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What is medical aid?

Medical aid is a form of insurance taken out by the individual, whereby they make a monthly contribution to a medical aid scheme, which then pays the medical costs of the person to the medical practitioner, specialist or hospital. There are various medical aid options available to suit your requirements, and your pocket.

A good medical aid in South Africa is essential for the health and well being of you and your family, and is probably one of the most important forms of insurance you can take out. It gives you peace of mind to know that you will have access to higher quality care and medication.

There are some cheaper medical aid schemes available for those that cannot afford the full comprehensive medical aid options. This covers hospital admittance in private hospitals and clinics where the medical care is more superior to that of state hospitals, especially when it comes to nursing and post-operative care and medication.

South African Medical Aid Schemes are currently totaling close to 160 with about 7 million beneficiaries. As reported by the Council for Medical Schemes in 2006, there is an annual contribution to medical schemes of around R35 billion, taking into account that there is a population of more than 47 million people. At this stage only 15 % of SA citizens belong to a medical aid scheme.

There are two main types of medical aid schemes. Some are private and not open to the public. An open medical aid scheme is available to the general public; i.e. anybody can join and become a member, provided that they can afford the monthly payments. Closed medical aid schemes are for employees of companies, unions and associations and are not open to the general public.

The question is how will you know which medical aid or hospital plan to choose to suite your needs?

“Choosing the right medical health insurance for you and your family is a crucial decision. An unwise or inappropriate choice sometimes only becomes apparent during times of dire need – poor health, sickness or medical emergency – obviously not the time you need to find out that you have insufficient coverage.

With an ever increasing selection of medical health insurance schemes available, and options within those schemes, it is difficult to pick the one that is most suited to your precise needs. The conveniently packaged or ‘one size fits all’ options can sometimes seem to offer a cheaper alternative, however you need to be aware of various factors when short-listing and making your final decision.

Before you start you need to determine your needs, both short and long term. What you need and what you can afford must be as close as possible, so get clued up, do your homework and scrutinize who will give you the best option for your money”.

Below is a list of some of the medical aid schemes in South Africa which we reviewed to decide upon or top scheme:

(“Be sure to continue reading to find out about or #1 rated medical aid. You can also get a quote at the bottom of this page!”)

Increased competition between medical aid providers and health insurance companies has contributed to lower prices for medical aid cover and to health insurance becoming more accessible in South Africa. This is great news for consumers, but further savings can be made by choosing medical aid cover that matches your needs.

A hospital plan might be enough cover for you if you are young and don’t suffer from any chronic diseases like diabetes. For older people a hospital plan might not provide sufficient medical cover as they are more susceptible to chronic diseases. Typically medical aid plans range from hospital plans for the young and healthy to comprehensive cover for older people.

This is why it is important to make the right choice.

Why we recommend Momentum Health?

Momentum Health is a comprehensive medical scheme, which covers the whole spectrum of medical expenses. “We strive to offer members good value for money by combining flexibility with comprehensive cover – because it is important to match your family’s healthcare needs”.

Momentum Health is administered by Momentum Medical Scheme Administrators, the fourth largest administrator in South Africa with almost 10% of the market share. Momentum Health goes hand in hand with Multiply, Momentum’s wellness program. Multiply provides the tools, information and incentives for members to adopt a healthy lifestyle.

Momentum Health offers six options within the following three delivery models:

Primary care options

The Base and Access Options offer primary care benefits to members who need affordable access to entry-level cover. They are based on a managed care delivery model, which means that Momentum Health has negotiated set rates with various hospitals and has capitation arrangements with specific providers for chronic benefits and certain day-to-day benefits (such as medicine, GP visits, conservative dentistry, basic radiology and basic pathology).

New generation options

The Custom, Incentive and Extender Options offer benefits based on a fee-for-service delivery model, where members can choose their healthcare providers for hospitalisation, chronic and day-to-day benefits according to their specific healthcare needs. This means that members are empowered to control their healthcare expenses, and can receive a direct discount in their monthly contribution, depending on which provider they choose.

Traditional options

The Summit Option is a traditional option that offers in- and out-of-hospital benefits payable from the risk benefit of the Scheme. It is based on a fee-for-service delivery model and is ideal for members who need unlimited private hospitalization, comprehensive chronic benefits and extensive day-to-day cover (certain sub-limits apply).

Added benefits to members

Medical Schemes should not only support their members in times of illness, but should actively assist them in preventing illness and detecting it as early as possible. Momentum Health has partnered with a Managed Care organization to offer revolutionary benefits to their members.

The following complementary products are available to Momentum Health members.

Health Saver is a Savings vehicle offered by Momentum to provide members with flexible day-to-day cover.

Health Waiver is a Momentum Insurance product that waives the medical Scheme contributions for you and your family following a life-changing event, such as death, functional impairment or critical illness.

Health Funder is a Momentum Investment product that allows you to provide for post-retirement healthcare needs.

Expacare is an international medical insurance product for individuals who are out of the country for extended periods of time.

With this information provided we trust that you will make the wise choice in choosing Momentum Health as your medical aid service provider. However whatever your choice may be, we wish you all the best in health for 2010.