Your health is your most valuable asset, and so having medical aid cover to support you through life’s challenges is really important. With various plans on offer, it can be daunting to choose the right one for you. However, asking yourself these four questions can help you make the best decision.
- What are my needs?
Your needs should be the primary determining factor in choosing a medical aid plan. Consider your age, state of health, and life stage. Do you have or plan to have a family? Are there any existing medical issues for you or your dependants? Remember, as you age, your need for medical cover increases due to the higher risk of chronic health conditions and the need for chronic medication.
Consider whether you require cover for:
- GP and specialist visits
- Dentistry and optometry
- Chronic illness
- Maternity care
- Mental health care
Additionally, prepare for unexpected medical issues that may arise. It’s essential to review your medical aid plan annually to ensure it continues to meet your changing needs.
- What plans meet my needs?
Medical aid plans typically fall into three categories: Hospital plans, savings plans, and comprehensive plans. At Profmed, we offer hospital plans, comprehensive plans with day-to-day benefits and network options that require members to use network hospitals and day clinics. This allows for a 10% saving on premiums. It is important to understand your healthcare needs to ensure you select the most appropriate cover for you and your family. For example, a comprehensive plan may seem expensive initially, but when you consider out-of-pocket expenses and the benefits covered, it can be more cost-effective.
- What can I afford?
Your budget is another critical consideration. Consider the best medical aid plan available within your price range to ensure you’re adequately covered without straining your finances. Budgeting for medical aid is crucial to ensure you have cover when you need it most.
It’s also important to remember that in South Africa, if an individual takes out private medical aid after the age of 35 for the first time, a late joiner penalty may be imposed on their membership for the rest of their life. For long term savings, the sooner a person gets medical aid, the better, even if it’s through an entry level hospital plan.
Before committing to a plan, carefully research all terms and conditions to fully understand what is being offered. If you feel uncertain, speak to a medical aid consultant to help you choose the option that best suits your needs and budget.
- What is the scheme’s network cover and accessibility?
When choosing a medical aid plan, consider the network cover and accessibility of healthcare providers within the plan. Check if your preferred doctors, specialists, and hospitals are part of the plan’s network. Additionally, look at the geographic cover to ensure you have access to medical aid services wherever you are in South Africa. This is particularly important if you travel frequently or live in a remote area.
At Profmed, we have selected our network hospitals based on quality healthcare outcomes. We encourage our members to make use of our networks because we have empirical data supporting the level of care that patients receive. The agreements we have in place with these hospitals result in savings, which are passed on to our members.