Most South African medical schemes now offer some sort of remote health consultation service. Making use of these virtual consultations is a great way to save on medical costs. My scheme (Momentum Health) offers a service called Hello Doctor free...
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Premium relief on medical schemes unlikely
Don’t expect a blanket premium relief, but if you are struggling, contact your medical scheme for options. If you are struggling to meet your medical scheme contribution this month, don’t hold out for a blanket offering of a premium waiver. Medical...
The difference between medical scheme cover and health insurance
By Riaan Oosthuizen, Alexander Forbes Health consultant As financial intermediaries we are often asked why medical scheme cover is so expensive compared to health insurance. Three main factors influence this. Underwriting and open enrolment The...
Understand your medical cover when ‘buying down’
With above-inflation price increases announced by medical schemes, many members may be looking for more cost-effective options when it comes to healthcare. But before making a change, ensure you understand what you are ‒and are not ‒ covered for....
When poor health saves you money
If you have been diagnosed with breast cancer, you may qualify for a higher income in retirement. When it comes to taking out life insurance, underwriting for the cover usually means that a prior illness results in a higher premium. However, when...
When your emergency is not paid by your medical scheme
Don’t rush off to the emergency room too quickly – it may cost you more than you realise. A recent twitter rant by a Discovery Health Medical Scheme member highlighted an often-misunderstood fact about hospital plans: they don’t cover visits to the...
Survey reveals confusing complexity in medical gap cover products
GTC launches inaugural Gap Cover Survey to rank and categorise all providers in South Africa Sanlam and Absa have emerged as the top-ranked medical top-up ‒ often referred to as ‘gap cover’‒ providers in South Africa, according to the first ever...
Medical aid annual review: six questions to ask before accepting the default option
Annual medical aid premium increases for 2018 are once again measuring in excess of inflation, and this often comes with a decrease in benefit levels. This means consumers will have to make increasingly tough choices if they don't want to be caught...
Which are the top medical schemes?
Discovery and Momentum medical schemes top the tables in the 2017 GTC Medical Aid Survey across most plans. The extensive survey, conducted by financial advisory firm GTC, takes various criteria into account when ranking the scheme options. Jill...
Using rewards to pay for medicine
This year our family is working our rewards programmes to cover the costs of medication. After realising we would pay R1 500 less per month on our premiums if we selected a medical scheme option that did not cover my son’s R900 per month chronic...
Previous Articles
How to select the right medical plan for your needs
If you are considering moving medical schemes or looking to take out a medical scheme plan for the first time, you need to consider the viability of the scheme as a whole and then select the plan that best suits your needs. The health of the scheme Jill Larkan, head...
Teamwork could lower our medical costs
Medical practitioners need to be incentivised to keep us well, rather than getting paid just when we are sick. Three weeks ago my son cut his finger badly and it needed to be professionally bandaged and assessed for stitches. I popped down to my doctor’s rooms and...
Why we’re paying so much more for medical cover
As long as medical claims outstrip premiums collected, our premiums will keep rising. This year most medical scheme members will see premium increases well above inflation with the industry average hovering around 11%. Depending on your scheme option, some members...
Understand your medical scheme’s co-payment rules
In order to provide lower-cost medical cover, most medical schemes offer plan options where co-payments apply for certain procedures. These procedures tend to be elective surgeries such as a colonoscopy or joint replacement and are clearly defined in the medical...
Is your medical scheme healthy?
A lack of young, healthy members is driving up medical scheme costs. The increases announced by medical schemes for 2016 ranged from around 8.6% to as high as 15%. If your medical scheme announced increases well above the market, it could suggest that the scheme, or...
Can my employer force me to have a medical aid?
Themba writes: Our employer is an NGO that doesn't subsidise the medical cover of employees yet it is compulsory to have medical cover according to the employment contract, unless the employee is dependent of someone else's cover like the spouse. The employer deals...
Too young to get ill?
A person under the age of 35 is more likely to claim for income protection or disability than death. While life cover may not be a priority, protecting your future income should be. When Greg, aged 35, was rushed to hospital after a virus attacked his heart, it gave...
You can’t claim from both your medical scheme and the Road Accident Fund
A reader wonders why her medical scheme deducted her medical expenses from her Road Accident Fund settlement. Paseka writes: I was in a car accident and was awarded around R2 million from the Road Accident Fund (RAF). I was admitted to a private hospital and the total...
Finding cost-effective medical cover
We set ourselves a challenge to try and find medical cover for one of our readers. Our findings show that medical cover is expensive for many middle-income earners and that a comprehensive hospital plan is possibly the best option. Elizabeth has three children aged 3,...
More clout for medical scheme members
The Council for Medical Schemes (CMS), which is the regulator for medical schemes in South Africa, has initiated new processes to put more power in your hands so that you are able to take on large medical schemes. Consumers have always been able to take complaints...