Medical Aid Benefits vs Premiums: Where Are You Going Wrong?

    October 18, 2016

    Access to health services is a fundamental human right in South Africa. And yet the reality is that the cost of quality healthcare is increasing – which poses a problem for many people. So it is important to have platforms to assist you when choosing the best plan for your needs. They must put you in contact with the right people. Figuring out medical aid benefits vs premiums is the key to choosing the right plan.

    We spoke to Derek Wilson, Head of, South Africa’s leading insurance and financial comparison website. He says that substantial financial and health insecurity comes from not having the best Medical Aid benefits vs. premiums available. That might put your health and wellbeing at risk.

    Medical Aid Benefits vs Premiums – Different Strokes

    “Individuals with chronic health problems require frequent medical consultations. They could find themselves paying lower monthly premiums at the risk of running out of Medical Aid savings before the year ends. That means they have too little insurance,” he said. “In other cases, people pay excessive monthly premiums but never use the benefits – which means they have too much insurance.”

    Wilson suggests that Medical Aid members consider managing and monitoring their spend sensibly, so as to evaluate which options and benefits work best for their needs and those which do not.

    Medical Aid Benefits vs Premiums – Remember These Points

    Things to remember if you are considering reviewing and switching your Medical Aid cover for 2017:

    • 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 twelve-month pre-existing condition exclusion, or both and a late joiner penalty. It’s important to remember that if you had the previous cover and had less than a 90-day gap between your old and new scheme, then the Medical Aid must 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.
    • 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.
    • Negative savings balance: Medical Aids usually provide for savings to be paid into members’ accounts in advance, pro-rated to the start date of cover. Should a member utilise the full advanced savings and switch plans before the end of the benefit year, the overused savings will be refundable to the scheme.
    • 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.
    • Notice period: Your Medical Aid requires at least one month’s notice if you plan on cancelling your Medical Aid cover.



    People can now compare different Medical Aid products from a range of South African providers by visiting Hippo is free to use and saves consumers the time and hassle of shopping around for the best deal. That’s because the website instantly retrieves real-time quotes from the different providers using the latest Internet technology.

    To get a FREE hospital plan quote just complete and send the form on this page

    All info was correct at time of publishing