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.
