Medical Aid has become a necessity

As humans, we all run the risk of getting sick at some stage. Sometimes it’s just a small cold, a mild case of the flu, or a passing stomach bug, and sometimes it’s something serious like diabetes, heart disease and cancer which can stay with us for life, and even lead to our death.

All these diseases can be treated and managed, but at a cost. Medicines are not cheap and some diseases require you to take a lot of medications to ensure you get back your health, or at least live a life as healthy as can be expected under the circumstances.

We also have categories of chronic medical conditions like high cholesterol, high blood pressure and depression (to name a few). These diseases are treatable, but it costs a lot of money to keep them in check.

Then there is the risk of injury in a car or work accident. Should you be involved in such an accident, you could need urgent medical attention, surgery and subsequent after care. For instance – should you break a bone, like for instance, your collar bone, you will need surgery to have the bones re-connected with a metal plate, a possible surgery to remove the plate once the bone has healed and a number of physiotherapy sessions to get the mobility back to normal. You will also need a number of x-rays, the anaesthetist’s services, bandages, antiseptic creams etc. And all of these cost a lot of money.

So what can you do to ensure you can carry these financial burdens, should they ever occur? Unless you are lucky enough to have a huge trust fund, or be one of the super-rich, you will have to go the route of the medical aid.

Medical aids help carry the cost

Medical aids have been around for many many years and are there to help you carry the costs of expensive medical bills and medication.

The way a medical aid works, as do most insurance businesses, is that a large amount of members contribute, to support a smaller amount of members who claim. That way everyone shares the load.
So what types of medical aid are out there? Well, you get your most basic plans, usually called hospital plans, that are ideal for young, healthy and care-free individuals (in other words, those with no dependants, such as children). These plans only cover the basics, and you will need to be in hospital to get the benefits. Some of these plans include a limited amount of basic doctor’s visits, and would work well for those who only go to the doctor on the odd occasion.

After the hospital plan, you get progressively more extensive plans. Some come with medical savings, which are funds that are separate from the main fund, in that your day to day expenses get covered from this. Day to day expenses will include prescription medication, doctor, dentist or optometrist visits and the likes.

Different plans will cover you more, and therefore cost you more – to make up for the added benefits. Doctors charge a fee for their services, and medical aids pay a certain amount for these services. It is important to know that many doctors (usually specialists) charge more than the amount that the medical aid is prepared to pay. Depending on your plan, you will need to pay the shortfall from your own pocket. The better your plan, the smaller the portion you will need to dish out (while some premium plans even cover everything).

There are many providers out there that offer medical aids. Some have similar plans, and some differ vastly from their competitors. You will need to look at all your options.

Firstly – see what you are able to afford per month. Take into account that medical aids usually increase their fees annually. So don’t go for the most expensive option if you know you won’t be able to afford another cent more in the next year.

You also need to understand that you can usually only upgrade your plan once a year (downgrades are sometimes allowed, depending on the plan), so make sure you know which plan will suit you best.

Speak to a representative of the medical aid and ask all the questions you may have. Ensure you understand exactly what is covered and what is not. Find out about the list of chronic medication the fund pays for (should you have any chronic conditions). Find out if there is a waiting period that falls into place after you’ve joined. You need to know everything about the fund before you make a decision.

Get personalized help in choosing a medical aid

Also ensure that you shop around. Compare the different funds with each other to ensure you get the best benefits for your money.

Some companies force you to join their specific medical aid. This is usually necessary to ensure that the fund remains ‘strong’ (in other words, has enough members to carry it), which will benefit you, as member.

A number of medical aids offer its members loyalty programmes with discounts to gyms, fitness clubs, magazine subscriptions, cheaper movies etc. These may be tempting, but don’t let these programmes be the only reason you join the scheme. Make sure the actual product – the medical aid, will ensure you best level of wellbeing. The rest can always come later. Also remember that the loyalty programmes cost you money, and only if you really make use of special offers and deals, will you be reaping the full benefits of this programme.

Whichever situation you find yourself in, ensure you are informed and empowered. Never feel intimidated by the jargon – ask questions and ensure you get proper answers.
In the end a medical aid can make a huge difference to your overall health and wellbeing, so make sure you choose well.