The lowdown on low cost medical aid

According to Peter Moyanga, Medshield Chairman, healthcare cover should rank as a top priority within one’s monthly budget. Moyanga explains, “Failure to take out sufficient cover will soon see your bank balance going south due to the exorbitant cost of medication, treatment and hospitalisation.” But what is regarded as sufficient cover? And can the average working class man in the street get a decent level of medical cover without having to part with half of his monthly income? Moyanga says, “With the average monthly income of South African households being R4, 415, many premium medical scheme options are simply out of financial reach.” He continues, “But many of these options are extremely comprehensive and go beyond the basic requirements of the average family. There are certainly cheaper options available that will meet the needs of many families, but they need to ensure they do their homework before making any decisions.” While cost will play a big role in determining the type of cover you choose, the danger is that cost is sometimes the only deciding factor. Healthcare cover then becomes somewhat of a white elephant – offering the consumer unutilised benefits and gaping holes where suitable benefits should be. “Many people don’t realise that carefully assessing their family’s healthcare needs is an incredibly valuable use of time. And the same goes for meticulously checking out various medical aid plans,” says Moyanga. “Know your needs, so that these can be suitably met.” There are some prerequisites that are simply not negotiable for a credible medical aid. Medshield’s Moyanga suggests opting for a plan that provides the essential benefits. He recommends asking the following questions in order to ensure you’re partnering with a medical aid that will stand the test of time: • Is the scheme widely accepted by doctors and other relevant practitioners? Some schemes do not have good credibility with providers, which could seriously inconvenience you when it comes to timely and efficient claim payments; • What is the fund rating of the medical aid and how do its reserves look? The Medical Schemes Act prescribes that schemes must maintain statutory reserves of 25 percent of annual contributions. The more favourable this figure, the less premiums are likely to increase; • Pre-funded medical aid: would you prefer a scheme with a facility that assists you in putting dedicated savings towards your retirement? • Does the scheme have a good credit rating? In addition, Moyanga recommends you ask the following questions about the specific healthcare option you are considering, in order to avoid any nasty surprises: • Does the medical plan provide comprehensive out of hospital cover? • Does the plan cover an extensive list of chronic illnesses? If so, what is the limit of your cover for these? • Is there sufficient cover for optical and dental treatment, usually two high cost items? • At what rate are benefits paid? And what potential shortfalls in payment will you have to fund? • Are the plan’s annual limits likely to be sufficient for you and your family’s needs? Moyanga concludes, “Be careful to choose a medical aid that won’t let you down when you need it most. If you don’t ask the relevant questions to determine both the credibility of the scheme and the comprehensiveness of the cover, your hard-earned monthly medical aid contributions may not only be wasted, but could also be the beginning of many more unplanned financial outlays.” Contact Details Name : Elizabeth Senger Company : Medshield Phone :021 425 7111 Email : This email address is being protected from spambots. You need JavaScript enabled to view it. URL : www.medshield.co.za Note to the Editor About Medshield: Medshield is South Africa’s fifth largest medical aid scheme. At present, Medshield has over 70, 000 principal members, with a total of approximately 180, 000 lives covered by the scheme. As of the end of December 2005, Medshield had a solvency level of 54.8%.