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Medical aid in South Africa |
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Financial Services – Medical Aid South Africa
The definition of the business of a medical scheme is found in section 1 of the Act and reads as follows:
“Business of a medical scheme” means the business of undertaking liability in return for a premium or contribution-
- To make provision for the obtaining of any relevant health service.
- To grant assistance in defraying expenditure incurred in connection with the rendering of any health service.
- Where applicable, to render a relevant health service, either by the medical scheme itself, or by any supplier or group of suppliers of a relevant health service or by any person, in association with or in terms of an agreement with a medical scheme.
Medical aid in South Africa is not one of the things that you necessarily need to consider whilst you are living outside of South Africa, but it is one of the most important insurances to consider when you think of coming home, as it differs significantly from what is offered in other countries, such as the UK where the NHS can cater for most needs. It is vital to investigate, understand and select a medical aid that suits you and your personal needs, and to get this in place quickly.
There are a host of different companies in South Africa that offer a variety of medical aid schemes – names that you may be familiar with such as Discovery and Momentum, to ones that you may not have heard of, like Renaissance or Selfmed. Each company has a selection of plans ranging from a basic “Hospital Plan” to fully comprehensive plan, depending on your personal requirements and budget.
Private Medical Aid in South Africa is relatively expensive and the costs tend to increase annually, so it is important to ensure that you have the right cover and are not caught short should you require treatment.
Although medical aid can be expensive, private hospital care is of a very high standard. However, if you do not have any medical aid, many of the private hospitals will not allow you to be admitted and will send you to a government hospital, where you may have to wait for long periods of time until a doctor will attend to you.
What questions do you need to consider when selecting the right medical aid to suit you?
- What is your budget for medical aid?
- What are your personal requirements? (full cover including doctor’s appointments or just a hospital plan)
- Do you have any special medical problems that need to be catered for? (high blood pressure, bad eye sight, etc)
- Does the plan you are thinking of taking cater for your special medical problems?
- What do the different medical aid plans offer?
- How does the payment structure for each different medical aid work?
- Do you have any chronic conditions?
- Are you over 35 and are you aware that you may have to pay penalties because of this?
- What are the penalties?
- Do you fully understand the different medical aid schemes?
- Should you get professional advice?
- Do different medical aids offer further services and what are they?
- What is a savings account and how does it work?
- What is a hospital plan?
Please also remember that there is no standard or set price structure for medical specialists and anaesthetists and you can be charged anything up to 300% over the recommended medical aid tariff, which will be for your personal account, if you do not have the correct cover.
Selecting the correct medical aid is no easy task, and you need to be well informed. It is best to contact an independent broker that can advise you on ALL the medical aid options available from all the medical aid companies.
The above article was contributed by Werner Stoltz. Werner is an independent broker, who is able to advise and arrange medical aid for all of South Africa’s main medical aid companies.
Werner can be contacted here.
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