly premium payments. To cater for the needs of as many members as possible, schemes offer a number of different products, each with its own benefits which, in turn, tend to determine the cost of the related monthly premiums.

A scheme’s product range will often include a hospital plan, which, in most cases, only applies while a member is hospitalised and provides cover based on the actual expense incurred during that time. Of particular importance is that this type of medical aid product is not suitable for your family, but is actually aimed at young, single individuals who enjoy good general health, and who only require financial support in the event of a costly emergency that could see them hospitalised.

Of the schemes currently operating in South Africa, few have been around as long, and even fewer have understood the importance of medical aid for your family as well as KeyHealth. The proof lies not only in its competitive premiums, transparent terms, and reputation for fair and prompt settlements, but also in its unique yet free core benefits, such as Easy ER.

Medical Aid - Benefits of a Medical Aid in 2019

What Are the Benefits of a Medical Aid in 2019?

There is little doubt that, in South Africa, as in most nations of the developed world, while our ability to treat illness has grown immeasurably over the years, the standard of general health among our citizens has fallen. The modern lifestyle with its tendency to be more sedentary than that of our predecessors coupled with a tendency to consume too much junk food is serving to make us more dependent upon a medical aid in 2019 than at any time previously. So, what are the benefits of joining a scheme?

The one overriding advantage is, of course, that members of a scheme receive financial support to help meet the cost of their private healthcare treatment. This could cover the entire cost in cases where the service provider charges the accepted rates, or it could just cover the bulk of the cost, leaving the member to make a small co-payment to make up the shortfall.

As in any year, the benefits of a medical aid in 2019 will tend to vary between the different schemes and their individual products. Each year, the premium payments are reviewed and, where there has been a significant increase in the cost of private healthcare, a scheme is permitted to submit a request to increase its premiums to the regulatory body for approval. Depending on the increase approved, a scheme may find it necessary to amend the extent of the cover it is able to offer.

When determining the benefits of a medical aid in 2019, some of the nation’s schemes will have chosen to maintain their usual offering by increasing their premiums. Others will have kept their premiums fixed or applied only a small increase and compensated by reducing the value of the cover they extend. However, the more innovative schemes, such as KeyHealth, have sought an alternative solution – one that has allowed them to maximise the value of the cover provided by each of its products whilst maintaining premium prices that are competitive.

In addition to the PMBs, or prescribed minimum benefits, all of which a medical aid in 2019 is required to fund in full, other conditions covered are named specifically. Any claims relating to these are subject to defined cash limits. These can apply both to a single event and to the annual sum claimable for that particular condition. It is, therefore, important to study a scheme’s terms and conditions thoroughly before deciding which one to join.

That said, not all schemes make it easy for the average non-medical applicant to understand their terms and conditions. Some schemes may even seek to divert them from pursuing too much detail about the benefits of a medical aid, in 2019, or in any year, with so-called freebies as part of a campaign to keep growing their membership.

As one of South Africa’s oldest schemes and one that can claim a record of dependability extending all the way back to 1968, KeyHealth promotes a policy of transparency and keeping things simple. There is no need for an attorney to interpret the terms and conditions. One of the major benefits of a medical aid membership with KeyHealth in 2019, or any year, is that what you see is what you get. That includes some unique, valuable, and totally free add-ons.

Medical Aid - How to Apply for a Medical Aid in South Africa

How to Apply for a Medical Aid in South Africa

In light of the current inadequacies in the state-funded healthcare system, the number of people turning to the private sector for their treatment has continued to grow. In practice, the bulk of those seeking private treatment could not afford to do so without some financial assistance. To qualify for help, they need to apply for a medical aid membership with one of the schemes in South Africa. So, what must one do in order to become a member of a scheme?

In many cases, for those who are in full-time employment, an employer will have arranged for a group scheme with a particular fund to provide cover for his or her staff. For the self-employed and others with no access to a group scheme, there are between 20 and 30 open schemes from which they can choose. In either case, to apply for a medical aid in South Africa requires one to provide a few personal details and some evidence to support them.

Though not as strict as an application for short- or long-term insurance, a scheme also needs to determine the extent of the risk a member may represent in terms of claim payments. Proof of age and identity must accompany the application form along with proof of membership of another scheme prior to the current application, if applicable. The latter can be important when you apply for a medical aid in South Africa, as it can determine whether you will be eligible for immediate cover or subject to the standard three-month waiting period for first-time members.

You will also need to inform a scheme of any pre-existing condition you may have and be prepared to fund any relevant treatment yourself for the first year of your membership. All other contingencies will be covered, subject to the three-month waiting period, if applicable. Naturally, when you apply for a medical aid in South Africa, you will also be required to provide the same details and documentary proof for any eligible dependents you may wish to be included in your membership.

Medical Aid Application - Understanding the Application Process

Understanding the Medical Aid Application Process

While most of those who need to work for a living will, at some stage, also need to complete a medical aid application form in order to offset the cost of private healthcare, not everyone may be familiar with the requirements of the process or why much of the information requested is actually necessary. In practice, the process is not overly complex, but it will require the applicant to provide all of the information that may be asked for by a given scheme as a mandatory condition of entry.

To begin with, it is important to know whether or not it is the first time you are making a medical aid application. Those who have previously been members of another scheme will not be subject to the mandatory three-month waiting period that applies to first-time members. However, this exemption will only apply if you were still a member of that scheme at some time during the three-month period prior to your current request. If this was the case, it is only natural that you will also be required to attach documentary proof of your previous membership.

As for that waiting period, it is necessary to protect a scheme from those who might otherwise complete a medical aid application and then promptly submit an expensive claim only to cancel their membership as soon as their claim has been settled and they are no longer in need of attention. It is a precaution that also serves to protect other members from possible premium hikes.

Perhaps the most basic requirement is to provide one’s personal details and, as the form to be completed is a legal document equivalent to a signed affidavit, it is necessary to authenticate those details by including a copy of your South African ID document with a medical aid application.

Unlike the nation’s insurance companies, South Africa’s medical schemes are forbidden by their statutory body to discriminate against any potential member who might pose an increased risk. Insurers are entitled to respond, in such cases, by charging higher premiums and may even refuse to provide cover altogether. By contrast, while every applicant is required to provide details of any pre-existing condition as part of his or her medical aid application, a scheme is not entitled to increase its premiums or to refuse entry to anyone who admits to a pre-existing illness. Instead, the scheme is permitted to withhold cover for the declared condition for a discretionary period of up to 12 months, whilst honouring all of the member’s other claims.

On the upside, all schemes are now compelled to provide full cover for a list of 25 chronic illnesses with all of their products. The illnesses covered include asthma, diabetes, epilepsy, and hypertension, in addition to more than two hundred other prescribed minimum benefits (PMBs). For submission of claims associated with these, only a three-month waiting period is applicable while for those who are able to prove they have had continuous cover for more than 24-months, certain of these PMBs may even be made available within the statutory three-month waiting period.

Ensuring that a medical aid application is completed correctly is obviously important, but it is just as essential to choose the right scheme. A growing number of applicants believe this is KeyHealth.