Changing Medical Aids – Procedures and Factors to Consider

Changing medical aids is a not a difficult task provided that various procedures are followed to ensure that it is done properly. The greater challenge lies in taking the risk of changing from one medical aid to another and whether this will work in your favour or not. Many medical aid members make decisions rather impulsively, blinded by the price factor, with little thought of how changing medical aids can impact on their cover. While it is always good to shop around, one should not be hasty in making a decision without first comparing the benefits of the new medical aid plan with that of the old one. After all, you either need the same cover or better cover over time as you get older and the risk of various diseases increase.

Old Medical Aid

You probably signed up for your existing medical aid cover several years ago when your needs were smaller, probably your disposable income greater and often by the urging of an overzealous broker or your employer. You may not have known much about medical aid cover at the time and never really bothered because you hardly ever fell ill. The little extras that your medical aid was giving you in terms of a gym contract or savings on certain purchases was a bonus and you were fine with your medical aid in this time.

The question that beckons is why then change your medical aid? The bottom line is that there is no better medical aid than another in South Africa. You get what you pay for. Every medical scheme has different plans for different budgets. You can upgrade or downgrade. The choice is yours. It is however, best to stay with the medical aid company that you are with as your long term membership will be a factor taken into consideration once certain chronic diseases develop.

Should you have had an issue with your medical aid, you can always take your grievances to the Council of Medical Schemes. The bottom line is that no medical aid in South Africa has policies or benefits that are better or worse than the next. It is consumer perception that has created much of this confusion. However, there are schemes that have better administration or are in stronger financial positions than others. This may be worth considering in the long term but rest assured, you as the member of the medical aid are protected by various regulations that exist for the health insurance industry – it works to your favour to ensure that you are always covered to some extent.

New Medical Aid

The motivation for changing medical aids in most instances is the price factor or a new company medical aid with a change in employment. While the latter may be unavoidable if you want to benefit from your employer’s contributions to the monthly premium, there are various factors that should be taken into consideration if you are looking for a cheap medical aid.

  • Cheap is not better. Cheaper cover = less benefits.
  • No medical aid is significantly less expensive than another for a plan offering the same benefits
  • You may save on the monthly premiums but it can cost you a large amount later when you have to pay for shortfalls in cash.
  • Your needs are greater with age, and the same applies to your family – your new cover should offer greater protection by the way of larger benefits.

This all boils done to the one point – YOU GET WHAT YOU PAY FOR.

These factors should not a discourage  a person from changing medical aids. There are many valid reasons for moving over to a new scheme but first assess if a change in medical aid plan with the scheme you are currently with is a better option.

Remember that there is no medical aid offering a single plan that is significantly better or cheaper than a similar plan on another medical aid. If that was the case then most of the country’s medical aid members would be flocking to just a single medical aid. Instead there are scores of restricted (industry-specific) and open (public) schemes that exist as outlined in the list of medical aids offering pretty much the same products.

It is always helpful to speak to a medical aid broker who can help you make a more informed decision with regards to cost and benefits between your old and new medical aid.

Procedure for Changing Medical Aid

If you are changing medical aids without the help of a broker, you need to ensure you follow certain procedures.

  1. Complete the application form for your new medical aid and wait for approval.
  2. Indicate the date when you would like to join the new medical aid once approved.
  3. Inform your existing medical aid that you will be changing schemes as of a certain date.
  4. Follow up with your new medical aid to ensure that they are ready with your membership as of the date stipulated.

Your old and new medical aids will communicate with each other so that there is a smooth transition from one to the other. This ensures that you are not without medical aid cover even for a day. It also ensures that you are not liable for certain medical aid exclusions that are applicable to new members who have never had any prior medical aid cover. This means that all waiting periods fall away once you move over to your new medical aid and your cover will not be interrupted at all. However, it is always wise for your as the member to keep in touch with both your old and new medical aid during this transition period.