Service Guide for Medical Aid

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Medical aid companies help members deal with excessive medical bills, such as GP services and hospital costs, in return for monthly membership and premiums. Some payments to practitioners are done at the member’s discretion, while others require approval from the medical aid company. Medical aid companies compile different packages that differ in benefits and cost, to suit clients’ needs.

Popular Medical Aid Services Include:

Assistance with day to day medical expenses

South Africans are privileged to have exceptional doctors at their disposal. Costs to obtain their services however, can be quite high. Medical aid companies offer packages that cover expenses for day to day medical expenses such as:

  • Visiting a GP for minor ailments or check-ups
  • Medicine for occasional or chronic medical problems
  • Seeing specialists such as:
  • Psychiatrists
  • Dentists
  • Optometrists

Covering hospital costs

A hospital visit can be a planned event such as a birth, or an emergency such as a burst appendix. South Africa has various government hospitals, but the conditions and availability of staff aren’t always favourable for patients.

A better alternative is to visit a private hospital. Costs pertaining to these institutions are quite high. Medical aid companies cover costs at these hospitals, up to a set amount, as determined by the package you subscribe to.

Life insurance

South Africans know life insurance is essential, especially for bread winners. Some medical aid companies offer life insurance packages. These packages may be more affordable than other brokers’ life insurance, since reduced rates apply when obtaining it along with medical aid.

Loyalty services

Many South African medical aid companies aim to help members live healthier lives. They offer loyalty programs and benefits to members who prove that they adhere to certain conditions such as:

  • Regular exercise
  • No smoking lifestyles
  • Purchasing healthy, fresh food products

5 Tips when in need of Medical Aid

1. The cheapest isn’t necessarily the best

Medical aid services are quite expensive, but don’t be fooled into using the cheapest company or the most affordable package. You may buy into a certain package, only to find out the company doesn’t cover the total amount of your expenses. This means you have to pay the excess yourself and can end up being more expensive than obtaining the pricier package from the start.

2. The most expensive isn’t necessarily the best

You need to match your medical requirements with the correct package. If you’re relatively healthy and rarely need to visit a GP, don’t purchase the most expensive plan the company offers. You may only need a plan that covers hospital fees for unforeseen circumstances.

3. Work through a broker

Medical aid plans and processes can be confusing to some. You need to find a plan that fits your lifestyle. You also need help to make sure all medical aid claims are handled correctly. A medical aid broker is the ideal partner for these circumstances. Instead of waiting for a medical aid’s call centre to answer, you can speak directly to a broker you trust.

4. Listen to reviews

It’s wise to listen to what the public and other members say about a specific medical aid. It will give you an idea of the service you can expect. If you know a certain medical aid company tends to take long on approvals, you can plan well in advance to prevent that pitfall.

5. Double check all charges to your account

Mistakes happen easily. Either a medical practitioner or medical aid company can wrongly allocate payments and claims. Make sure you keep track of all expenses and payments pertaining to your medical aid account, so you can have mistakes tended to immediately.

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