Women's Month - Essential Healthcare Financial Planning

Women's Month is a timely reminder to reflect on one of the most crucial aspects of financial wellbeing: healthcare financial planning. While this matters for everyone, women face unique challenges that make strategic, professionally guided health planning particularly important.

Why healthcare planning matters for women

Certain considerations and conditions that disproportionately affect women should be factored into your planning and budget.

Martin Rimmer, CEO of Sirago Underwriting Managers, a gap cover provider underwritten by GENRIC Insurance Company Limited, says: "Women generally have longer life expectancies and may experience career interruptions due to caregiving responsibilities, which can influence lifetime earnings and retirement savings. Combined with elevated risks for certain health conditions, these factors underscore the importance of having appropriate healthcare cover in place."

Independent financial advisor, Janette Rooney of Le Forge Financial Consultants, adds that women are often also the ones managing the family's health administration. "From medical aid claims to children's check-ups to caring for ageing parents, much of this load falls on women's shoulders, often alongside full-time work. Women drive healthy habits across the whole family, yet their own health checks are often the first thing pushed down the to-do list. This Women's Month is a reminder that the same care women extend to their families deserves to be turned inward too, starting with a proper review of their own healthcare planning," says Janette.

As the gap between income, savings and rising costs widens, many people are forced into trade-offs between immediate needs and planning for an unknown future health event. Getting professional advice from a qualified healthcare broker is one of the most effective ways to strike the right balance in your healthcare plan.

Top considerations for your healthcare financial plan

1. Medical scheme benefit: your foundation

Given the high cost of private care, many consumers prefer private healthcare because of accessibility and service considerations. For many consumers seeking access to private healthcare, medical scheme membership is an important consideration. Choosing the right benefit option requires careful thought. Work with a professional healthcare broker who can assess your healthcare expenditure, family and personal medical history, and any pre-existing conditions, to strike the right balance between cost, benefits and needs. A professional broker can also help you identify opportunities to earn better rewards and coverage simply by being more proactive about health checks and healthy lifestyle habits..

It is important to remember that medical scheme membership and insurance products serve different purposes and are regulated under different legislation. Gap cover and other insurance products are not substitute for medical scheme membership and are intended to complement qualifying medical scheme cover.

2. Get gap cover: protecting against unexpected shortfalls

Even with a comprehensive medical scheme benefit, gap cover may be appropriate for consumers depending on their medical scheme option, healthcare needs and affordability. It covers the shortfall between what your scheme pays and what specialists charge, and specialist and in-hospital fees can run up to 400% above scheme tariffs. If your scheme pays out at 100% or 200% of tariff, you carry the remaining 200–300% yourself if you don’t have gap cover. Many schemes also carry deductibles and co-payments, especially on lower-tier options. Based on internal claims experience, Sirago's average "large loss" gap claim currently sits at R40,000–R60,000, which makes the case for gap cover on its own.

3. Plan for a health crisis

A serious illness or disabling event can affect both your health and your ability to earn. Cancer, for example, may mean months away from work and income. For stay-at-home mothers, a health crisis also disrupts childcare, schooling support and care for ageing parents, responsibilities that carry real financial cost if a caregiver needs to step in. Speak to a qualified and authorised financial adviser or healthcare adviser

4. Prevention, prevention, prevention

Preventative care is a benefit worth using, not leaving on the table. Commit to annual screenings - early detection can reduce both the health and financial impact of serious conditions. Make sure your plan covers essentials such as mammograms, pap smears, bone density tests and cardiovascular screening.

5. Reproductive health and maternity planning

If you're planning to have children, prioritise a plan with strong maternity and reproductive health benefits. Childbirth is costly, and significantly more so with complications. Check for adequate cover for prenatal visits, screenings and postnatal care for both mother and baby. Sticking to your scheme's maternity programme can meaningfully ease both the health and financial load during this period.

6. Managing a chronic condition

Many people live with chronic health conditions that require ongoing medical care and treatment. Having appropriate healthcare cover in place can help reduce the financial impact of specialist consultations, diagnostic tests and long-term medication. When planning your healthcare needs, it is important to ensure that your cover aligns with your personal health circumstances, so that managing a chronic condition does not result in significant out-of-pocket expenses.

7. Lifestyle as financial strategy

Small, consistent changes pay off, in health and in rand terms. Eat well, move daily even if only briefly, limit alcohol, cut out smoking and vaping, manage stress, and prioritise sleep. These habits help you avoid costly chronic conditions later and can reduce your long-term healthcare spend.

8. Maximise available resources

If you have access to group employee benefits, use them. Just make sure your individual and employer-provided cover work together, without gaps or unnecessary duplication.

9. Get professional advice

Healthcare financial planning is genuinely complex, which is why professional guidance is so valuable. A qualified advisor can help you identify coverage gaps, understand potential out-of-pocket costs, plan for shortfalls, and balance affordability against comprehensive cover, cutting through the complexity of how different insurance products work together.

Healthcare financial planning is important for everyone, but women may encounter certain health, life-stage and caregiving considerations that make proactive planning particularly valuable. It is not only about managing costs when you are unwell, but also about giving yourself the confidence and financial flexibility to prioritise your health and wellbeing throughout your life.

This Women's Month, take the opportunity to review your healthcare and financial plans to ensure they remain aligned to your needs, priorities and budget. Speaking to a qualified adviser can help you make informed decisions and adapt your plans as your circumstances evolve.

This article is provided for general information purposes only and does not constitute financial advice. Consumers should consider their individual circumstances and obtain advice from an authorised financial services provider before purchasing any financial product. Benefits, terms, conditions, waiting periods and exclusions apply and differ between products.

Sirago Underwriting Managers (Pty) Ltd is an Authorised Financial Services Provider (FSP: 4710). Products are underwritten by GENRIC Insurance Company Limited (FSP: 43638), an authorised Financial Services Provider and licensed non-life Insurer and a member of the Old Mutual Group.

Le Forge Financial Consultants (Pty) Ltd is an Authorised Financial Services Provider (FSP 51625)