8 Key Factors When Choosing a Medical Aid

8/16/2019 8 Key Factors When Choosing a Medical Aid

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8 Key Factors when choosing a Medical Aid

5 December 2015 By Alan Straton Add Your Comment

We all shop around for good value !hether "t comes to buy"ng a car# grocer"es# cloth"ng orsometh"ng as "mportant as a ne! home$ But ho! much thought do !e g"ve to choos"ng amed"cal scheme that can truly fulf"ll our needs%

&Your med"cal scheme "s an "mportant "nvestment "n your and your loved ones' health and!ellbe"ng# and "t "s therefore v"tal to ensure that your scheme "s not only offer"ng youaffordable cover# but benef"t r"chness as !ell#( says Dr )ac*ues Snyman# Act"ng C+, ofAg"l"ty -lobal .ealth Solut"ons /Afr"ca Ag"l"ty Afr"ca# a med"cal scheme adm"n"strator andmanaged care prov"der to the South Afr"can healthcare mar3et$

When cons"der"ng a healthcare partner# Dr Snyman recommends that "nd"v"duals and fam"l"esal"3e bear the follo!"ng 3ey factors "n m"nd4

1. Understand what you are paying for

here are 67 med"cal schemes "n South Afr"ca$ he"r benef"ts vary tremendously# as do the"rcosts$ Choos"ng the best one for you and your loved ones can therefore be a daunt"ng tas3$ 8t"s !orth see3"ng adv"ce from an ob9ect"ve healthcare "ntermed"ary or bro3er !ho can offeryou a global v"e! of !hat "s on offer "n the "ndustry$

.o!ever# al!ays ma3e sure that your bro3er "s accred"ted !"th the Counc"l for :ed"calSchemes$

2. Do your homework and read the literature

;ead the scheme l"terature carefully# part"cularly the f"ne pr"nt$ h"s !"ll ma3e sure you arenot left red:Bs# !h"ch "nclude 25 chron"c d"seases def"ned "n theChron"c D"sease ?"st# and all emergency l"fe threaten"ng cond"t"ons$

&a3e t"me to understand the >:Bs as th"s !"ll g"ve you a clear understand"ng of !hat falls!"th"n the"r amb"t# and !hat does not$ >:Bs are not a blan3 che*ue$ You are notautomat"cally covered "n full "f you choose to use a prov"der for your >:B treatment that "snot contracted to your scheme$ ,nly "n the case of an emergency can you use any prov"der#and then only unt"l you can be moved to a scheme preferred prov"der#( Dr Snyman notes$

#. $he costs

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W"th med"cal schemes you get !hat you pay for$ hose !ho are pr"ce


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&:y adv"ce to healthcare consumers !ould be to !e"gh up the pros and cons of a med"calsav"ngs account versus the secur"ty of allocated benef"ts "n a trad"t"onal opt"on#( says DrSnyman$

&W"th the healthcare mar3et evolv"ng every year# "t "s "mportant to reloo3 at your healthcare

opt"on "n relat"on to your needs at the end of each year and be sure that the cover you aregett"ng "s the cover you need#( Dr Snyman concludes$

;ead more4 http4mype$co$ane!6

Fully-Insured vs. Sel-Insured (Sel-Funded) Health lans

!hristina "erhar Fe#ruary $% &' at &*'' "

+'

inShare

+mployers sett"ng up a health plan need cons"der both the type of health plan to offer# and

ho! the health plan !"ll be structured$ here are t!o common !ays to structure a group

health "nsurance plan4 fully "nsured and self


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So# !hatHs the d"fference bet!een a fully<

"nsured and self


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to cover cla"ms that s"gn"f"cantly e@ceed the e@pected level for the group of covered

persons aggregate coverage$

Variations of Self-Insured (Self-Funded) Health Plans

8n add"t"on to the types of selflan .;>$ :any

employers usually smaller and m"d

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8 Key Factors When Choosing a Medical Aid