How to Reduce the Cost of Your Medical Aid.

Are you, like so many medical aid members, struggling to meet the cost of your medical aid plan?

Many, many members are battling to pay medical aid premiums.
They are so expensive that we need to consider ways to reduce this cost.
However, this is not a decision you can easily make!

There are so many schemes and plans option available, so much technical wording and a lot of confusing information available,


Here are some ideas to consider that may help you keep your medical aid

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.

The answer is to consider joining a lower benefit and cheaper plan.

Remember, the greater the benefits of a plan, the higher the costs.
So, consider cheaper options that have smaller medical savings plan or no savings plan at all.

Hospital Only plan. No day-to-day savings.

The greatest medical expense threats are in private hospital and dentistry. Visits to the GP, opticial and chemist can be controlled and are very unlikely to bankrupt you! BUT hospital and dental costs can be huge!


All medical schemes offer plans that cover in-hospital costs only.

There is a plan that offers unlimited in-hospital cover AND R 25,000 for certain out of hospital dental benefits!
This plan addresses both the major cost threats we face – all in one plan. It is unbeatable!

Please see: The Best, Affordable Hospital Plan with Dental benefits!

Hospital cover with smaller day-to-day savings.

The savings account within a medical aid is simply a fund of your money, saved from an added amount on your contribution.
If you can reduce the fund you feel you need - you reduce your premium!
And medical schemes have a few plans with different savings contributions to investigate. One scheme even allows you to design the savings you want!

You may also be on 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. It may well be that the cost of that benefit is higher than the actual costs it covers 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 and has a small savings.
At least you have cover for those unexpected costs, whilst managing your normal day-to-day costs yourself.

Please see: Unique value-added Medical Aid

How about a plan with hospital cover and a small co-payment for day-to-day needs?

You have unlimited in network hospital cover and network GP consultations, acute and over-the-counter medicine, eye and dental check-ups and sports-related injuries with a co-payment when you access these benefits?
So, you only pay for certain out of hospital costs when you need them, not as part of a monthly contribution!
If you are young and healthy, this may be an ideqal plan for you?

Please see: The Smart plan

No savings.

Your create own savings plan in a bank account or with a medical debit card. Even adding extra to your bond – if you have an access bond facility – is a good alternative! In this way you reduce the interest on your bond, which will far outweigh any return you get with a medical aid savings account! And you have access to a large savings fund!
However, don’t forget that medical schemes do offer you credit in the form of advances on your annual savings fund, if need be.

Of all day-to-day costs, dentistry is generally the most expensive. So if you are expecting dental treatments, be sure you save a sufficient amount each month. OR look to the only scheme we know that pays dental benefits as well!

Please see: The Best, Affordable Hospital Plan with Dental benefits!

Lower rates depending upon where you source chronic medicines.

There is a medical scheme that offers lower rates depending upon where you source chronic medicines.
Premiums differ if you get your medicine from any chemist, a network supplier or the state.

Please see: Momentum Health Medical Aid

Move to a network plan.

nurseWhere a scheme is able to control provider costs - through linking them in a network - the premiums are cheaper.
Most medical schemes offer network provider plans and you really only need to make sure you can use these providers in their networks. If you are happy to use their networks of private hospitals and day-to-day providers, you can save money!
There are also network plans that are linked to your income. These are the lowest cost medical aid plans available. However, they can be restrictive in the benefits they offer.

Please see: INGWE Medical Aid

Top Up/Gap Cover - what you need to know:

Medical schemes pay in hospital costs at differing rates. At the beginning of a year all medical providers and medical schemes decide on the cost of a procedure. That is known as the scheme (medical aid) rate. Schemes then pay at that rate.

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 aids now offer more expensive plans, that will pay up to 3 times their scheme rate.

And they are increasingly adding co-payments for certain in hospital procedures. Again, more expensive plans have fewer co-payments.

What can you do to address this threat?
If you can use providers who are have a payment agreement with a medical scheme, they will charge what the plan pays.
So, you should never experience an in-hospital claim shortfall.

medical aid

Or, best of all, buy a Top Up/Gap plan that will pay any in hospital shortfall and co-payment.

If you have a Top Up plan, YOU CAN CONSIDER THE LOWEST COST IN HOSPITAL PLAN THAT PAYS AT SCHEME RATES, because you are safe in the knowledge you are protected against high hospital costs! Every member should have an insurance-based Top up plan. It is a vital part of having full in-hospital cover!best-gap-top-up-plan.

Please see: The Best Gap/Top Up plan!


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.

Please see: How to Join the Best Student Medical Aid

Children older than 21 years of age

Some medical aids offer cover – at child rates - for children to age 27, as long as they are unmarried and not earning more than the maximum social pension.

Please see: Fedhealth Medical Aid

Children working with small incomes

And if they are earning a small income, look at the income-related network options. Good benefits for very reasonable premiums.

Please see: INGWE Medical Aid

Your Parents as Dependents

You may also have elderly parents on your medical aid. Again, it would be more than worth your while to investigate moving them to an income-related network plan. This could have a significant overall premium saving for your family.

Please see: KeyCare Medical Aid

So you can see there are a number of ideas to help you control your medical aid premium.
But the best advice is talk to a broker.
Let us investigate and present the various options open to you.


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