Whether you are going overseas on a short holiday or having to stay for an extended period of time for personal or work commitments, you should not forget that the onus of proper medical coverage for you and your family rests on your shoulders. Many of us think that since we have medical aid cover then we can rest assured of having this assistance when abroad.
Do medical aids cover you when overseas?
In most cases, no. Most medical aids only cover you for medical expenses incurred within South Africa. Cover while abroad is by way of travel insurance and whether you take it or not is up to you. Medical aids have very strict policies regarding medical bills incurred while out of the country and much also depends on the type of medical service rendered and on the practitioner, clinic or hospital itself. Emergency services may be considered but had you gone abroad for medical care specifically, then this is not part of your medical aid’s responsibility.
Fortunately there is some respite for medical aid members – most schemes provide free travel medical insurance for its members for anywhere between 30 to 90 days. It is not a mandatory cover on the part of the medical aid and members of lower plans usually do not enjoy this benefit. The onus, however, still rests on the medical aid member to inform the scheme of their travel plans prior to leaving South Africa.
Medical Expenses When Travelling
Medical aid is a form of security. Should you fall ill then you have the cover to assist you with the medical bills which can be difficult to afford for most people. However, your medical aid only covers for necessary medical expenses accrued within South Africa. Most schemes will cover some of the medical bills that you accrue overseas provided that you went to legitimate practitioners and facilities. This will only be for essential bills usually for emergency medical services. However, you will first have to pay in cash and there is no guarantee that you scheme will reimburse you.
Although medical services can be cheaper in some countries, the reality is that emergency medical care is expensive throughout the world, especially for private medical care. South Africans often complain about the state of government health care facilities within the country but public facilities in some countries are much worse. Without proper medical cover or cash in your hand, many private facilities abroad will not allow you admission. Travellers are considered to be a high risk as they may leave the country before settling all the bills. You may then be at the mercy of substandard health care facilities with staff that may not even speak English since this is free care.
Overseas Medical Insurance Cover
Travel medical insurance is not the same as a medical aid. You buy cover for a certain value and there are many restrictions in place as to how it can be used. It is only valid for a specific period of time with a once off payment at the outset. Although it is not as flexible as a medical aid, it still offers the peace of mind that your essential bills will be covered. For any responsible traveller or family going abroad, travel medical insurance should be seen as essential and not optional. Your medical aid may provide this service for free, but so does many credit card companies should you purchase your flight tickets with the card issued by them.
And if neither option suits you, travel medical insurance can easily be purchased over the phone from many private financial service providers. It is best to speak to your travel agent about this additional cover should you not go with your medical aid or credit card company. As with the any product and service, there are some in the market that are better than the rest. Your travel agent will be familiar with the better products on the market. However, you should still notify your medical aid company that you are travelling abroad. The extra cover that your medical aid company may provide is just an added bonus should you opt to purchase your own travel medical insurance.
Keeping Up Your Medical Aid when Travelling
Although you may be going abroad for a long period of time, it is advisable to maintain your medical aid cover if you can afford it. Cancelling the cover with the intention of restoring it upon your return is never advisable. If you are older than 35 years then there will be added lifetime costs for medical aid when you try to restore the cover. Furthermore, you may need to rush back to South Africa for medical care only to land in the country and be forced to pay cash for services.
Should any medical conditions start overseas, these will be considered as pre-existing conditions upon your return if you cancelled your cover before leaving. This means that you be subject to an exclusion period. It may not be a chronic disease. Even a fracture that you sustain abroad can be considered a pre-existing ailment and you medical aid will not cover the bills if you cancelled your cover before leaving and try to restore it once back in South Africa. The best approach is to keep your medical aid membership active in South Africa unless you are emigrating and have no intention of returning permanently.