Updated 08 February 2016

Spot a lousy medical schemes broker

A bad healthcare broker could cost you a lot more than money. Here's how to spot a bad one. Run for your life, while you still can.


Brokers may receive a commission of up to 3% of your monthly contribution (up to a maximum of R75 plus VAT per month), so clients should never feel they are imposing if they ask for advice on medical scheme options.

Here are 10 signs that your broker is under-performing severely. Your search for a good healthcare broker is not over if you recognise the following behaviour patterns:

No needs analysis. A detailed needs analysis should be done to determine your health care requirements. This will ensure that the broker fully understands your past, present and as far as possible, your future health care needs. This forms the foundation to any further advice or recommendation.

No yearly review. Healthcare needs change as does your life stage. A healthcare broker should inform you towards the end of each year about the changes to your medical scheme for the following year, and should not rely on scheme communications for this. An assessment should then be made to ensure that the scheme as well as your option is still suited to your needs.

Uses complicated jargon. A bad health care broker will use complicated terminology and make medical aid sound as complex as reading the medical scheme brochure. A good healthcare broker will be able to explain the scheme to you in simple and easily understandable terms.

Trying to sell you ‘add on’ products. Most medical schemes have linked products and loyalty programmes which offer the broker additional income. While many of these products may be suitable in certain instances and offer value, beware the broker who primarily focuses on selling you these, rather than focusing on your healthcare requirements. These ‘sexy’ additions come at a cost.

No regular contact. Health care is not a ‘once-a- year’ business. Your healthcare broker should contact you at least twice a year to discuss your health situation. More importantly he/she should regularly guide you on obtaining the best value from your chosen medical scheme. This could include something as simple as advising you to register on the chronic programme if you have recently been diagnosed with a chronic illness, through to more complicated claims such as for cancer treatment.

No after-sales service. Beware the broker who merely refers you to the call centre of the medical scheme. A good broker should be prepared to assist you with claims queries, information on the scheme, benefit understanding and so on. If needs be, the healthcare broker should be prepared to ‘take on’ the medical scheme and, if necessary, elevate your concerns to the Medical Schemes Council.

Limited scheme contracts. Many healthcare brokers only have contracts with one or two schemes. They therefore focus on selling you these. A good healthcare broker will have contracts with at least four medical schemes and therefore will be able to offer you a selection of possible solutions for your needs, and not just the one with the highest commission payment.

Up-selling. Beware the broker who tries to sell you the more expensive options within the medical scheme using ‘fear-of-the-unknown’ tactics. Your purchasing decision should be made on current and anticipated healthcare needs. You can change your option on a yearly basis within any medical scheme and therefore you are not overexposed to risk by selecting suitable and affordable options each year.

Other products. Many life- and short-term brokers use medical aid to develop a ‘trust’ relationship with a client. This is seen by them as a door opener to selling the more lucrative and higher commissioned life products. Whilst they may be excellent life- or short-term brokers, they often have limited medical scheme knowledge and this could work against you in the long term. Ensure that your financial advisor focuses on medical aid as a core aspect of his business with full back-up resources. If not, find yourself a dedicated medical aid broker.

And finally. If you think you do not have a healthcare broker phone your medical scheme (if it is an open one, and not an in-house one from the company for which you work) to check if there is a broker linked to your account. You may be surprised to find that you ‘have’ a broker on your account. This broker could be earning a commission every month on your account, although you may not be aware of this and no service is being offered to you. If this is the case, ensure that you immediately find yourself a good healthcare broker who can offer you ongoing assistance and who deserves to earn the commission.

(Victor Crouser, for Health24, May 2010)


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