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Why do you need Medical Aid?

As with insurance, Medical Aid (also called a Medical Scheme) is a product we know we should have – but why do you need it?

Whether we love the healthy benefits and the reward programmes, or knowing we are covered in an accident; the unfortunate reality is that emergency medical treatment does not give us advanced warning.

A Medical Scheme provides members with access to private healthcare facilities*. Subject to your selected scheme, option and provider, your medical expenses can fully or partially be covered. However, when we don’t have Medical Aid, all medical expenses become your responsibility and need to be paid personally. You will not enjoy the benefit of a Scheme paying your costs, which can run into the hundred of thousands, or even the millions. Additional scheme benefits can cover a variety of benefits, such as GP visits, chronic medication, specialist visits, oncology care, maternity benefits, and many others.

When you consider which provider to choose, it is often quite daunting, as other than seeing a variety of benefits, the art is knowing how to select and choose the scheme option best suited to your needs so you only pay for what you need. Additionally, you may be uncertain as to whether you have chosen the right scheme and option, as we often only learn about Medical Schemes from the adverts we see or what family and friends recommend.

Let’s look at this scenario

Bob, now working his first job after university and about to move out of his parents’ home, is told by his dad that he needs to take care of his own medical aid and pay for it. When Bob investigates affordable Medical Schemes, he is aware of the various benefits offered. As Bob is young and healthy, he opts for a hospital plan and signs up with his chosen provider over the phone with their call centre.

A few months later, Bob falls ill and needs to visit his doctor. As Bob chose a hospital plan without a savings or day-to-day benefits in order to save money, Bob has to pay for his doctor’s bill and prescribed medication in full. Bob is frustrated that he chose a Medical Scheme without the benefit of doctor’s visits, as this benefit would have covered his consultation and prescription medication. Bob ended up paying more over a 6-month period than if he chose a suitable Medical Scheme to meet his needs.

Choosing the right Medical Scheme is a critical decision you make for you and your family, particularly when understanding how the benefits integrate with your Scheme Benefits, your Gap Cover and other insurance products.

As consumers, what we often forget to ensure that our scheme is tailored to our family’s need, covering you and them in time of need.

*Medical Schemes provide funds towards your hospital bill. If you do not have medical aid, you can go to a Private Hospital, but you will be liable to settle the full bill amount.