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Some Useful Information About Medical Schemes in South Africa


It is that time of the year when many of us are re-evaluating our investments and risk cover, or engaging in these administrative services for the first time in order to prepare for the new year ahead. One of the most important things to address is how we are going to look after our health. While proper healthcare can be very expensive, there are a number of affordable medical schemes in South Africa to choose from, each offering a variety of plans to suit a variety of healthcare needs.

Before you start researching medical schemes in South Africa, here is some general information that applies to all of these service providers, and which will be useful to keep in mind when making your decisions:

All Medical Schemes in South Africa Are Governed by A Set of Rules

These rules exist to clearly explain the benefits available to members, the rights and responsibilities of both the member and the service provider, as well as the corporate governance of the scheme. If a dispute arises between a member and a service provider, these rules are often the factors that determine the outcome.

What are Prescribed Minimum Benefits?

These are benefits defined by law to ensure that all members of medical schemes in South Africa have access to certain basic health services, regardless of the benefit option they have selected from their service provider.

100% Cover Does Not Always Mean Cover for The Complete Bill

Because healthcare tariffs are not regulated in South Africa, each medical scheme has its own fixed rate at which they reimburse service providers. This might vary substantially from the rates charged by premium service providers, and the member is responsible for this shortfall.

To find out more about medical schemes in South Africa to help you make the right choice, get in touch with the friendly consultants at KeyHealth. We understand this can be a complicated topic, which is why we go to great lengths to make it as easy and simple for you as possible.