List of Medical Aids in South Africa

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Our list of medical aids in South Africa are divided between the open schemes and restricted schemes. An open medical aid is one that is open to all South Africans who can pay for the membership. Restricted medical aids are only for people with a certain academic qualification, who works in specific industries, belong to certain professional associations or are employees of a certain company in South Africa.

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Medical Aid for Children On Their Own or After Divorce

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There are many situations where parents may want standalone medical aid cover for their children without an adult member. This is a common situation that arises after divorce. With the rising cost of living, many parents may want to keep children on medical aid cover despite dropping their membership. Irrespective of the circumstances, the concern is often the same – can minor children be on a medical aid on their own?

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Medical Aid for Pensioners and Retired Senior Citizens

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It is accepted part of life that as we need more medical care as we get older. Pensioners and retired senior citizens are understandably concerned – both age and their income are obstacles to ensuring health and affording medical care. Fortunately South Africa has a world class private healthcare sector but it can be expensive. Medical aid is necessary to afford these services and pensioners should ensure that they have the best medical aid cover that they can afford.

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Avoid Suspension for Unpaid Premium, Debit Order Bounced

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An unpaid medical aid premium at the beginning of the month will mean that your membership is immediately suspended. Remember that medical aid premiums are paid for cover in the month ahead. So a bounced debit order or unpaid premium means that you are not covered from that point onwards. However, this situation can easily be remedied provided that you have available funds to settle the bill.

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Medical Aid Pays For Accident Injuries Treatment

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Over the past year there has been an ongoing social media campaign to highlight that certain medical schemes will not cover its member for injuries sustained as a result of road traffic accidents. It has been said that schemes pressurise members to claim instead from the Road Accident Fund (RAF) for the medical expenses and then settle the scheme for any bills that have already been paid as part of medical aid coverage. However, these claims are largely untrue.

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Baby 4D Scans Not Covered By Medical Aid

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The excitement of having a baby is often surpassed by the curiosity to know what your unborn baby may look like. Up until recently, there was no way of knowing for sure. Regular antenatal ultrasounds could show the outline of the baby’s facial profile, but could not give parents any idea of what the baby would look like. This was until the 4D scan came into being. Even though the images are computer generated and are not 100% accurate, it does allow parents to see their baby’s face beyond the traditional grainy black-and-white ultrasound images. Unfortunately this type of scan is not covered by your medical aid.

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When is the best time to join a medical aid?

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The best time to join a medical aid is IMMEDIATELY. Ideally a person will belong to a medical aid from childhood and continue through to adulthood but this is not always possible. The moment you become economically active by the way of a job or your own business, you should sign up for medical aid. The best time is when you are young and do not need cover. Waiting to fall ill or sign up for medical aid once you need it is risky and can work against you.

Medical schemes have various penalties, exclusions and waiting periods in place to ensure that new members to a medical aid do not only sign up to claim without having contributed to the pool over time. But if you signed up for cover at least a year before you need to claim, then you can rest assured of full medical aid benefits as per the plan you chose.

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Self-Insurance Cannot Replace Medical Aid

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People around the world practice self-insurance for various reasons. Self-insurance means saving money every month in expectation for certain needs that may arise without buying cover from an insurer. It is a form of emergency fund aimed at replacing different financial products like medical aid, car insurance and so on. While saving is always a good practice, self-insurance cannot replace a medical aid even with your best attempts. You may swear to save the equivalent of your monthly medical aid premium and even a little more but when it comes to crunch time and you need to pay bills, you may find that your own savings will just not suffice. This is especially true if you are hospitalised and need major surgery in a private hospital in South Africa.

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Medical Aid for Newborn Baby

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Having a baby is a time of joy and excitement but have you considered the healthcare costs that may be incurred by a newborn? Nobody likes to equate such a joyous time in life with money and expenses, but the reality is that if you do not have medical aid, you may have to leave your newborn in a government hospital. Newborn babies are fragile – leaving the protection of their mother’s womb to face the harsh environment filled with bugs, allergens and irritants. As their system is still maturing, they may be prone to repeated illnesses in the first few months of life. This means repeated visits to the paediatrician, blood tests, scans and even hospital stays. Without medical aid, it can be difficult to afford having a newborn baby and offering him or her quality health care.

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Are Private Rates Charged by Doctors Unethical?

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We all dread hearing the words “doctor is contracted out of medical aid” when we step into a practitioner’s rooms. But the reality is that more medical professionals are contracting out of medical aid and charging cash rates these days. It also means that in many cases, although not always, the practitioner is charging fees above what your medical aid pays. This means having to fork out cash from your pocket and claiming back from your medical aid only to be reimbursed a portion of what you pay. You may find it frustrating and even upsetting but it is the reality of the private healthcare system in South Africa today. Many claim it is unethical for doctors to be charging higher rates. But is it so?

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