As many as 85% of South African citizens don’t have a personal medical aid. Everyone should, at least, have a hospital plan but something that’s more comprehensive is likely to save money in the long run. This kind of coverage is the one area where money should be put aside, but there are ways to save on health schemes too.
Selecting coverage options should feature some thought towards the conditions covered by prescribed minimum benefits. Many choose a higher grade of insurance because they are unaware of this financial treasure. PMB are available to every SA citizen with health cover, regardless of their benefits or the company they use.
They are the minimum benefits medical aids are legally required to give their members. Absolutely all providers have to pay for these set conditions, even for those who have no funds available in their scheme savings. There are 270 conditions included in PMB, including some mental health conditions, heart attack, stroke, fractured hip and some kinds of cancer.
Certain chronic illnesses are also included in PMB and include high blood pressure, asthma and diabetes. When selecting a scheme, PMB matters because people who have conditions relevant to PMB don’t need to specifically obtain a higher benefit level to get coverage for those problems. Many people spend a fortune on high benefit options specifically to obtain a better level of coverage for a condition that is paid for under PMB anyway.
Conditions covered by PMB will factor in when deciding on the level of benefits one wants. It’s also important to factor in how solvent the provider is, as it’s a relevant facet in today’s dwindling economic climate. It may also be necessary to spring clean one’s annual credit report before application by paying debts, closing credit cards and incorporating remaining debt under a single lender.
Providers without good solvency have the potential to go under at times when health care could be critical. The site for global credit ratings gives accreditation and information to providers that have performed well financially in the past. Generally, larger providers will tend to have this kind of accreditation and positive performance review but some small ones may also provide surprises.
How fast the provider pays, their turn around time and whether or not they give monthly statements are important to consider. There are excellent personal medical aid providers in SA that pay within 24 hours of invoicing, are reliable about what they cover and don’t try to expand exclusions. Unfortunately, there are also poor SA providers who leave their members without payment for months, make constant attempts to redefine their exclusions and have terrible turn around times.