For quite some time now, medical aid, particularly related to private schemes, has been a hot, often argumentative, much-debated topic in South Africa, which currently does not have a universally applied national health service, such as is available to all citizens in various overseas countries. In this country, one currently have two choices related to obtaining healthcare services and treatments.
Two Fundamental Options
Your personal circumstances may compel you to rely on state-supplied services, available free of charge or for a nominal fee at government hospitals and clinics. Alternatively, you may belong to a private medical aid scheme, which provides you with financial assistance or cover in the event that you require associated curative assistance, for which you would otherwise have to pay out of your own pocket.
In the first instance, people who rely on state resources for their health care typically have a modest income or none at all. In the latter case, you will be required to pay a monthly membership contribution, which is set for each calendar year, according to the specific scheme’s plan or option which you selected.
Given a choice, if money and affordability were not relevant issues, it is most likely that essentially all South Africans would opt for medical aid membership, rather than rely on over-stretched state health resources, which have been unable to cope optimally with the vast numbers of patients seeking treatment at their facilities.
What Is It?
Despite all the recent focus on private health care versus a government (and tax) funded system, some individuals still do not quite understand exactly what medical aid is, and how it is designed to function.
Insurance Products
In a nutshell, medical aid is a short-term healthcare insurance product, much like the type of insurance that people sign up for to protect their valuable assets, motor vehicles, property, and contents of their homes or businesses.
In the event of a claim that arises from an unforeseen incident in which the insured person suffers loss or damage to their insured items, the insurer pays out the value of, or replaces that which was affected. Excluding the replacement or repair values, the extent of the insurance cover depends on the plan selected by the insured or policy holder. Different plans require regular payment of different monthly premiums.
Similarly, medical aid schemes may partially or fully pay suppliers and service providers when the insured party (member) lodges a claim for doctors’ consultations, medicines, treatments, therapies, surgery, and major medical emergencies.
Membership (insurance cover), provided by the scheme, also requires that the member’s monthly contributions (relating to insurance premiums) be up to date. In order to make membership more accessible, schemes offer a variety of plans, each with its own variety and extent of cover, which generally commensurate with the stipulated amount of the monthly contribution.
Choose the Right Scheme
It is important that you choose a reputable medical aid scheme and plan that is right for you and your own personal circumstances. We advise that you ascertain the scheme’s prompt claims payment history; solvency record; credit rating; transparent, easy-to-understand management tools and terms and conditions; and selection of benefit options.
Your health and wellbeing is by far your most precious asset. Your medical aid scheme and seven plans provided by Medshield are designed to ensure that you make the best, most affordable choice for your individual healthcare needs.