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6 smart ways to select the best medical scheme

By Athenkosi Sawutana

It’s important to belong to a medical scheme that offers great benefits at affordable prices.

However, due to insufficient knowledge, many people find themselves paying higher premiums for a medical scheme which does not even meet their needs.

Tip: Ensure your family has access to better medical care. Get a medical aid quote here

Justmoney has these pointers to help you find the best medical scheme.

1. Don’t underestimate the small and medium-size medical scheme

People usually choose a medical scheme based on magnitude. The general perception is that if the medical scheme is bigger, they will pay a lower contribution. 

However, according to Elmarie Jensen, spokesperson for Genesis Medical Scheme, this is not always the case. She says that small and medium schemes also offer competitive benefits and good value for money. 

According to the GTC Medical Aid survey in 2017, Genesis, Makoti, Medimed, and Compcare were some of the top-performing medical schemes in the country.

Take a look at their most affordable plans below and compare their costs:

 

Makoti (Primary Option)

Genesis (Private Comprehensive)

Medimed (Alpha)

Compcare (AXIS)

Contribution

From R258 to R751 for the principal member

 

From R258 to R584 for an adult dependant

 

R269 for a child dependant

R1,150 for the main member

 

R390 for a child dependant

R1,130 for an adult

 

R450 for a child

R1794 for the principal member

 

R1794 for an adult dependant

 

R554 for a child dependant

 

Remember to do a comprehensive calculation when purchasing your medical aid. Do not be alarmed by the principal member contribution. You could pay less for your medical aid when you include your dependants.

 READ MORE: Medical aid questions to ask before switching employers

 2. Always ask about the pension ratio

According to Jensen, a scheme that has many pensioners is likely to charge higher premiums because there is a high claim rate.  Healthier and younger clients usually pay for the high cost of the elderly without realising it. So, if you’re joining a medical scheme with a higher pension ratio, be prepared to pay higher premiums. Currently, the industry average for open schemes is 10.5%. 

3. What is the average age for beneficiaries?

According to Jensen, the industry average age of all beneficiaries including main members and their beneficiaries is 35.7.

Be mindful of this statistic when you join a new scheme, as there seems to be a direct relationship between a higher average age beneficiary profile and higher claims, resulting in higher contributions for all members, says Jensen.

4. Make sure you know the solvency ratio

You don’t want to join a medical scheme that is on the brink of closing down. If the company’s solvency ratio is low, that means its debt is too high in correlation to its assets.

Jensen says that if the company’s solvency ratio is low, chances are it will increase its annual contributions to keep its business afloat.

5. Will you be able to keep up with the annual increases?

According to Jensen, medical schemes with higher increases have had three things in common: low solvency ratio, a high pension ratio, and a higher average age of beneficiaries. If your scheme is guilty of these, you will pay higher premiums.

6.What happens with your money?

Jensen says a good medical scheme is prudent in its expenditure. She says some of those big brands spend their money on marketing, making flash flyers. Your premiums are paying for that marketing, and don’t be surprised when they are high.

 Many South Africans do not belong to a medical scheme. If you’re one of the lucky ones who can afford a medical scheme, ensure that you join the best one your money can buy. Fill in this form for a competitive quote.

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