Medical aid schemes

jsheed_sa

Executive Member
Joined
May 27, 2005
Messages
5,069
Hey guys, looking to join a medical aid, dont earn much at all but reckon its a needed expense - any cheapish plans you can recommend?

Thanks
J
 

gifs

Expert Member
Joined
Mar 1, 2007
Messages
1,429
I recommend that you go for a good hospital plan only, as with more expensive packages you end up paying for day to day medical expenses such as the doctor and dentist anyway.

Try to get one where you can go to any private hospital you want to, some plans restrict you to certain hospitals.

I can't give you advice on which medical aid to join, as I am forced to be on whatever my employer's aid is (which is a momentum affilliated medical aid) and haven't really needed to deal with them yet.
 

The_Unbeliever

Honorary Master
Joined
Apr 19, 2005
Messages
103,199
We're looking at a hospital plan as well - a basic medical scheme package is too expensive, but a hospital plan should suffice.
 

AutoX

Expert Member
Joined
Jan 30, 2008
Messages
1,408
I think the burning question here would be which hospital plan that wont cost you an arm and a leg?
 

Mr M

Well-Known Member
Joined
May 15, 2007
Messages
207
Agree - just get a hospital plan .

If you live at the coast, have a look at Discovery's coastal core plan - R613.

Haven't had any issue when going to a private hospital so far.
 

LancelotSA

Banned
Joined
Aug 20, 2007
Messages
14,713
Some pointers. Look out for :

1. Percentage cover offered in hospital. Usually quoted as 100%, 120%, 200% or 300% of what used to be known as medical aid rate but is now called various things by different companies. Most refer to the same thing (besides Discovery who make up their own base rate! So just ask about it and get a second opinion on what you are told it means when dealing with them....)

All procedures and medical costs have been quoted at set prices on the NHRPL (national health reference price list). This is the amount you should be charged. Specialists however can charge what they want, anything up to 500% of this quoted price. The medical aid you take will only cover you to the percentage quoted by them, anything above that is out of your pocket.

2. Check on co-payments. Some medical aids show wonderful percentage cover but when you read the small print you find that most procedures require up to a 20% co payment by the member. This means you have to fork out 20% of the cost. One of the more popular medical aid does this for a lot of procedures.

3. Check you overall limit. Some medical aids are unlimited others have annual limits of as low as R150,000 pa. The latter will obviously be cheaper but one major event with a long stay in hospital and some specialist visits won't take long to use up this limit!

4. Check the sub limits for individual procedures. Oncology, MRI/CAT scans are two of the common ones that vary quite substantially from one MA to another.

5. For someone young make sure the casualty/emergency benefit exists and is preferable unlimited. This is the benefit that covers those visits to the hospital that do not require admission eg broken legs, cuts, falls etc.
 

Johand

Expert Member
Joined
Jan 21, 2005
Messages
1,372
No matter what anybody told you - steer clear of Discovery. The main objective of a medical aid should be medical cover and not fringe benefits. Discovery is NOT good at medical cover because they only pay 200% of the old NRPL whereas other schemes pay 300% of NRPL - which makes a massive difference to the amount you need to pay in when you have a claim.

I suggest going to the following site and compare medical schemes directly: http://phango.org.za/medtool/index.php?pageid=1
 
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