9 Questions You Should Ask Yourself When Choosing A Medical Aid

These are the NB questions you should be asking (PLUS, you could win R5 000 just for having your say).


This post is sponsored by 1Life Insurance |

Yes, it’s that time of year again — and no we’re not referring to the Festive Season madness. It’s the time of year when you need to reflect on your health and start thinking about your medical scheme options for 2019. Whether you are considering another option or planning to switch schemes entirely, these are the questions you need to ask:

1. What is the premium increase for the year ahead?

You should receive a letter from your current scheme explaining the increases. Can’t afford the new premiums? Consider downgrading your plan, for example from comprehensive to hospital cover.

2. Do I need chronic medication?

All medical schemes have to offer you 54 prescribed minimum benefits (PMBs), which include 27 chronic conditions. If you sign up for a medical scheme’s chronic plan, your medication will be paid out of the scheme’s risk pool and not your day-to-day savings.

3. What about co-payments for surgery?

Do your homework — you need to take a look at your scheme’s T&C’s around the required co-payments for surgeries and then it’s worth comparing your scheme with all the different options offered by your medical aid.

4. What does my ‘hospital cover’ actually cover?

You need to investigate what your scheme’s hospital and special cover entails. It’s worth comparing it against other medical scheme offerings to see how yours measures up.

5. What is the rate of cover for specialists and doctors?

When it comes to your health, it’s really important to know if your scheme’s rates for medical professionals have increased or decreased. For example, you might find that this year you enjoyed cover that reimbursed specialists at a rate of 300%, but this may drop to 200% in the year ahead, which means you will now face a co-payment.

6. What is my cover for day-to-day expenses?

Consider the day-to-day expenses you racked up this year and make sure you will have sufficient cover for the year ahead.

7. Does my scheme have a preferred doctor network?

Agreeing to use a service provider network that has been named by the scheme can reduce your medical scheme contribution by 15 to 35%. However, if you are considering this, research the accessibility of the preferred doctor network in relation to where you live and work.

8. Have your requirements changed?

You might be getting married or starting a family, in which case you will want to take a very careful look at maternity benefits on different options of your scheme or the benefits for children.

9. What’s the state of my health?

When last did you visit your GP for a general health check? It’s really important to determine how well you’re doing health-wise, which is why 1Life have come up with this quick wellness survey so that you can make your health a priority in 2019 (PLUS, you could win R5 000 just for answering a few questions!):

Create your own user feedback survey

TERMS & CONDITIONS: *This survey is owned by 1Life Insurance Limited. Winners will be chosen by the advertiser and no correspondence will be entered into. Prizes are not transferable. If email addresses or contact numbers are provided, you may receive promotional information from the advertiser. Winners will be notified by telephone or email. View the full terms and conditions of 1Life’s ‘Honey, Listen’ competition before entering.

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