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Things to Consider When Reviewing Medical Aids

Do you know the things you need to consider when planning on upgrading, downgrading or switching your medical aid plan?

With the year coming to an end, you might be getting your financial matters in order before you go on holiday and before the pressures of the New Year hit. It is also the time when your medical aid asks you to update plans and schemes. Our friend Hippo suggests you consider the following before deciding on your medical aid cover for 2017.

  1. Underwriting – Based on how long you have had medical aid cover and your state of health, schemes reserve the right to impose either a three-month general waiting period or a 12-month pre-existing condition exclusion, or both, and/or a late joiner penalty. It’s important to remember that if you had previous cover and have less than a 90-day gap between your old and new scheme, then the Medical Aid is obliged to offer you cover for a basic set of treatments and chronic conditions known as Prescribed Minimum Benefits (PMBs). This cover also applies during waiting periods.
  2. Positive savings account balance – If you switch from a medical aid option that has a savings account component with a positive savings balance, this money can either be paid out to you or transferred to a new medical aid savings account.
  3. Negative savings balance – Medical aids usually provide for savings to be paid into your account in advance, pro-rated to the start date of cover. Should you utilise the full advanced savings and switch plans prior to the end of the benefit year, the overused savings will be refundable to the scheme.
  4. Pro-rated benefits – Medical schemes pro-rate benefits according to your membership start date in a benefit year. A benefit year runs from 1 January to 31 December.
  5. Notice period – Your medical aid requires at least one month’s notice if you plan on cancelling your cover. People can now compare different medical aid products from a range of South African providers by visiting certain free-to-use websites that save you the time and hassle of shopping around for the best deals.

Source: Hippo

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