Six useful tips when switching medical aids
Ensure benefits of the new scheme are a good match for you
NEW year, new resolutions and a time to re-evaluate your medical scheme and medical aid options.
Before you make the decision to switch, make sure you do your homework. Fedhealth provides six useful guidelines to look out for when making a decision: Tip 1: Timing! It is better to change schemes at the beginning of the year or the end of the year as many schemes tend to pro rate benefits so they take into account that you weren’t a contributing member for the full 12 months of the year.
The best option is to change when you can enjoy the full 12-month membership benefit. Tip 2: Check if there is a preferred network of providers Many people may prefer to use their own doctor, but if that doctor is not on the scheme’s provider network, they may have to change doctors.
There are definite savings to be made by using a doctor on the network so it is worth thinking about carefully.
If you use a doctor outside of the scheme’s network you will be forced to pay co-payments and deductibles from your own pocket. Tip 3: Are my varsity dependents still covered? If you change schemes, you might suddenly find yourself having to pay adult rates for your child who is studying at university. Some schemes allow you to keep your student children registered as dependents up to the age of 25 while others cut-off at 21 or 23. Tip 4: Are your benefits the same or better? Never assume that the benefits under the new scheme may be the same as your current medical aid.
There are often subtle differences members may miss.
Check for example how they manage the savings portion of your option. Are you paying upfront for what you have not used yet or only when you use it?
Choose responsibly and ensure the benefits of the new scheme are a good match for the health conditions you and your family experience or are likely to experience to the best of your knowledge. Tip 5: Watch for non-disclosure of material information Non-disclosure in the medical aid environment could be serious.
If there are skeletons in your health closet you need to be careful of switching and be warned that non-disclosure can lead to your membership being suspended or cancelled.
“Many consumers do extensive online research and seek peer-to-peer recommendations before narrowing their choice down to two or three options. It pays to do the legwork.”
Tip 6: Be aware of waiting periods Medical aids are able to apply waiting periods, where you won’t be covered for a certain period of time after you join their scheme depending on your health and previous medical aid cover.
If you’re joining with a pre-existing condition, remember that you won’t be covered for up to 12 months as soon as you become a member, so you’ll need to set aside money for any related costs during this time.
Jeremy Yatt, principal officer of Fedhealth said: “Many consumers do extensive online research and seek peer-topeer recommendations before narrowing their choice down to two or three options. “It pays to do the legwork.”
— Business Editor.