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You are young, fit, and healthy. The last thing that you ever need to worry about is having a medical aid scheme for yourself and your family members. This may be the mentality that you have, but the truth of the matter is everyone should have some sort of medical aid scheme in place to help take care of things when emergencies occur. Though you may feel that you are invincible and that you and your family will never get sick or have any sort of accident, though that would be nice if it never occurred, the truth is illnesses and accidents happen every day to even the healthiest individuals. It is for this reason that everyone, no matter what age or level of health, needs to have some sort of pre-existing medical aid scheme such as Bonitas Hospital Plan. Having one of these plans in place will help you to deal with the unexpected medical emergencies or illnesses that can happen.
When you start looking into a medical scheme for yourself and your family, you need to consider what type of cover you need to have. Do you only need to look for medical cover for yourself? Does any member of your family, that you have to get coverage for, have a pre-existing medical condition that needs special attention? Are you on a tight budget so you can only afford a very basic plan that doesn’t have all the extra benefits of expensive plans? Regardless of any pre-existing medical conditions, or your budget, you are sure to find a Bonitas Hospital Plan that will work for you and your family.
With Bonitas, you can choose for a couple of different options, the BonEssential and the BonCap. Both of these plans will provide you with the coverage that you need should you, or your loved ones, require hospitalization due to an unforeseen accident or illness. You will not have to worry about how you will pay for the hospital stay or the treatment with one of these plans in place. Both of these plans cover hospital visits and cover 26 chronic conditions that you are your family members may have or be diagnosed with at some point. Of the two policies, the BonCap is a more elaborate plan that offers the individual more benefits. Some of the additional benefits include coverage related to optometrists, dental services, and pharmaceutical needs in addition to hospital stays.
If you have yet to get yourself some type of medical aid scheme for yourself and your immediate family members than look into one of the Bonitas Hospital plans available and have the peace of mind that comes with knowing when illness or accidents happen you are covered.
GEMS medical aid was established in January 2005 in order to help Government employees to satisfy their healthcare needs. Prior to the founding of GEMS medical aid many government employees were not able to afford any type of medical cover. Those who did have cover found that it was becoming more and more expensive over time and they were not getting value for money. In addition, the government did not have much of an opportunity to participate in the management of the medical scheme which their employees are enrolled with.
GEMS medical aid have a very clear mission statement in that they aim to ‘provide all public service employees with equitable access to affordable and comprehensive healthcare benefits’. They have very strong values including simplicity, flexibility, integrity, value for money and clear communication with members.
With 5 different products, GEMS medical aid has a plan to suit everybody. The plans are named after gemstones : Sapphire, Beryl, Ruby, Emerald and Onyx. The plans offer a range of benefits at different price ranges. In fact, GEMS medical aid claim that when compared to similar plans from other providers that they will come out between 10% and 25% cheaper. The Sapphire plan in particular is designed to be as affordable as possible by providing out of hospital care at private treatment centres and in-hospital care at designated public facilities. Meanwhile the Beryl plan will provide in-hospital care at public or private facilities.
The Beryl and Sapphire plans are the entry level choices offered to GEMS medical aid. Members who are subscribed to these plans are required to access medical care only from designated providers. There area number of service providers who are contracted to GEMS medical aid to provide a number of different services including:
Access Health – Maternity Programme;
Europ Assistance – Emergency Medical Evacuation Dispatch (EMED) contact centre;
Medipost Pharmacy – Chronic Medicine Courier Pharmacy;
Medscheme – Contributions and debt management services; Correspondence services;
Medscheme Health Risk Solutions (MHRS) – Managed care services;
Metropolitan Health – Membership and claims services;
Metropolitan Health Risk management – Clearing house services;
Opticlear – Optometry managed care services;
Pinnacle Health Solutions – Marketing and tele-marketing services;
Prime Cure – HIV/AIDS disease management services, Dental management services; and
Universal Healthcare Services – Chronic medicine management services; Strategic managed care services.
For the most comprehensive cover, members can opt for the top level Onyx plan from GEMS medical aid.
If you are expecting a child then it is only natural that you will start thinking about your baby’s health right from the moment of conception. It is also natural to be concerned about healthcare before, during and after the birth of your baby. These are the kind of healthcare needs you need to consider before signing up to a scheme like Hosmed medical aid or similar. If you know that at some time in the not to distant future you will be looking to start a family then you would be wise to ensure that your medical aid provider actually covers pregnancy and newborn health care.
Before The Birth
Prior to actually giving birth, you will need appropriate prenatal care including obstetrician visits, ultrasound scans and perhaps even prenatal vitamins. You will need to check with your medical aid provider to ensure that you are covered for these treatments as not all schemes will. If we take Hosmed medical aid as an example, members are limited to two ultrasound scans per pregnancy although they will cover all treatments and consultations up to the agreed cover limit. This applies to all three levels of cover offered by Hosmed medical aid, but other schemes may only offer cover on certain plans or may require an additional premium to be paid.
During The Birth
If your medical aid provider covers prenatal care then it is usually the case that they will also cover your hospital expenses and doctor’s fees during the birth itself. It is usually for even caesarean sections to be covered as long as they are not elective. It is important to be aware that you may need to choose a hospital from an approved list provided by your medical aid scheme and if your gynaecologist’s rates are above the usual tariff rates you will be liable to pay the excess.
After The Birth
You will need to register your new baby as an additional member/ dependent on your medical aid program. However, this is a hectic time for your family and the majority of medical aid schemes will cover newborns for up to 30 days following birth. Cover should include any necessary ICU treatments if the child is in difficulty. However, a prolonged hospital stay for the mother may not be covered.
It is fairly easy to add your new baby to your medical aid scheme providing that your name is on their birth certificate. The majority of schemes will offer a family plan for your convenience. In fact, with Hosmed medical aid you only have to pay for your first 3 children, so larger families can enjoy free cover for any additional children that they might have.
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When it comes to getting the best possible coverage at an affordable price from schemes such as Netcare medical aid there are a few important things that you need to keep in mind. The choice can be overwhelming if you do not know what exactly to look for, so we have put together this list of the key points to consider when choosing medical aid.
Look At The Level Of Coverage
Every medical aid program offers slightly different levels of coverage. You may find that one scheme covers pregnancy while another doesn’t. Even between plans in the same scheme there can be large differences in cover. It is important to think about what sort of cover is important to you so that you can make sure it is included in your plan.
Look Into Payment Policies
When it comes to paying for your medical treatment procedures differ between schemes. For example, what Netcare medical aid does may not be what Liberty does. Some schemes will pay providers directly meaning that you only have to pay your agreed deductible or co-pay amount. However, with other schemes you may be expected to pay your own medical bills and then submit a claim to be reimbursed. Depending on your medical aid provider it could take as long as 30 days to receive your refund.
How Much Will It Cost
Perhaps the most important consideration when choosing your medical aid provider is the cost of cover. It is a good idea to work out how much your budget for health care is so that you can immediately eliminate those which are too expensive. It is never wise to sign up for medical aid you cannot afford as your cover will lapse if you are not up to date on payments. Always keep in mind that more expensive is not always better, it could be that you would be paying for services you will never use so make sure you are looking at which plan offers the best value for money.
Have You Considered Your Health
When choosing medical aid you need to take your own health and the health of any family members attached to the plan into consideration. If you have an existing condition then you need to make sure that your medical aid will cover your treatment. Some of the chronic illnesses covered by Netcare medical aid include: Asthma, Bipolar, COPD, Crohn’s Disease, Diabetes, Haemophilia, Parkinson’s Disease and Schizophrenia among others. However, this list will be different with other providers so take care to ensure your condition is on the list.
Does The Scheme Cover Hospital Care?
Not every medical scheme covers hospital care as standard. Often it is added as an additional premium for those requesting it. If you can afford to do so you should definitely opt for a plan which offers hospital care as you will never know when you might require treatment in a hospital or ER. As an example, the Netcare medical aid scheme does include hospital care provided you are admitted to an approved treatment facility within the Netcare group. Hospitalisation must also be pre-authorised under the rules of the Netcare medical aid scheme.
These are the top 5 things to take into consideration when choosing the right medical aid cover for you and your family, but you may have additional needs in which case you must thoroughly examine the terms and conditions of the program before making a commitment.
It is a rather common fact that most of people do not think about their health and the need for medical coverage until the unexpected accident or illness strikes. It is in that moment that we not only have to deal with the stress of having to deal with a medical problem, but we have to find a means to pay for the medical treatment and medications that we will need in order to recover properly. With so many different medical aid schemes available, it can be a daunting task trying to find the right policy that will work for you and your family. You may feel that because of your financial situation that you will not be able to afford to get a quality scheme. The reality of the situation is there are a wide variety of options that you can choose. LA Health medical aid has a variety of plans that offer a broad spectrum of benefits.
With each of the five different benefit options that you can choose from at LA Health, you are sure to find something that can fit into your budget as well as provide the benefits you need. The different plans offered are LA KeyPlus, LA Focus, LA Active, LA Core, and LA Comprehensive. Although each of these policies varies on what specific items they cover, they do cover a number of important medical needs and issues that can arise. Just some of the items that are covered include planned operations, oncology, and emergencies and casualties that require a hospital stay. Additional coverage takes care of the medicines that are required for chronic illnesses or other prescribed medicines.
Along with the cover for hospital stays and medicines, the right medical aid scheme can also offer coverage a number of additional items. This can include trips to your general practitioner, specialists, dentists, physiotherapists, and a host of other medical professionals. If you are planning to become pregnant, this is an additional medical benefit that is covered. The most important thing with LA Health medical aid is the overall health and well-being of those that use their various medical aid benefit plans. The goal is to help you live a life that is not only fulfilling, but one in which you are as healthy as you can be to have a quality life.
Your health and the health of your family is one of the most important things there is, because without it, life can be a struggle. Take care of your health, and those you love, by getting the proper medical aid scheme that will ensure that they are taken care of, in case an illness or emergency strikes that requires medical attention.
There are a number of complex issues that affect medical aid programs and it can be difficult to understand all of the ins and outs. One of the common areas that causes confusion for medical aid members is late joiner penalties. Let’s take a look at Transmed medical aid as an example in order to explain the basics of something that is a feature of the majority of medical aid programs.
What Is A Late Joiner Penalty?
A late joiner penalty is not a one off fee like many people assume, it is a penalty that will be applied to your medical aid payments for the rest of your life. A late joiner penalty is applied when you apply to join a medical aid plan at a certain age. It means that the premiums you pay will be higher than those paid by regular members. The late joiner penalty usually applies to those aged 35 years and over. The penalty is generally between 5% and 7% and is determined by a formula which is outlined in Regulation 13 of the Medical Schemes Act (131 of 1998). The ins and out of the late joiner fee may differ from scheme to scheme, for example with Transmed medical aid the penalty is imposed on applicants over the age of 35 years who have not been a member of a medical scheme since 1 April 2001 without a coverage break exceeding three consecutive months.
Why Do Late Joiner Fees Apply?
If you look at the Transmed medical aid scheme, the members cover a diverse age range from 21 years to 75 years and older. It is pretty logical to consider that the younger members are healthier than the older ones in most cases. The younger members are more likely to be participating in sports and generally leading a healthier life style, which may mean they claim often for sports injuries and preventative benefits. However, older members are more likely to have ongoing health conditions that require regular claims. In short, older members are more demanding than younger members. If a member joins young then by the time they reach an age where they have a greater need for medical care then they will have paid in enough money to cover that additional need. However, if they join at a later stage then they are depending on funds paid in by younger members. If you consider it this way then it is not unreasonable to expect those joining at a later stage to pay a little extra to compensate for the years they have missed!
Often when people think about their medical aid they are often thinking about treatment that they might need in future when they fall ill or sustain an injury, but often medical aid programs also offer preventative benefits to help members to keep healthy. Pharos medical aid provides a wide range of preventative benefits which are designed to help keep members healthy and prevent any serious illness. Let’s take a closer look at the benefits on offer.
Access To Vaccines And Immunisations
One of the main preventative benefits offered by Pharos medical aid is immunisations. Children up to the age of 6 years old who are registered on the ‘our-baby’ program are eligible for all baby and childhood immunisations as per the schedule set out by the Department of Health. In addition to this, any member who is over the age of 60 year old or who is at a higher level of risk because of a chronic condition is eligible for flu and pneumococcal vaccines on an annual basis.
Well Woman Preventative Care
The preventative benefits offered by Pharos medical aid also include some preventative measures that every woman needs to take into consideration. The first of these is cervical cancer screening which is available to all female members of child-bearing age every 3 years, or every 2 years for those at a higher risk. Pap smears are carried out by either a GP or a registered nurse and includes consultation and pathology. All women over the age of 35 years, and those at a particular level of risk, are also eligible for mammograms or breast ultrasounds. Basic screening is offered to those aged 35-39 years and those aged 40-49 years are eligible for screening every 2 years. Those over 50 years and those at risk because of a strong family history of breast cancer can take advantage of yearly screening.
Early Identification Of Serious Conditions
One of the best ways to ensure that you stay healthy is to catch serious conditions as early as possible. Some of the preventative benefits offered by the Pharos medical aid program include:
Prostate Cancer Screening
Colon Cancer Screening
Blood Pressure Monitoring
Cholesterol Testing
Blood Glucose Testing
HIV Antibody Testing
Annual Health Risk Assessment
Maternity & Baby Program
Pharos medical aid also offer the ‘our-baby’ program which offers a range of pregnancy and baby related benefits to members. The our-baby program offers cover for services including antenatal visits, urine tests and ultrasound scans. Members can also take advantage of baby massage classes, nanny training and other benefits.
These are just a fraction of the preventative benefits that are offered to Pharos medical aid members. It is important to take a proactive approach to your health and benefits like these can help you to achieve this. We have used Pharos medical aid as a case study, but many medical aid programs also offer preventative benefits so be sure to use our comparison tool to find the right program to meet your needs.
We live our lives striving to obtain different needs and desires. These typically include a good job, a nice home, and plenty of money, but there is one thing that is far more important than any other is – that is our health. It is of the utmost importance that everyone that resides in South Africa has some type of medical aid scheme not only for themselves but also for every member of their family. Having a medical aid scheme can mean the difference between getting the treatment and medications that you need, and going without them. Medical aid schemes, like Bonitas hospital plan, are critical to have in place when the unexpected emergency occurs and you need to spend time in the hospital.
As you can quite imagine when the time comes that something happens to your health, or the health of a family member, you want to know that they will get the treatment that they require. In many cases if you do not have any type of pre-existing medical aid scheme then you could be left having to pay a large amount of money out of your pocket. If you do not have the money to get the treatment you need, it is quite possible that you can end up going without it. If you take the time and effort to choose a medical aid scheme, such as Bonitas hospital plan, then you can live with the knowledge that you or your loved ones that are covered, will be able to get the treatment that is required.
This plan, offered to you by Bonitas comes in two variations. Although some of the features and benefits are the same within the two plans, there are some differences. The two plans are the BonCap and the BonEssential.
Of the two plans, BonCap is the ideal option for the individual that is on a tight budget but still wants to insure that they are covered. This plan covers a number of basic medical needs, which include hospital stays, pharmaceutical needs, optometrists and dental services. With the basic services included in your medical aid scheme, you will get the preventative treatments that you need that can stave off potential serious conditions to your health or those family members covered under your plan.
The BonEssential plan is designed to cover all of the unexpected incidents that may occur to the young, fit, and healthy individual. It does not have all of the benefits that the BonCap plan offers, as it is set up to cover issues that may arise unexpectedly. If you are not concerned with having coverage for an optometrist or dentist, but want to be covered if you fall ill unexpectedly, this is the ideal coverage as it is affordable and will cover you when problems arise.
If you do not have a medical aid scheme of any kind, consider what your needs are and look into one of the Bonitas Hospital plans.
The health, happiness, and well-being of your loved ones and yourself are generally at the top of most individuals list of priorities. Despite this thought and belief, there are many individuals that forget the importance of getting the correct medical aid scheme. A proper medical aid scheme is critical when it comes to the health of your family. Without a good plan in place, if something is to happen to yourself, or one of your dependents, there is a possibility that proper medical treatment and/or required hospitalisation may not occur. By taking the time to select a medical aid scheme that is right for yourself and your family you will be able to rest easy in the knowledge that you are covered. In the unfortunate event that one of you come down with an unexpected illness, or have an unforeseen accident, you will not have to wonder how you can afford the treatments and medications that you will need.
If you are uninsured and are looking to find a medical aid scheme that will work best for you and your family then consider the different plans available with Sab Medical Aid. They offer different plans that suit a variety of needs and budgets. The plans they offer are Essential Options Benefits, Comprehensive Options Benefits, Premium Table Essential Option and Premium Table Comprehensive Option. Each of these plans were designed to meet the different needs that individuals and their families have when it comes to preventative medical care, diagnosis, treatment, hospitalisation and so much more.
Each of these medical aid schemes offered by Sab Medical Aid offer a wide array of medical benefits at various levels. Just a few of the benefits that will be covered regardless of the scheme that you select include dental services, mental health assistance, ambulance services, optical services, alcoholism and drug dependency treatment. There are a host of other benefits that each of the different plans offer that will guarantee that you and your family will be taken care of regardless of your medical condition.
Do not risk the health and well-being of your family by not taking the time out of your busy schedule to find the perfect medical aid scheme for your family. By determining exactly, what you need by way of treatments in case of emergencies, as well as preventative medical treatments and diagnosis, you will not have to worry about how you will pay for the medical assistance that you may need or require at some point in your life. Do not leave your health and medical treatment to chance. Choose the one of the plans offered by Sab medical Aid and never worry about what you will do in the event of a medical emergency or illness.
Ensuring that your family and yourself are protected and receive the medical care that they may require from time to time can only be achieved if you have signed up for the correct medical aid scheme. The health of yourself and your family is not something that you should ever take for granted. Things happen, whether they be accidents or becoming suddenly ill, and when they do you need to be protected otherwise you may be in a position where you cannot receive the medical treatment that you need. As daunting, a task as finding a medical aid scheme may be there are a number of options available for you and your family. Afrox Medical Aid is a provider of medical aid that will help you ensure that when they need it, your family as the medical coverage that they need.
When it comes to selecting, the proper medical aid scheme for you and your family you need to take into consider your current age, physical condition, and medical condition. Although you may be on a tight budget, it is still extremely important that when selecting your scheme that you get the absolute best plan for your money to truly benefit from it. It is also important then you consider any of the plans offered by Afrox Medical Aid that you get a plan that covers your current condition and any plans you may have that will require medical attention, such as chronic illnesses or a future pregnancy. By getting the appropriate medical aid scheme you can rest easy in the knowledge that when you or one of your dependents become ill, that you will have the medical help ready to help with the treatment and recovery.
Some of the key benefits that are offered by Afrox Medical Aid are as follows. Most importantly, your medical aid scheme is good for the period of a year, from January 1 to December 31. This means that regardless of the day of the week, or the month you will have the help that you or your family needs. Other basic benefits are the 100% coverage of any hospitalisation that takes place throughout the year when you are required to be admitted. It is important to note that this coverage is only in effect when you are admitted into an approved hospital a co-payment is required. You and your dependents will also receive chronic medication benefits, and care for a list of 26 specified chronic conditions.
Do not leave your health or the health of your dependents at risk; look into getting the correct medical aid scheme that you require in the case of illness or accidents. Having coverage in place can make the difference between quality treatment that is covered or costly treatments.
