Medical Aid

Medical schemes may impose a three-month general waiting period, a 12-month condition-specific waiting period and late joiner penalty (LJP).
How will this affect you?

Medical schemes have various benefit plans available to members. Members have to choose between hospital plans, hospital plans with a savings component (New Generation Options), traditional plans, comprehensive plans and network plans.

What are the basic principles of medical aid – how does it work?

Your medical scheme membership fees have gone up again. Is it worth it?

Benefits can become complicated. For your own good, here’s what you should know.

Before choosing a medical scheme, and an option within that medical scheme, you need to consider the following points...

Most South Africans join a medical scheme through their employment. Another reason why individuals join medical schemes is because they are seeking a perceived higher quality of care in the private sector, particularly for hospitalisation.

Often you hear the complaint; "I'm paying way too much for medical cover". Often you hear people exclaim that they will never buy into the exploit medical scheme cover has become, as there is simply no value for money to be had.

Prescribed Minimum Benefits (PMB) is a set of defined benefits to ensure that all medical scheme members have access to certain minimum health services, regardless of the benefit option they have selected.

What does '100%, 150%, 200%, 300% and 400% of scheme tariff' mean?

Few parents at the outset plan their pregnancy with their medical scheme cover in mind – but that is exactly what should be done.

Scepticism of the National Health Insurance (NHI) scheme is not a reaction against change, but shows concern about its impact on the wider economy, consultancy Frost & Sullivan said today.

The proposal for a National Health Insurance (NHI) was without doubt the most significant development in South Africa's healthcare sector in 2010.

Looking for answers specific to the Medical Aid Industry, visit our Frequently Asked Questions to find those answers.

Easy-to-understand explanations of medical scheme terms, jargon and abbreviations