Switching Over to a Cheaper Medical Aid Plan

Although a medical aid is an essential insurance cover these days, at times it can be unaffordable and you may  have no other choice but to consider a cheaper option. If you want to keep your medical aid but cut the costs then you will have to switch over to a lower plan or even change your medical aid provider entirely.

Not paying your monthly contributions or giving up your medical aid altogether should never be considered unless you can really not afford the cover. However, before switching to a cheaper plan, it is important to make yourself familiar with all the changes that may affect the extent of your health cover.

Cheaper Medical Aid Benefits

With medical aid cover, you get what you pay for. So if you choose a cheaper medical aid plan, you will get less benefits. The range of benefits on some lower plans may be similar to more expensive cover but the allocated benefit amount is usually significantly less.

This is where the confusion arises among medical aid members.

For example – plan  A and  plan B may both offer optical benefits but the more expensive of these plans will allow you a larger benefit. If you are on the cheaper plan, then you may still have to part of your spectacle costs in cash despite saving a little on the contributions for cheaper cover. If you add it up according to each benefit, you may find that by saving a little every month on a cheaper plan, you will actually fork out more money by subsidising your medical costs with cash payments or levies.

Medical aids structure their plans according to your total annual contribution. A lower plan is better than no medical aid cover at all but if you are used to comprehensive cover, then you have to prepare yourself for lower benefits.

You will be significantly restricted on a lower plan – your medical aid may only allow you to visit certain doctors or hospitals (network providers) or you may find that you quickly exhaust your available funds, well before the year end.

Save on Medical Aid Costs

Before switching your medical aid plan or provider, it may be worthwhile reassessing your monthly budget. You may find that you can save in other areas of your monthly expenses to keep your current medical aid cover active.

Never be hasty to change over to a medical aid which appears to have cheaper plans. Most medical schemes provide a range of plans that are priced similarly to cater for various budgets. It is better to stay with your current provider but speak to them about how to change your medical aid plan.

You should also carefully evaluate your medical needs. If you are young and healthy and do not use your out-of-hospital benefit on a regular basis, it may be more feasible to switch over to a hospital plan with greater cover and pay for your daily medical expenses on a cash basis.

Speak to your doctor about consultation fees. Often you can negotiate on a cash rate and claim back the amount from your medical aid. It may not directly save you money on the monthly medical aid contribution but it can stretch your benefits for a longer period. This will prevent you from having to pay both a hefty medical aid premium plus paying cash for your doctor’s fees once you medical aid funds are exhausted.

Missing a Medical Aid Contribution

Non-payment of your monthly premium means that your medical aid cover will be inactive during that period. This should be avoided as far as possible as you may suddenly  need the cover.

If you are unable to make payment for one or two months, it is better to call your medical aid in advance and discuss the possibility of putting a hold on the premiums. Some medical aids may agree to this and keep your cover active during this period. this gives you a short reprieve to get your finances in order.

However, you will have to pay the outstanding contributions a month or two later and you should expect a double or triple debit on your bank account.