Assessing medical aid needs – talking to health care provider.

A guide to your first medical aid

When choosing a medical aid plan for the first time, you should spend a good deal of time assessing your needs – now and for the short-term future. Consider your health situation, budget, and whether you're planning to start a family. Once you've realised what your medical aid requirements are, you'll be a lot better equipped to comparing the different medical aid options, and managing it over time.

Read our guide to your first medical aid

Breast reduction surgery – why won’t medical aids cover?

Macromastia is a medical condition that affects women both physically and mentally. Yet most of the time, medical aids still consider breast reduction for this condition as cosmetic surgery. However, some medical aids will consider the medical motivation from specialists but there are no standard protocols to guide a medical aid's decision.

Find out more about why medical aids won't cover breast reduction surgery
Female measuring chest
Family choosing a medical aid plan

Does choosing a medical aid have to be so complex?

There are currently twenty open medical aid schemes in South Africa all offering a plethora of products in a variety of forms and pricing. This makes just choosing one a daunting and time-consuming task. It's no wonder that so many people are most likely not on the right medical aid according to their needs and budget. Not only do comparison websites provide medical aid quotes, but they offer easily accessible and objective information that consumers can understand.

Read more about why choosing a medical aid is so complex

Mammograms and pap smear - do medical aids cover?

With the risk of cancer in South Africa increasing at an alarming rate, regular check-
ups are critical to aid in the prevention and early detection of disease. Medical aids
try to encourage members to go for preventative screening from blood pressure
tests to bone density scans and pap smears to mammograms, of which most plans
will pay for without it coming out of your savings account.

Get more information on mammograms and pap smears
Female gynecologist looking at a mammogram checking for breast cancer at a hospital.
Types of young married couples considering medical aid

Medical aid for young married couples

There are primarily three types of young married couples, the budget conscious, the active, and the adventurous. At the same time there many more medical aid schemes and products on offer. When choosing a medical aid, every young couple should assess their needs upfront so that they end up with the best medical aid plan suitable.

Read more about medical aid for young married couples

Medical aid advice for singles in their thirties

The thirties are that stage of life when you're likely to have established yourself in a steady job or career. You've probably also made some big purchases, such as, a house and car leaving very little in the kitty to save for a rainy day. Additionally, your health needs are probably not the same as they were in your twenties. This may be a good time to reassess your medical aid plan to see how it matches up, and to calculate whether it offers you the best value for money.

Medical aid advice for singles in their thirties
Singles enjoying pizza and wine
Lady in hospital bed, doctor holding her hands

What is gap cover?

With so many different types of medical cover on offer, from hospital plans to fully
comprehensive, what is this thing called 'gap cover', and is it even necessary? Actually, gap cover is an important short-term insurance product to understand, because how much you need it or not can depend on the medical aid plan you're currently on. This is key, because gap cover is not a standalone product, but rather one that complements an existing plan. We'll walk you through how it works and what you should consider when making your decision.

Find out more about gap cover

Medical aid providers: is bigger necessarily better?

As consumers we sometimes tend to think that when it comes to certain products, it’s better to go for the bigger brand names. In some cases and industries, this may be true – where their continuing research and development initiatives or advanced technologies are advantageous to you as a consumer. In the medical aid industry, things are often more complex, with so many providers all offering something slightly different to the next. What is ‘better’ is perhaps less about simply being ‘bigger’ and more about the bigger picture.

Read more about bigger vs smaller medical aid providers
Doctor with stethoscope in hand
Lady holding heart shaped toy

Comprehensive medical aid - is it for you?

In a survey by Stats SA in February 2019, it was found that on average, medical-aid schemes increased their tariffs by 8,3%, slightly higher than the 8,0% average recorded in 2018. In 2020, the upward trend continues, with South Africans seeing average increases as high as 10%.

With the seemingly never-ending rise in their medical aid premiums, consumers are digging deep to see where they can cut costs, and comprehensive medical aid is usually a good place to start.

Find out more about comprehensive medical aid

Medical aid & health insurance options in South Africa

One of the most common questions medical aid providers receive is “What’s the difference between medical aid and medical insurance?” As consumers, we may be forgiven for thinking they’re the same, and in some ways they are. Both offer some form of cover for certain medical situations, but how they are structured and regulated can vary vastly. Why not find out a little more.

More about medical aid & health insurance options in South Africa
Building blocks with medical icons on them
Health insurance concept where specialist has stethoscope against screen illuminating additional options

Which are the best medical aid schemes in 2020?

There are more than 150 'open' medical schemes in South Africa. These are schemes that any member of the public is allowed to join subject to the rules of the scheme. Choosing one requires a certain amount of homework – the most important factors to take into account are your own personal triggers and needs. Thereafter, it's a matter of deciding which one offers the amount of flexibility, value for money, and customer service you're after. This, in effect, is likely the best medical aid scheme for you.

Find out more about the best medical aid schemes

Switching medical aids in 2020

Many people don’t realise it but it’s important to reassess your medical aid scheme every year. Schemes themselves will revise their benefits annually, so members should do the same to understand whether they’re receiving the optimum value based on their individual needs. When evaluating which medical aid suits you best, some of the key aspects to consider is figuring out which benefits you’re likely to make the most of, and calculating what your out-of-pocket spend is. Before making the switch, it’s important to investigate the practical as well as financial consequences of changing from one plan to another.

Read more about switching medical aids
Person jumping from one rock 2019 to another rock 2020
Doctor with stethoscope around neck holding piggy bank in left hand

The most cost effective medical aid in 2020

In 2020, savvy consumers are looking to cut costs, scale down, and consume less. From clothes to cars, we're always on the hunt for the best value for money, and it should be no different with our medical aid. But making medical aid decisions is less fun and more cumbersome than choosing a SUV and takes a little discipline. Just as your transportation needs may change as you grow, so do your medical needs. Reviewing your medical aid plan annually is really worth your time and effort, as long as you begin by understanding what your specific needs are in your current situation.

Read more about the most cost effective medical aid for you

What to look for when comparing medical aids

With the vast array of medical aid schemes available in South Africa along with their own plethora of plans on offer, it’s not surprising consumers are confused. Naturally, you want to begin by comparing the ones that fit your needs to find which of those offer the best value for money. But comparing medical aids is never easy – because they’re not all apples. We’ll point out ten important considerations to help you decide which one to choose.

Click here for more on comparing medial aids
Syringe made of medical icons
Stethoscope on pile of books

Glossary of medical aid terms

Choosing a medical aid plan is difficult enough on its own, but the industry jargon that comes along with it certainly doesn't make it any easier. Even the more common terms that are bandied about may seem simple enough to understand – but what do they really mean? With a little more basic knowledge in your hands, making your final decision will feel less like guesswork, leaving you better equipped to making the right choices.

Click here for the medical aid glossary