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Medical schemes


Medical schemes are individual or group plans that act as health care insurance in South Africa. There is a broad range of products available to provide medical aid from an equally broad range of companies. Some medical schemes are more geared to providing health cover for government and private sector employees, some target businesses with group plans and others are more oriented towards the individual. Health care costs have increased greatly in South Africa over the past two decades and making sure that you can still afford the medical scheme you are enrolled in may mean re-evaluating your needs and budget each year.

An important thing to look for when trying to select from one plan from all the medical schemes is whether or not it will provide adequate coverage for your potential risk of health problems. Younger adults have different potential health risks than more senior adults. Also, a good medical scheme will have allowances and emphasis on providing benefits for preventative health care. While having a comprehensive medical scheme that can cover treatment for chronic disease, dread disease and surgeries is great – it is better to have a plan that recognizes that preventative care saves everyone money and encourages the use of the benefits to prevent illness, not just react to it..

More and more medical schemes providers are becoming less restrictive about members ability to move between plans. Some allow you to downgrade your plan at will, which can be an immense help if your income changes. Unfortunately, upgrading a plan or signing onto a new one is still restricted to set enrolment periods that may only occur once or twice a year. Also, many medical schemes use two different payment approaches. The first and standard approach is a monthly payment towards the plan, much like a premium rate on other types of insurance. The second is the use of a health savings account. These accounts allow members to save money towards future health expenses so they are not caught unprepared when they have to pay the excess on the policy.

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