One of the challenges of living in South Africa is that if we want access to high-quality medical cover, we generally need to pay for it ourselves.
Medical care is expensive, and it’s highly complex. Even for simple hospitalisations or scans, there are several service providers in the healthcare chain, and they all need their compensation. We’re also finding, more than ever, that early detection and early treatment are highly beneficial to most diagnoses. Having quick and appropriate access could make all the difference to your recovery.
With that in mind, here are a few of our SFP quick questions for your medical cover.
Before assessing the cover, you need to understand what type of plan you would like and can best afford. Towards the end of the year, most providers allow their clients to upgrade their plans, and generally, this is the only time an upgrade is allowed.
There are three prominent types of plans:
- Hospital plans – with a sub-selection of provider networks or free choice
- General cover plans – provide you with in-hospital and some out-of-hospital benefits.
- Comprehensive plans – deliver in-hospital and extensive out-of-hospital benefits
With this in mind, the first quick question you need to fire at your plan choice is…
Did I consult an independent financial planner?
With around 20 product providers, each with several plan choices, you have over a hundred options. Consulting with an independent financial planner is crucial to ensuring that you choose the best product provider and plan for you and your family.
An SFP independent adviser will also help you with the second quick question…
Can I afford this? Full medical cover can be expensive, and if you can’t afford it, you can’t afford it. If you have a monthly income of R10 000 (and rely on most of that money for expenses), you may not be able to spend R7000 on medical cover.
This needs to fit in with your financial plan and is a foundational part of your portfolio.
What are the exclusions that would affect me?
Immediate exclusions could limit you from claiming for certain conditions for a limited period (not normally more than one year). Be aware of these possible exclusions before signing on the dotted line. Also, if you are not coming straight from another scheme, and this is the first time you join, you may not be able to claim for day-to-day expenses in the first three months.
What are the overall hospital limits?
If a scheme limits its hospital payouts to R700 000 per family per year, what would happen if you were all in the same accident? Your SFP financial planner can help you assess the risk verse the cost and help you make the best choice for your personal situation.
In some cases, you might be able to get a better deal across your whole portfolio if you align your medical cover provider with your other risk providers. Again, your financial advisor will know to look out for this and advise you accordingly.
Some medical aid schemes are aligned with insurance companies and provide medical aid products, car insurance, life insurance and investment products. Legally, medical aids are not allowed to reduce their monthly contributions through product bundling or integration.
However, certain companies discount life insurance products when members’ health benefits are with the same company and achieve certain health outcomes.