How to Compare Medical Aid Plans in South Africa

Choosing a Medical Aid Plan

Each scheme has several plans offering different levels of benefit and premiums.
From Comprehensive to in-hospital only plans enefits.

Each plan has its own rules, exclusions and waiting periods, so it is vital you deal with bestmedicalaid.co.za, a medical aid professional who knows the "small print!"

Why Should You Compare Medical Aid Plans?

The only way to identify the right medical aid for you, is by looking at what cover and cost similar plans offer.

Premiums vary widely, from around R500 to over R14,000 monthly, depending on the provider and plan benefits offered.

The risk of joining a plan based only on the premium is high. It may cost less each month, but leave you with major claim shortfalls when you really need it most.

You may be subject to restrictions like using only network providers, or have high co-payments with certain treatments and procedures.

With rising costs and changing needs, completing regular comparisons can save you money and improve your benefits.

Comparing medical aids helps you:

• Avoid overpaying for unused benefits.
• Ensure sufficient cover to prevent out-of-pocket costs when seeking medical treatment.
• Get and use valuable benefits like wellness programs, healthy rewards and digital tools.
• Investigate your medical aid's solvency or any ratings decline and consider new schemes if necessary.

We will help you investigate all these concerns.

bestmedicalaid.co.za a professional, licenced medical aid broker will confirm all these concerns with you, before you join a plan.

6 Basic Steps to Take when Comparing Medical Aid Plans

Are you healthy or have chronic illnesses you need to cover?
Are you looking for just yourself or family as well?
Do you have hereditary health care concerns like diabetes or glaucoma?

Schemes and plans have different levels of cover and we will help you find the right one to meet your needs.

Medical aid premiums can get very expensive ranging from R 486 to over R14,000 per month.
Unfortunately, the more cover you need, the higher that premium will be and it is important that you join a plan that you can afford today and well into the future.
You may need to consider an in-hospital only plan, a network provider plan or a plan with premiums based on your income.

Let us help you find a plan that you do not have to cancel because of high premiums.

Hospital - In-hospital only, emergency and chronic illness benefits.
You self pay out of hospital costs.
Look for unlimited in-hospital benefits that include specialists.

Savings plans - Include a savings account for day-to-day expenses like GP visits, medicines or optometry.

Comprehensive plans - Includes both in-and out-of-hospital benefits, like doctor visits, medicine, dental, optical and chronic illness benefits, however with higher premiums.

Network Plans - Requiring the use of listed doctors or hospitals, giving you for full cover.

Chronic Illness - All plans have chronic illness medicine benefits, but they are dependant on listed on formularies
Non-formulary medicines have co-payments, so check they are reasonable.

All medical aid plans must offer Prescribed Minimum Benefits (PMBs) for 271 conditions and 26 chronic illnesses, ensuring basic coverage regardless of the actual plan benefits.

Use our expertise free of charge and based upon your current an future needs, you will find the right plan.

We will compare and explain the monthly premiums, benefit details and limits, exclusions and waiting periods, out of hospital savings accounts, and network restrictions.

Some plans restrict you to using network hospitals or doctors for full cover.
This does reducing the premium, but can limit your ease of getting help and being treated. It is important to compare the plan provider networks and facilities, to see if you can use them.

We will present all this information to you in a simple to understand format where you can ask questions about anything that concerns you.

It is important that the schemes you consider are financially sound and meet the requirements of the Medical Schemes Act. They need to have good administrative systems, claims paying ability and communication when problems arise.
Are they recommended by their members?

Bigger schemes have more members and good financial reserves, and generally pay claims more reliably. We will show you those schemes.

It may be that you need a more expensive plan with higher benefits. We will justify that decision with you.
You don't want to join a plan only to self pay costs when the benefits are exhausted.

Waiting periods of between 3-12 months for pre-existing conditions is another factor to consider.

Late Joiner Penalties can also result in up to 75% additional premium! These definitely need to be investigated.

We will guide you to the right plan should you need better benefits.

How bestmedicalaid.co.za Makes it Easier to Compare Plans:

Simply answer the questions needed for a quote and send it to us.

We will return with a quote, including any penalties that may be required
We will include the brochures, so you have full information on what the plan offers.

Please note the Rules on Switching Medical Aid plans:
You can switch plans and schemes anytime, but there are restrictions that apply to both processes.

Voluntary scheme changes will incur a 3-month general waiting period and, because you are underwritten by the new scheme, you may get up to 12-months pre-existing waiting periods.

Internal medical aid plan switches have no restrictions at at year-end.
However, outside of that you may only have certain plan option changes allowed.

Please use us to clarify what your options are.If you have further concerns, email, WhatsApp or phone us and we will provide the answers for you.
(We prefer using email, as the process in writing and misunderstandings are less).

Important Things You Should be Aware of:

• Medical aids give you comprehensive benefits for hospital treatment, day-to-day and chronic illness costs.
• They cover prescribed minimum benefits (PMBs), including essential chronic and life-threatening conditions that medical aid must pay for.
• Medical aids pay providers directly for services received by members.
• Medical aids are more expensive, but their benefits are way superior to medical insurance.
• Contributions to medical aid are tax-deductible up to certain limits, whereas health insurance premiums are not tax-deductible.
  
  
• Medical insurance plans pay fixed amounts for specific, listed events or illnesses.
• They do not have to pay for PMB conditions.
• They focus on essential or specific healthcare needs, rather than full medical treatment like a medical aid.
• Medical insurance pays you a lump sum or daily amount, and you are responsible for settling medical bills.
• Medical insurance premiums are lower than medical aids, but they do provide less benefits.

Out-of-Pocket Costs:
Medical aids are increasingly imposing certain procedure co-payments and private providers do charge fees in excess of what most medical aids pay. Both these "hidden costs" are for your account.

Please contact us to investigate joining a Gap/Top up insurance plan that will help you meet these costs.

There is a plan that allows you to upgrade your plan at any time you suffer a life-changing event, like pregnancy.

Why Use bestmedicalaid.co.za as Your Broker?

We are a licenced, qualified and trusted medical aid broker.
We aim to make choosing and joining a medical aid easier for you.

We offer:

Wide choices: We work with the best medical schemes like Discovery, Momentum, Bonitas, Fedhealth, Genesis, Compcare and Medshield all done with one brokerage.

Easy tools: Use our on-page forms, to get personalised recommendations ... fast

Save time and money: Find the right plan without wasting time and money. We help you through your mobile phone, laptop or desktop computer, with no undue sales pressure.

Trusted and professional: We care about matching plans to your needs, not just selling you the most expensive medical aid.

We are truly independent and you are our most important asset.

Free service: We are paid by the medical schemes, so you pay nothing extra.