There are so many schemes and plans option available, so much technical wording and a lot of confusing information available,
THAT YOU MUST USE AN INDEPENDENT MEDICAL SCHEME ADVISER!
I can help you AND I CHARGE NOTHING FOR THAT SERVICE!
Here are some ideas to consider that may help you keep your medical scheme:
Your biggest financial risk is the cost of private hospitalisation. You cannot compromise on this!
Next highest expense is normally in and out of hospital dentistry. Again effective cover is a must!
Lastly doctor, chemist and glasses, which you may be able to self-fund through your own savings plan.
Your answer is to consider joining a lower benefit and cheaper plan. Remember, the greater the benefits of a plan, the higher the costs. Read this...
So, consider cheaper options that have smaller medical savings plan or no savings plan at all.
However, please consider other areas of cost saving before you consider changing your medical scheme.
If you still need to change your medical cover, your options are as follows:
- look at a cheaper plan (possibly a hospital only plan).
- reduce your number of dependants, by placing them on theior own plans.
- change to a cheaper network or income-related plan.
- opt out completely and use state healthcare facilities.
Here are some ideas...
Cannot pay high medical aid contributions? But know you need a one?
If you can save for normal day-to-day medical expenses, such as GP visits, yourself consider an in-hospital only plan. It is far more affordable than full medical cover!
There are 2 areas of high medical costs you must cover: private hospitalisation and dental costs! This is where unexpected high expenses will happen.
Most GP and chemist bills can be paid, but 6-week in intensive care or wisdom teeth removal can be extremely expensive!
You need to have medical cover for these threats!
Now you can address your 2 greatest medical finance risks AND use any provider you want - all in one plan!
Many happy medical scheme members are doing just this! They feel secure in knowing they are protected from these high costs.
All medical schemes offer plans that cover in-hospital costs only, BUT THEY ARE NOT ALL THE SAME!
There is a plan that offers unlimited in-hospital cover AND cover for certain out-of-hospital dental benefits!
Check it as you will not be disappointed!
Add the GAP COVER and TOP UP PLAN and yopu will have UNLIMITED PRIVATE HOSPITAL COVER, PAYING UP TO 5 TIMES MEDICAL SCHEME RATES, WITH DENTISTRY BENEFITS AND NO NETWORK PROVIDERS!
UNBEATABLE BENEFITS AND COST!
Yes, you pay your own out of hospital costs, BUT I can virtually guarantee you that your saved premium will - over a year - add up to more than the savings in a medical aid!
And it is your money to spend as you wish - no restrictions!
It really is not such a risk…I have never heard of a chemist account causing a bankruptcy!
Not only will you address your highest medical financial risk, but you control your savings and have access to the money when you need it!
Take the “saved” premium – over a comprehensive plan premium and save that yourself. Why?
Well it is really the same as what you do with a comprehensive plan. The only difference is that a medical scheme will give you credit for the year - up front in your savings, whilst your own savings takes time to grow. BUT, at least that money is yours.
You can use it as you wish.
You can’t use money in a medical aid savings account as you wish!
You can’t get to it for holiday, or for your retirement. If fact, you can only get it 6-months after you leave the scheme!
Yet it is your money. You “saved” it as part of your monthly contribution. Is that fair?
And they only pay you bank interest on your savings. Surely you could do better with your savings? Of course you can!
Your create own savings plan in a bank account or with a medical debit card.
Or add extra to your bond – if you have an access bond facility – as a good alternative!
In this way you reduce the capital loan of your bond and can save immense interest, which will far outweigh any return you get with a medical scheme savings account! And you have access to a large savings fund!
However, medical schemes do offer you credit in the form of advances on your annual savings fund, if need be.
Cover for additional members is typically very affordable, making this an excellent option for young families, low income individuals, retirees, or people in good health who only need private hospital and dental cover and can comfortably pay their day-to-day expenses.
A savings fund can be a great help when you have high out of hospital medical expenses and do not have the cash flow to meet them.
The savings account within a medical aid is simply a fund of your own money, saved from an added amount onto your contribution. The Medical Schemes Act, allows you to save up to 25% of your premium in a savings account.
Note that if you accumulate a credit savings balance, you cannot draw the cash.
You can only access it when you terminate membership and as long as you don't join another plan with savings option - as the funds are transferred.
If you can reduce the amount of the savings fund you feel you need - you reduce could your premium by that savings portion!
Medical schemes do offer few plans with different savings contributions to meet these member preferences and one scheme even allows you to design the savings you want!
You may also have a plan that offers a safety net, should you use up your savings. These plans are very expensive and here you need to investigate carefully to see if you really are using that threshold benefit. Most members only need threshold benefits late in the year, so they do not use the benefit fully - yet have paid for it since the start of that year.
It may well be that the cost of that benefit is higher than the actual expenses you have and it would be cheaper to pay those costs (after your savings are used) yourself?
Coupled with your Top Up plan, you could look at a plan that pays in-hospital costs at medical aid rates (not the more expensive 2 or 3 times medical aid rates plan) and has a small savings.
The Top Up will ensure you have private rate cover for those unexpected costs, the lower plan contribution will help pay that Top Up cost - all whilst managing most of your normal day-to-day costs yourself!
You may be young and/or healthy and only need a fund for the unexpected.
This type of plan will cover your hospital and chronic needs.
You then have access to a savings account for day-to-day expenses that works in a different way to the standard savings model.
Suitable for people who are in good overall health, but do incur occasional medical expenses out of hospital.
Some providers also bundle maternity benefits into these plans, making them an affordable option for young mothers-to-be.
Here are 2 of these types of medical schemes:
flexiFED plans give you more control, flexibility and choice over your medical aid. And the chance to save on your monthly contributions!
They offer in private hospital cover, chronic condition benefits and a unique method of using savings for day-to-day costs.
Most medical schemes take a portion of your monthly contribution and place it in a medical savings account which is used to pay for day-to-day benefits.
Now, for the first time ever, this plan has turned this model around. FlexiFED allows you to begin paying for day-to-day benefits only when you need them.
You pay back that amount you have used over 12 months, interest free!
Here’s the saving for you… normally members are charged for day-to-day benefits from the beginning of the year regardless of whether you have used your savings account or not!
With these plans, your premium will be lower until you use your savings and begin to pay those monies back - interest free.
The longer you delay using the savings account, the longer you experience lower premiums!
How about a plan that offers unlimited network private hospital cover, guaranteed full cover for network in-hospital specialists, chronic medicine, unlimited network GP consultations, a list of defined acute medicines, a dental check and an eye test – all with a small co-payment?
It also offers specific sports-related injury benefits!
You only pay for certain out of hospital costs when you need them, not as part of a monthly contribution - paying for savings, when you don't need them!
If you use private providers, they can charge what they want - known as the private rate. This can be 5 times more expensive than the medical aid rate!
So, medical schemes now offer more expensive plans, that will pay up to 3 times their scheme rate, however these more expensive medical aids still leave you with a claim shortfall.
And schemes are increasingly adding co-payments for certain in hospital procedures. Again, more expensive plans have fewer co-payments.
Every member should have an insurance-based Top up plan. It is a vital part of having full in-hospital cover!
In some cases the scheme will continue to pay your GP costs, even if your savings have been depleted, as long as you visit GPs associated with the scheme.
Most medical schemes offer these preferred provider network plans at lower premiums and you should investigate them. If the providers are acceptable, then joining these plans is your answer!
All medical schemes have to cover the costs related to the diagnosis, treatment and care of an emergency medical condition, a defined list of 270 diagnoses and a defined list of 27 chronic conditions.
You could qualify for chronic medication benefits, if the medicine is on a list with your medical aid. The scheme will pay for it, without you using your savings.
Ask your doctor to motivate for this and by completing a simple form, you could save yourself hundreds of rand a month!
There is a medical scheme that offers lower rates depending upon where you source your chronic medicines.
Premiums differ if you get your medicine from any chemist, a network supplier or the state.
IF YOU DO NOT NEED CHRONIC MEDICINE, THESE ARE THE PLANS FOR YOU!
Most medical schemes offer network provider plans.
If you are happy with the network of private hospitals and day-to-day providers, you can save on premiums with these plans!
There are also network plans that are linked to your income. These are the lowest cost medical scheme plans available.
However, they can be restrictive in the benefits they offer, but they do offer life-threatening and life-sustaining benefits for extremely good rates!
They are ideal if you need medical aid for pensioners, children who become adult dependents on your medical aid, students and those who earn low incomes, but want access to private healthcare.
If your child is a full time student, there are plans specifically designed for students. They offer excellent benefits for a really good price!
Moving them onto their own plan, which you can pay for, is first prize in reducing your overall premium!
Although student plans have smaller monthly premiums, they don’t compromise on quality cover.
This means you will still get peace of mind knowing that your child’s healthcare needs are covered, but at a much more affordable rate.
Once your child turns 21, they will no longer be listed as a child dependant on your scheme, but as an adult dependant.
This means that their dependant premium will increase substantially or even double!
Some schemes do offer cover – at child rates - for financially dependent children up to age 27, as long as they are unmarried and not earning more than the maximum social pension.
Is your child studying part time, but earning an income?
In such a case, he or she will become an adult dependant on your medical aid at an increased premium. (Any income precludes them from joining a student plan.)
You need to look at getting them their own income-related Network Plans (above), as the premium will depend upon income and should be very competitive. You can pay the contribution if needs be.
They may not be comprehensive plans, but they do allow access to private providers, have unlimited hospitalisation and mostly unlimited basic day-to-day benefits.
Is your child is working full time, but earning an entry level salary?
Even though entry level salaries are small, as a full-time employee your child will become an adult dependant on your medical aid at an increased premium, when they turn 21.
Again, consider the income-related plans (above) or investigate more affordable medical aid cover such as hospital plans with gap cover.
The premiums on these plans are lower than comprehensive plans, but they still cover the most important medical needs.
With both these plans, even if you keep on paying your child’s premiums, you may still end up saving hundreds each month!
Prescribed minimum benefits - conditions such as high blood pressure, type 2 diabetes or cholesterol become problems as we age.
These conditions often require expensive, ongoing medication. The government has legislated for prescribed minimum benefits (PMBs). This is a list of 270 conditions which, by law, even the most basic of medical schemes have to cover. So regardless of what form of medical cover you and your parents choose, at least their chronic medication is paid for.
1. Make them a dependant on your plan. - Your scheme will allow you to add your parents as dependants, as long as you can prove that you or your dependant spouse support them financially.
BUT, if this is the first time your parents are joining a medical aid, or they have a long break in membership, they will be subject to late-joiner fee, which will increase your premium.
And besides the normal three-month waiting period when they become members, they may have to wait a full year before they can claim if they have a pre-existing condition (excluding PMBs) such as cancer.
2. Your parents to have their own medical aid plan. - because they are not earning high incomes, look at the income-related plans (above). The only concern may be access to network providers?
3. At the very least, hospitalisation and dental care can be covered through the Best, Affordable Hospital Plan with Dental benefits!
This excellent plan covers the 2 highest risk areas of their healthcare needs as they age. It will cover all in-hospital care, as well as PMBs.
4. Please AVOID Hospital cash-back plans!
The reality is many of us are going to have to contribute to our parents’ upkeep, so it’s worthwhile looking into medical scheme options before it gets to the point where they really need it, and your choices are limited.
Well, here is the answer for you...I can resolve these concerns for you AT NO CHARGE!
Yes, you pay what you are currently paying – nothing more.
BUT, I do need to be appointed as your broker, as this gives me and my team access to your problems.
If you can do this, then I can solve your concerns.
I only deal with certain schemes.
Stop that worry and frustration. Complete the appointment and return to me.
In a couple of days, I will confirm acceptance and we can quickly get onto your concerns.
Medical aid is a complicated product. We do need to have it, but we must fully understand what the benefits and limits are. This is where we can help! We know these products...all the fine print. And we can show you what cover you have! I am a fully licenced and accredited broker with over 30 years experience.
Many members experience unneccessary stress at year-end, when the time comes to select you plan for the following year. THIS IS WHEN YOU NEED HELP!
We work with medical schemes all day. I know the in's and out's of a good plan and can readily show you the best options to suit boith your needs and pockets.
It is NOT always best to change medical aids. You can get waiting periods with new scheme.
Rather investigate moving to a different plan, within your current scheme.
Again, appoint me and I'll help you make those decisions! And I'll be here 24/7 to assist you!
If you want to change schemes, then let me assist you in a comprehensive analysis of a new plan for you.
And I can show you ideas to help you to reduce the cost of your medical aid.