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Factors to Consider Before Selecting a Health Insurance Plan

For South African citizens, getting affordable health care is almost a necessity.  Accidents and ailments can occur at any time and it is your responsibility to protect your family’s health and well-being. However, the South African healthcare industry has witnessed a rapid rise in healthcare providers, each claiming to be the best at what they do. Because of this, making the right decision while selecting appropriate schemes can be a tedious task. Most people end up making ill-informed decisions and get stuck with the scheme for prolonged periods of time. (Information credit: GetSavvi Health)

We have compiled a list of considerations which will enable an individual to make well-informed decisions and reap the benefits of a credible medical aid plan.

1.  Health Status:  Getting full cover is the most practical solution for families where one or two members suffer from chronic medical conditions or illnesses. Thus, it is advised to sign up for a hospital plan, as any other emergency medical problems will already be provisioned by your medical aid scheme. 

2.  Financial Capabilities:  Reputed healthcare providers understand that their clients can come from different financial backgrounds. Some may not simply have the financial resources to sign up for full medical cover plans, which are relatively more expensive. Thus, having a clear understanding of your family’s paying capabilities, as well as the benefits provided by a particular scheme, is essential to consider before making the final decision. 

3.  Scheme and Provider Details: Besides gathering all relevant information about the scheme you’re choosing, you should also gather information on the experience of the organization, as well other client reviews.  One important consideration is the company’s latest solvency ratio information. According to South African law, a company’s scheme should have at least 25 percent of the annual contributions of members, stored as a reserve. Many people consult local physicians about the service provider’s past payments to check whether they have been made in a timely fashion. 

4.  Benefits: Before signing on the dotted line, make sure you have a proper understanding of all scheme related benefits.  This includes checking the per annum limit for your medical savings account. A change in your medical plan is advised if your MSA gets depleted before the completion of the allocated year.  There are several comprehensive online tools for applicants to compare medical aid benefits from different providers.

The decision of applying for the required scheme should be made after considering a lot of factors and understanding the nuances of each. As it stands, there is no outright winner between hospital plans and full plan coverage, as it depends on the individual and circumstances in question. There are several medical aid service providers in South Africa who provide top-notch facilities to their scheme holders, ensuring that they get the treatment they deserve. 

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