Medical Aid Cover
Medical aid cover is health insurance. It is simply financial protection against the probable risk of incurring medical expenses during your and your family’s lifetime.
A monthly premium or contribution, calculated according to the estimated overall risk of health care expenses in South Africa, is paid to the medical aid scheme of your choice.
In turn, the medical aid cover will ensure you have sufficient funds to pay for treatment by a network of service providers when required.
Benefits of Medical Aid Cover
The primary benefit of medical aid cover is the access to excellent health care.
Although South Africa has both a public and private health care system, the state institutions are overburdened with the task of providing primary health care to an estimated 41 million people who do not have the means to pay for medical aid cover.
With adequate medical insurance, you and your family will have the distinct advantage of treatment in private hospitals and by the best medical professionals in the business.
Who Should Apply For Medical Aid Cover?
All South Africans should apply for medical aid cover. It’s essential to insure your and family’s health. Accidents, illnesses and chronic diseases are part and parcel of our day-to-day lives.
Although it’s impossible to predict our health over the long term, the probability of requiring hospitalisation, chronic medication or treatment by GPs, specialists and other health care professionals is high.
Medical Aid Options
Medical aid options available in South Africa include:
- Comprehensive Plans– provide blanket cover for virtually all medical costs including benefits for day-to-day expenses and in-hospital expenditure.
- Hospital Plans– are less expensive than comprehensive plans, are routinely offered by all medical aid schemes and only cover the cost of treatment while in hospital.
- Hospital Plans with Medical Savings– are a combination of traditional hospital plans together with savings accounts which are topped up by fixed monthly contributions by the member. The total annual amount in the savings account is available, in advance, for day-to-day expenses in that year. Once the fund is exhausted, members pay out of their own pocket. Any credit balance is carried over to the next year.
- Capitation Plans or Network Options – offer cover for day-to-day expenses at cost effective rates at specific network providers designated by each individual medical aid provider.