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07 July 2011

How do I choose a medical scheme?

Choosing the right medical scheme is very important espcially when there are so many medical aid companies out there.

How do I choose a medical scheme?
Make sure you have the best cover for when you fall ill and need medical attention. Choose the best medical scheme for your specific needs and budget. Keeping in mind that the industry is complex, you can get expert advice from people who deal with the industry and its complexities on a daily basis. This service will be at no extra cost to yourself as the scheme administrator will be reimbursing the broker for this service. (Note that this fee is already included in your contribution, whether you use a broker or not.)

  • Make sure the scheme is a registered Medical scheme in terms of the Medical Schemes Act 131 of 1998, and that it is financially sound. The last thing you need when you're lying in the trauma unit is to find out that your medical scheme has gone under. You can check these details on the site of the Council for Medical Schemes.
  • Financially sound means:
    • they have a solvency ratio of 25% and more
    • they don't have an average member age of much more than 43 years (the average age of members of the healthier schemes)
    • the non-healthcare costs of the scheme are not too high
    • there is a fair numbers of members belonging to this scheme
  • Check things such as exclusions and benefits . Remember your membership of a medical scheme constitutes a legal contract, and it is in your best interest to understand the terms of that contract.
  • Find out which chronic conditions are covered and what your monthly contributions would be.

The following website gives a good summary of some of the different options on offer:

 
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