Ten tips for choosing the right medical aid
The medical aid landscape can be tricky to navigate , so it ’ s best to compare the options to find a medical aid that works for you and your family and is within your budget .
# 1 Analyse your healthcare needs No two people or families are alike – which means medical needs differ . Do a quick personal healthcare needs ’ analysis to determine what cover you need . If you have dependants , factor in their healthcare needs too . Consider the following :
• How often you and your family visit a doctor or specialist
• What over-the-counter or chronic medication is required
• Chronic conditions like high blood pressure or diabetes
• Specific conditions like cancer , HIV / AIDS or renal failure
• How much you spend on dentistry or optometry
Then consider which of the expenses were once-off and won ’ t come up again soon ( like childbirth ) and which are likely to come up again and again ( such as flu ). This will help you decide whether you need a comprehensive medical aid or a hospital plan .
# 2 Read the small print Take the time to read the information sent to you by the medical scheme and / or your broker . Benefits vary from plan to plan , so establish what is and isn ’ t covered .
Ask what supplementary benefits might be available to you that can potentially save significant day-to-day expenses . These could include preventative care benefits , ranging from basic screenings ( blood pressure , cholesterol , blood sugar and Body Mass Index ( BMI ) measurements ) through to mammograms , pap smears and prostate testing . In some cases , this extends to maternity programs , dental checkups , flu vaccinations and more .
Once you understand what is on offer , you can make an informed comparison and decision .
# 3 Managed Care options Managed Care programmes help members manage severe chronic conditions such as cancer , diabetes and HIV / AIDS .
# 4 What about savings ? Medical savings are a fixed amount a medical scheme gives you at the beginning of the year . There are ways to maximise your savings but first you need to know what your annual allocation is .
# 5 The day-to-day detail Look at what the scheme suggests as ways to make your benefits last , bearing in mind the following :
• Some plans require you to use a specific GP , hospital network and have a list of Designated Service Providers ( DSPs ). These keep costs down because the scheme will have negotiated special rates with these services providers . Check the network in your area before making a final decision
• Must you be referred to a specialist by your GP ?
• Does your medical aid offer additional GP consultations , which they will pay for , after you have exhausted your day-to-day benefits ?
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Bonitas Member Magazine Issue 3 | 2021