Deciding on whether to opt for full (comprehensive) medical aid cover or a hospital plan only, depends largely on the individual and one’s budget. A hospital plan is more affordable and offers protection for the most expensive of services – hospital care. However, one’s medical needs may not require hospitalisation and can still be costly to the point that it can be unaffordable. In this respect, comprehensive cover or full medical aid cover offers the best of both worlds. Fortunately recent changes in private healthcare legislation has now offered the consumer, even those without full medical aid cover, the protection for certain life-threatening chronic ailments.
Private medical aid is not compulsory for South Africans but is often considered as a necessity by most given the overburdened public health system. Medical aid is a form of insurance that differs from medical insurance and national health insurance. The latter, national health insurance, is not as yet available in South Africa (2011). However, it has been planned for the near future and this will most likely be necessary for all South Africans irrespective of whether they have private medical aid or not. For now, and for most of the foreseeable future, medical aid will be the tool to access quality healthcare without the restrictions that befall many who opt for public healthcare.
Medical aid is a form of insurance that covers the cost of medical services. It is available for foreigners and their family living and working in South Africa but depends largely on the type of visa one has while in the country. Any foreigner who is staying in South Africa for extended periods of time should consider medical aid cover although they can access public health services. The public healthcare system in South Africa is not up to the level of many developed nations and without medical aid cover or travel insurance, a person can only access these public health services or fund their medical care out of their own pocket.
Many employees do not consider the impact on their medical aid cover by changing jobs but this is an important consideration from the moment you hand in your notice of resignation. Much depends on whether you are a member of a open (public) medical aid or closed (restricted scheme). Without proper planning you may find that you do not have any medical aid cover for a month or two during the transition period and this can significantly impact on your personal budget should medical costs arise. Furthermore, even a short period without cover may mean that the new scheme will then impose certain waiting periods and exclusion criteria that can affect you for a few months or even in the first year of cover.
Prescribed minimum benefits are list of conditions and treatments that a medical aid has to cover for every member on its scheme, irrespective of the individual plan or availability of funds for that year. Basically prescribed minimum benefits are an assurance that every member will have medical aid cover when they need it the most. It comprises any medical emergency, diagnosis and treatment for some 270 medical conditions and full treatment and management of 25 chronic conditions. This required benefit is now part of the Medical Schemes Act and a medical aid may therefore not refuse to pay for at least minimum services for these conditions.
Medical aids are an essential form of financial assistance for any person who wishes to utilise private medical services in South Africa. With the spiralling costs of private healthcare in the country, most of us need a medical aid to ensure that we can meet with the financial obligations should we fall ill or be injured. These costs are not affordable for most of us and the only other option is the public healthcare system. A South African citizen or any person legally residing in South Africa may join a medical aid in the country, irrespective of the health status of the person.
