Good health - and the ability to quickly recover from ill-health - is the most important aspect of a successful life!
And in South Africa, private healthcare is a non-negotiable benefit when having to seek medical help.
In simple terms, we have medical aid to ensure that we are able to pay for the best treatment received from either a GP, specialist or while in-hospital.
We are all too aware of the horrific cost of medical treatment in this country and it is not getting any cheaper!
While the cost of living in South Africa continues to rise, so do medical bills - but at a faster rate!
It is therefore vital that you “insure” your health, after all, that is what a medical scheme does.
Accidents and illnesses are unpredictable and you cannot plan for them. You have to have a way of accessing immediate funds when they strike.
In return for paying a monthly amount – called a contribution – medical aid covers you financially for various medical expenses. Depending on the medical scheme plan you’re on, these can include in-hospital treatment as well as things like screenings for certain diseases, day-to-day expenses like medication or GP visits, and dental treatment.
Medical schemes usually require that you use their own network of hospitals and healthcare providers to be fully covered: if you use providers outside of the network, you may be liable for extra charges.
If you have a history of hereditary chronic disease in your family - like high blood pressure, cholesterol or diabetes - you must consider a comprehensive plan with good chronic medicines benefits!
If you have existing or are expecting future health issues – that are NOT PMB conditions - then again, a comprehensive plan may be best for you.
If you are healthy then consider a hospital only plan and pay your own day-to-day costs.
They are more affordable, whilst protecting you against the real threat of not having a medical aid - hospitalisation!
Some even pay out of hospital dental costs along with Private hospitalisation!
Medical aid is an insurance that covers you for large and unexpected events which could financially ruin you.
It allows you to access the best treatment when you do need it and that cannot be under-estimated!
In order to get fast access to the best medical care, you DO NEED TO JOIN A MEDICAL SCHEME and before you look at a scheme's benefits and cost, you should understand what lies behind medical aid.
When joining any open medical scheme in South Africa, the medical scheme has the right (with reference to the Medical Schemes Act ) to implement underwriting on any member joining that scheme.
To find a medical scheme with no waiting period is very unlikely.
Waiting periods can be imposed on new members, the length of which depends upon your health and how long you’ve been without medical aid cover.
They can range from a 3-month general waiting period to a 12-month condition-specific waiting period.
There are Also, Monthly Late Joiner Penalties to consider. The older you are when joining a medical scheme, the more severe the late joiner penalty. The penalty depends on how many past years of medical scheme membership you have.
So, the sooner you join a medical scheme, the lower any possible penalty will be.
You can never be too young or too healthy to join a scheme!
We will email you a quote, showing you the cost of various plans. Once you choose one, we will email you the application with instructions on completing it.
Return it to us and we will check and send it to a dedicated team we have within the medical scheme. We will track it and assist with problems all the way through to getting your certificate.
ALL FOR FREE! You pay what you would going direct because, the medical scheme pay us our fee!
There is no added fee!
You may think that you’ll never need medical cover, but considering that one episode in a private hospital can set you back hundreds of thousands of rand, is it not better to pay a small monthly contribution to ensure you are covered?
Look ahead 5-years to try and assess what cover you’re likely to need, track your health history and consider any genetic factors that may play a role.
Ask me for independent advice to help you choose the right medical scheme package.
Medical Schemes only allow plan upgrades at year-end - ALL EXCEPT ONE!
If you suffer a life-changing event (from pregnancy to cancer) you canIMMEDIATELY upgrade your plan.
So you can choose a cheaper plan, safe in the knowledge that, if you need better benefits, you can get them!
The scheme should be financially stable.
Check the claims-paying ability and solvency level.
Remember, the more members - the better the scheme!
So choose from larger medical schemes. We only offer plans from the top 5 schemes.
Choose a plan purely on cost?
Identify what it is you need, then look for plans that best meet those needs. Be realistic about the state of your health and don’t bank on the invincibility of youth, or your current state of good health lasting forever.
Compare costs and trim your plan to your budget. You must get quotes before joining a scheme and this is not always an easy or understandable process!
We try to make this as easy and simple as possible. USE US!
I do not charge an additional fee! You pay the same as if going direct, but I have years of experience in this field. You run a real risk “cutting out the middleman!”
Especially where it costs you nothing extra!
What about exclusions, limits and implications of a scheme’s network of doctors?
We provide the information – all you need to do is READ IT!
It is in writing, so there is no misunderstanding. And you can see that discussion ….anytime!
We are just an email away.
We will respond far more quickly than getting a broker appointment.
Why Avoid Hospital Cash Plans?
They are insurance products, not bound by the same rules medical schemes have to meet. They pay fixed cash benefits and can be extremely restrictive when claiming - very unlikely to meet more than a small fraction of your actual costs.
Get an in-hospital only medical plan because, claims are determined according to the actual healthcare expenses you face and not on a pre-agreed, daily cash sum. Far more secure.
What about wellness and loyalty programmes?
These should not be the reason you are buying a medical aid! It costs money to belong to these programmes! To get reasonable rewards costs you money. A free rewards programme is worth what you pay for it!
However, some wellness plans are worth it, if you are dedicated enough to use them properly. Again, talk to me for help in making a decision.
If you do your research properly and get professional help, you can choose a plan to best suit your needs.
Then you won’t be disappointed when claiming, because your expectations will be met.
You also need annual screening and diagnostic tests, procedures and specific vaccines out of hospital (Mammograms, cholesterol tests, prostate tests, flu vaccinations and immunisations for babies and toddlers).
Ensure you have professional and extreme sports cover if you lead an active lifestyle.
If you want some out of hospital benefits, the Smart plan offers unlimited, network hospitalisation and a copayment should you need a network doctor, medicine, dental and optical treatments.
The best of both worlds!
If you can afford to save for your out of hospital costs yourself, then an in-hospital only plan is your answer.
If you use private providers, they can charge what they want - known as the private rate. This can be up to 500% or 5 times more expensive than the medical aid rate!
To help you meet these high costs medical schemes now offer plans, that will pay up to 3 times their scheme rate, but these are still not good enough!
In addition, they are increasingly adding copayments for certain in-hospital procedures. More expensive plans have fewer copayments.
What can you do to address this threat?
If you can use providers who have a payment agreement with a medical scheme, they will charge what the plan pays. So, you should never experience an in-hospital claim shortfall.
Every medical scheme member should have an insurance-based Top up plan.
It is a vital part of having full in-hospital cover!
These are totally separate products to a medical scheme and will work with any medical aid