Medical Aid for the New Year

As the new year approaches, many of us reassess our medical aid cover as many schemes only allow a change in plan at the end of the year. The decision to change your medical aid plan in the new year should be based on both your needs and your budget. It is not possible to foresee just how much of cover you would require but if you are sure of an increase in pay scale in the new year, then it may be worth looking at increasing your medical cover by switching to a higher plan.

All medical aids will inform members of the change in benefits of each plan before the year end. You should read the notices carefully and verify whether your current plan will suit you and your family. If not, it may be worth considering switching to a higher plan or even changing your medical aid altogether.

The preceding year is a good indication of your medical needs for the new year. If you have been diagnosed with a chronic condition, fell ill repeatedly or exhausted your medical aid benefits well before the year end, then it may be time to switch to a better plan. New additions to your family like a baby or increasing medical costs for your dependents may be other reasons to consider increasing your medical aid cover.

Medical Aid Rate Increases in the New Year

Medical aid cover never gets cheaper. Rate increases may vary among medical aids but it is not unusual to expect anywhere between a 9% to 12% increase every year. Your medical aid will however notify you at least 2 to 3 months before the year end of the increases for the new year. While the monthly contributions increase every year, your benefits may not rise accordingly. Medical aids are always assessing the cover they provide and cutting costs where funds are being abused or wasted and increasing benefits for essential services.

While your medical aid benefits may rise in terms of the total monetary allocation for different services, it is also important to consider the increase in medical costs in the new year. Doctor’s fees, medicine prices and the cost of hospitalisation is always changing and usually on the rise. Even though you may be quite satisfied with the increase in medical aid benefits for the new year, it may actually pay for less services than it did in the preceding year.

Switching Plans on a Company Medical Aid

Your employer may have strict policies when it comes to changing your medical aid plan. You may be limited by the amount that will be paid for by your employer (employer’s contributions) and if you do not give your employer sufficient notice, you may not be able to change your medical aid plan at the last minute.

Your options on a company medical aid may not be the same as a private medical aid. It is therefore important to discuss your medical needs with the company’s medical aid broker or directly with the medical scheme. The company’s human resources department or your employer may not be aware of all the options on the company medical aid and often do not factor in individual’s needs.

Increasing Medical Benefits in the New Year

If you do not have an option for a higher plan or cannot afford the increase in monthly contributions, it may worth considering other options. Medical gap cover and hospital cash back plans may help to pay for added medical costs but it is important to bear in mind that these financial products are not medical aids. The products are usually not subsidized by your employer and will have to be paid for entirely out of your own pocket.

Ideally, you should switch to a higher plan within your medical aid if you can afford better cover or feel that you will need more cover in the new year. While more expensive cover may seem like the answer to more benefits, it is prudent to read through the benefits of each plan and find one that suits your needs. A broker and the scheme can only advise you to a certain point so the onus is on you to do your homework, understand your medical needs, calculate the costs and your budget and choose a medical aid plan that will best suit you in the new year.