How to choose a medical aid
There are so many medical aid providers in South Africa, it may be difficult to decide which one is right for you. And beyond selecting a provider, you’ll then also have to narrow down which plan is going to suit your needs best.
Have a look at the following questions, which you ought to consider before making a decision about your chosen medical aid:
- Do I need more than a hospital plan to cover my medical needs?
- Would I like to have dental cover included?
- Do I only need to cover myself, or will my plan include dependents?
- Will I require the assistance of any other medical specialists?
Once you have an idea of the above answers, it would be best to get in touch with a consultant to chat with you further about your interest in a medical aid. While having this conversation, it’s important to keep the following in mind:
- Your preferred medical aid plan
- Your medical history
- How much you’d be able to afford
This information will help you have an informed conversation with the consultant so that they can serve you best. Following this, you can request a quote, or multiple quotes, to get an indication of what your various options are. Don’t be shy to request any further information, such as brochures, pamphlets, and even the fine print, such as the terms and conditions of a certain plan.
How do waiting periods work?
When you take out medical aid, you may be subjected to waiting periods. This usually lasts for a period of three months for general waiting periods, but it could also extend to twelve months for pre-existing medical conditions. So which conditions or situations count under each of these periods?
- If you have not been a member of a medical aid scheme for 90 days or longer, you will have to accept a waiting period.
- Similarly, if you have never been part of a medical aid, you will also be susceptible to waiting periods.
If a medical aid decides to apply a waiting period to your cover, this means that you still need to pay your premiums, but you won’t be allowed to claim until your waiting period has come to an end.
The reason medical aid providers apply waiting periods to certain clients is to prevent them from taking advantage of a scheme. If someone without medical aid finds out that they have an expensive medical condition and they decide to join a medical aid in order to fund their medical bills, it would be unfair to the scheme’s other clients who had already contributed to it for years.
Waiting periods allow new, high-risk members to contribute to the general fund before they are allowed to claim. Without this failsafe, medical aid schemes would be taken advantage of and long-term, loyal clients wouldn’t benefit as much as short-term newbies.
If you’d like to prove to your new medical aid scheme that you were still recently a member of another medical scheme, you simply need to request proof of this from your old scheme.
Another consideration is the late-joiner penalty. If you’re 35 and you’ve not been part of a medical aid scheme yet, you will have to pay a late-joiner penalty. Note that, unlike waiting periods, this will remain applicable rather than be restricted to a certain time period.
But regardless of waiting periods or late joiner penalties, risking a medical condition or accident without any cover can leave you in a precarious financial position. If you’re ready to find out more, fill in the above form and a consultant will get back to you.
