What does medical aid do?

Medical aid covers members’ healthcare costs such as hospitalisation, treatments and medicine. These costs are covered according to the rules of the medical scheme and the member’s medical aid plan type. These rules ensure that members are fairly cared for.

How do medical aid claims work?

Medical aid schemes are actually non-profit organisations, where resources are pooled by a large number contributing individuals who can then access this money when they need to pay for various medical expenses. This money is then used to pay out medical claims made by members.

What are the benefits of having medical aid?

The advantages of belonging to a medical aid: It financially protects you if you suddenly have to pay large, unexpected medical cost. You can look after your family and focus on early treatments as opposed to waiting until someone is really sick.

How quickly does medical aid work?

According to the Medical Schemes Act, medical aid schemes are entitled to impose a 3 months general waiting period and / or a 12 months condition specific waiting period(s) for any pre-existing medical condition(s).

How do medical aid schemes make money?

A medical scheme therefore does not make any profits. Schemes exist for their members as all funds are pooled and safeguarded, to be used to pay claims in accordance with the scheme’s rules, and ensure that all members are equitably and fairly cared for (relative to their choice of benefit plan).

How much is medical aid per month in South Africa?

Medical aid prices in 2021: Discovery vs Bonitas vs Momentum and others

Is medical aid necessary?

Nowadays, belonging to a medical aid fund is not only important, but it’s practically essential in this country. Depending on your fund and plan, you can rest assured that you have full or a degree of important cover to assist you financially when life and its myriad of medical misfortunes happen.

Is there a waiting period for Gems medical aid?

There are two types of waiting periods that GEMS may apply. These are: A General Waiting Period (GWP) of up to 3 months; and/or • A Condition-Specific Waiting Period (CSWP) of up to 12 months.

What is needed to open a medical aid?

All medical aid schemes will require a completed application form that includes your details, as well as certain supporting documents, when you sign up with them. When you join a medical aid scheme, it’s vital you make full disclosure as to the age and status of your dependants and your medical and membership history.

Which medical aid is the best?

Best Medical Aids for 2021

• Bestmed 77.4.
• Medihelp 77.1.
• Discovery Health 76.8.
• Bonitas 74.9.
• Momentum Health 71.1.

Can I have medical aid if unemployed?

Fortunately hospital plans either in the form of a medical aid or hospital cash back plan do not discriminate based on your employment status. In other words any person can have a hospital plan even if they are unemployed.

Can I add my girlfriend to my medical aid?

Yes. If your boyfriend or girlfriend is living with you, you will be able to add them as an adult dependant to your medical aid – just as you would if they were your spouse.

How does a medical aid scheme work?

In a medical aid scheme, members pay a monthly amount called a premium or contribution into a “collective pot” that is administered by the scheme. This money is then used to pay out medical claims made by members.

How does medical aid work in South Africa?

How does medical aid work? Medical schemes, the providers of medical aid cover, are non-profit organisations in South Africa that are either self-administered or administered by third parties. The monthly contributions (premiums) of all its members are pooled together and then benefits paid out for member’s legitimate medical bills.

What does it mean to be contracted into medical aid?

This allows for medical aids to either reimburse the practitioner directly for treating a patient (a process known as being ‘contracted into medical aid’) or to refund the patient who has settled/will settle the practitioner’s bill on their own (‘contracted out of medical aid’).

Can You claim medical aid for in-hospital treatment?

Depending on the medical aid plan you’re on, you can claim for in-hospital treatment, as well as other benefits like screenings for certain diseases, day-to-day expenses like medication or GP visits, and dental treatment.