Should you join just for the re­wards pro­gramme?

BY LIESL PEYPER

Finweek English Edition - - COVER -

ARE THE RE­WARD PRO­GRAMMES OF­FERED BY MED­I­CAL AIDS RE­ALLY WORTH IT? OR SHOULD YOU RATHER OPT FOR A MED­I­CAL AID THAT GIVES COM­PRE­HEN­SIVE COVER FOR MORE SE­RI­OUS AIL­MENTS?

In t his day and age many big com­pa­nies, from re­tail­ers and banks to life in­sur­ers, of­fer re­ward pro­grammes as a means to re­tain clients, or to soften the blow of a grudge pur­chase.

In the med­i­cal aid arena Dis­cov­ery, Lib­erty and Mo­men­tum wield the scep­tre over re­ward pro­grammes – and it’s no co­in­ci­dence that they are also part of big­ger fi­nan­cial ser­vices com­pa­nies that also of­fer other prod­ucts, such as in­sur­ance and in­vest­ment ser­vices.

It is par­tic­u­larly this back­bone that en­ables the three mar­ket lead­ers to of­fer re­ward pro­grammes, as med­i­cal aids are by law not al­lowed to al­lo­cate mem­bers’ pre­mi­ums for any­thing other than the med­i­cal aid-re­lated ex­penses. If you be­long to a re­ward pro­gramme, rest as­sured: your med­i­cal aid membership fee is not used to pay for re­ward pro­grammes. Rykaart, an in­de­pen­dent health­care con­sul­tant at CureMED.

The state of your health, your age, mar­i­tal sta­tus and whether you have chil­dren or not de­ter­mine what type of med­i­cal aid is right for you, he says.

A hos­pi­tal plan may be suit­able for a young per­son in his or her early twen­ties, who has just started work­ing, is rel­a­tively healthy and has a tight bud­get, but a fa­ther with young chil­dren who of­ten need to go to a pae­di­a­tri­cian would prob­a­bly need more cover.

“Peo­ple need to l ook at t heir health­care needs holis­ti­cally and make sure the med­i­cal aid they choose will cover them,” says Rykaart.

“Although a re­wards pro­gramme is a nice to have, you need to ask your­self what your ob­jec­tive is. What benefits or risks need to be ad­dressed? Take the time to ask the se­ri­ous ques­tions on benefits, such as what can­cer cov­er­age is of­fered. Do I have co-pay­ments? Does the med­i­cal aid plan have any ex­clu­sions? Also make sure that you un­der­stand the struc­ture of the plan you choose, and make sure when you claim your costs will in­deed be cov­ered.”

Hos­pi­tals are an­other ex­am­ple. “Read your con­tract care­fully. In some cases med­i­cal scheme mem­bers are un­der the im­pres­sion that they could go to any pri­vate hos­pi­tal of their choice, mean­while they’re only cov­ered if they go to the scheme’s net­work hos­pi­tal part­ner.” In a re­cent med­i­cal aids sur­vey of the South African Cus­tomer Sat­is­fac­tion In­dex (SAcsi), the net­work cov­er­age op­tion was men­tioned as a rea­son for scheme mem­bers’ un­hap­pi­ness. One of the rea­sons could be that con­sumers don’t un­der­stand t he co-pay­ment as­pect of net work schemes, Adré Schreuder, founder of SAcsi, said in a state­ment. A med­i­cal aid with­out a re­ward p r o g r a mme t h a t o f f e r s more com­pre­hen­sive cover for chronic ill­nesses, or dreaded dis­ease may be a bet­ter op­tion in the long run. Do not for­get that your first pri­or­ity is to pro­tect your­self from risk and do not sight of med­i­cal aid benefits.

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