What To Look For In A Medical Aid
The Medical Aid
With more competition and less monopolisation providers are being
forced to offer customers more choice in product and easier access
to private health care.
There are two types of people in the
world of medical aid – new members and existing members, says
Gerhard van Emmenis, Chief Operations Officers at Bonitas Medical
says both groups are price-centric and both expect high value
returns for their monthly contribution, not surprising when one
considers the economic hardships consumers are facing in South
either group, there is one common question and that is 'how does one
go about choosing a medical aid that truly addresses my individual
and specific needs?'"
Medical aid providers must start the relationship with a
comprehensive, in person presentation to management, unions and
employees that leaves the new member with a fair understanding of
the benefits being made available to him.
good medical aid provider will be able to offer a concise range of
options with a solution to meet the specific and varying needs of
members in South Africa," he says.
always prudent that members note that, while most medical aid
providers build their options as holistically as possible, each
option comes with pro’s and con’s, all of which should also be
troubled times it’s always reassuring to know that the chosen
medical aid is solvent enough to cover its members claims and future
Council of Medical Schemes requires that medical aid providers keep
a stockpile of at least 25% solvency levels, which equates to the
provider being able to cover a minimum of three months worth of
claims for each of its members without receiving any contributions.
Some providers keep strictly to this requirement while others offer
over 45%, which means long term coverage in times of financial
second indication that a medical aid provider is financially stable
would how the company performed financially over the last two years.
can visit the Global Credit Rating web site (www.globalratings.net)
where schemes are accredited and rated by unbiased professionals."
Emmenis says there are a few questions members should ask:
quickly will my bill be paid?
What kind of turnaround time can I expect on queries?
Will I receive a monthly statement that will highlight where I’ve
been, who’s been paid and, in cases where bills haven’t been paid
will I be told why?
no one place members can go for this kind of information and it is
generally past experiences or referrals that play a role here," he
could also ask their local GP’s as they will be able to tell you
about their experiences with medical aid providers across the
Emmenis says consumers should consider that many providers promise
low contributions in order to grow market share.
“The sometimes crippling surprise follows when consumers are hit
with exorbitant increases. Consumers should take a look at the
provider’s increases over a minimum of three years (detailed
information can be found at:
Lastly, a good question to ask is whether your provider can manage
the costs associated with conditions like diabetes, asthma, cancer
or even HIV.
the provider is cost conscientious, have investigated the most
reasonable solutions and always keep the long term care of its
members at the top of mind, they’re already leading the pack.
a world where medical aid is no longer viewed as a 'have to have',
it is of utmost import that the consumer be able to see exactly what
he's getting in return for his buck from the start," he concludes.
the more transparent the provider and its range of offerings, the
less chance that members will face upset in the future."
Source: ITInews – Insurance
Times and Investments Online