Take the burn out of your medical scheme

You can get your money’s worth and have peace of mind with healthcare needs.

The key is to understand the product and benefits offered and staying on top of the latest regulation, medical scheme rules and new industry information.

The right medical scheme

Medical scheme premiums have become one of our biggest monthly expenses, so it’s important to ensure you continue to have access (and cover) to high quality healthcare that fits your needs.

Familiarise yourself with the other options available and compare your health cover portfolio with alternatives. Should your financial situation change for whatever reason, you might need to find an option that might be more affordable, with sufficient health cover. This is where your medical scheme specialist plays an important role.

Understand your benefits

If you are a member of a registered medical scheme in South Africa, you get automatic cover for the 270 illnesses and diseases listed as Prescribed Minimum Benefits (PMB). PMB cover applies to the most basic hospital plan.

Be wary of short-term insurance products such as hospital cash back plans. These products aren’t registered medical schemes and don’t give access to PMB cover or the full hospital benefits.

Register your chronic medication and tightly manage your dayto-day savings, with the help of an advisor. Most scheme members would benefit from gap cover.

Karin Haggard-Andrea with Optivest Health Solutions is