Medical aids normally release their new rates and plan amendments for 2016 in November. It is, therefore, essential for you to read your Medical Aid’s 2016 brochure carefully and if you do not understand any of the changes to contact us straight away.
Here are some factors which you should consider when reviewing your medical aid:
- Are you generally satisfied with your current medical aid?
- Is your medical aid affordable and is it covering all your medical needs?
- If you were admitted to hospital, would the option that you have chosen cover your entire hospital bill?
When medical aids state that your plan has unlimited in-hospital cover, what is meant is that the cover is unlimited at medical aid rates. There may be sub-limits applied to certain procedures in hospital. Alarmingly, anaesthetists and surgeons regularly charge between 300% and 700% of the medical aid tariff. Some plans may provide additional cover for this but you need to be certain. Once again, we can advise you on this very important issue.
In recent cases, a neuro-surgeon charged R64 813 to remove a brain tumour. The medical aid tariff for the procedure was R24 528.60. Therefore there was a shortfall of some R40 000 for the member to pay.
This is why it is so important to know exactly what your chosen Medical Aid plan actually provides in terms of cover.