Six use­ful tips when switch­ing med­i­cal aids

En­sure ben­e­fits of the new scheme are a good match for you

Weekend Witness - - Leisure -

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.

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