Plan ahead for health care

>>→ As season to change opens, medical aid, gap cover become a no-brainer.

- Dawn Ridler

HEALTH. Understanding your medical costs today can buy you flexibility tomorrow.

(Picture: AdobeStock)

It's that time of the year when you can change the plan you're on with your medical aid.

Just a quick heads up: changing your medical aid is not for the fainthearted, and frankly, you have to be mighty miffed at them to do that. You could end up with general and condition-specific exclusions that will leave you financially vulnerable.

Medical aids in South Africa are built on a core “hospital benefit” product, in or out of network, and the out-of-hospital and daily benefits are built around it, usually with limits, becoming ever more expensive.

Don't confuse this with the short-term product that pays per event, often, confusingly, called a hospital plan. With a few exceptions (like dialysis), the potentially bankrupting expenses come from hospital events.

There are some safeguards in place. First, you are protected by prescribed minimum benefits that medical aids have to provide “free”.

These include any emergency medical condition, a limited set of 271 medical conditions (defined in the Diagnosis Treatment Pairs), and 26 chronic conditions (defined in the Chronic Disease List).