12 Tips when choosing a Medical Aid
Many consumers are paying too much for medical aid schemes that either have
costly extras they don’t use, or they stick with plans that no longer suit their
pocket.
Those in the know say that by shopping around, you could save up
to 30% of your premiums.
The difference between a network scheme at R1441 and the full
monty at R5885 is almost R4500 per month.
Economic pressure is forcing many people to give up vital health
cover, according to a survey by online guide www.justmoney.co.za.
The survey found that 25% of visitors to its website could no
longer afford to pay for medical aid. A total 44% have never shopped around for
cheaper plans, 16% have not reviewed their medical aid for at least five years
and only 15% shop around annually.
Paul Beadle, the managing director of Justmoney.co.za, says that
many people are paying too much for schemes that are not appropriate.
“Medical aid brokers have told us that most people only review and
change their scheme once every eight years — but when they do switch to a
cost-effective one, many end up saving 30% in premiums,” says
Beadle.
TAKE THESE TIPS : 1. REVIEW YOU MEDICAL AID REGULARLY
Your circumstances and your needs might have changed, meaning your
current scheme may not be cost-effective anymore.
Shop-around for quotes from at least three different schemes to
compare features and costs — and, if your broker will only offer you one scheme,
get a new broker!
2. DO YOU REALLY NEED THE BELLS AND WHISTLES?
If you don’t need gym membership or haven’t made use of the
theatre ticket discount in a while, do you really need the extra cost of
lifestyle benefits? Rather take the money and put it in a savings account.
3. HOW HEALTHY ARE YOU?
Unless you visit the doctor every week or have a chronic medical
condition, then a hospital plan could be sufficient for most people. But check
the coverage because some schemes are limited to certain geographic regions.
4. DO YOU NEED A MEDICAL SAVINGS ACCOUNT?
If you don’t visit the doctor often, put the money into an
investment account instead of paying into a medical savings account.
You can access the money if you need to pay for medical bills,
but, if you don’t, you’ll get the growth in interest instead of the medical aid
scheme.
5. DO YOU UNDERSTAND YOUR PRESENT SCHEME?
Medical aid schemes can be complex, but that’s all the more reason
to understand what you are paying for, what cover you are getting and what the
restrictions are. Otherwise, how will you know if you have the best deal?
6. WHAT CAN YOU AFFORD?
You should not be paying more than 10% of your salary on medical
aid. If affordability is an issue, consider joining a network medical aid scheme
— the costs are lower and you are only allowed to use doctors and hospitals
linked to the network.
You will still get emergency cover if, for example, you have a car
crash.
7. CHECK YOUR SCHEME’S FINANCIAL FITNESS
Your medical aid needs to have enough money paid in by its members
to cover all potential claims.
Visit the Council for Medical Schemes (www.medicalschemes.com) and
check the balance sheet section of the council’s most recent annual report to
find out the status of every scheme currently operating.
A scheme should have a solvency ratio of at least
25%.
8. DO YOU STILL HAVE DEPENDANTS AGED OVER 21?
Some schemes charge adult rates if your kids are over 21 and are
no longer studying, even it they are still living at home, while others levy the
higher rates only when your child dependant reaches 27.
Check your scheme’s rules because paying adult rates for your son
or daughter can add a hefty whack to your monthly premiums.
9. SWAP SCHEMES
By law, medical aid providers cannot impose a three-month waiting
period when you move to a new scheme, if you have been with the previous scheme
for at least two years without any breaks.
Don’t let the fear of three months with no cover stop you from
shopping around for cheaper medical aid.
10. LATE JOINER FEES
If you have not had medical aid for a while, ask your broker to
advise on which schemes do not charge a late joiner fee.
If you have older family members who do not currently have medical
aid, you might be able to get affordable cover for them by making them your
dependants.
11. DISAPPEARING BROKERS
If you have not heard from your medical aid broker since he or she
sold you the scheme that you are presently a member of, then you should look for
a new broker — along with a new scheme.
12. NO NEGOTIATIONS
Unlike short-term insurers, medical aid providers will not
negotiate lower premiums with you, no matter how long you have been with them,
so you have to do the comparison yourself via a broker.
LOW-COST SCHEME
The cost will depend on your income as well as the type of network
and the availability of doctors and hospitals.
Equivalent to a standard, full-cover scheme:
A monthly salary of less than R3000 > R1028
R3000 to R5500 > R1122
R5500 to R6000 > R1335
R6000 to R6800 > R1441
THE FULL MONTY
Maximum cover for every possible medical eventuality, with a range
of “lifestyle” add-ons.
Full Cover: R4210 (100% of cover in hospital) to R5885 (300% of
cover in hospital) per month
Hospital Plan Only: R2020 (150% of cover in hospital) to R2500
(300% of cover in hospital) per month.
