What You Need to Know About Being on a Network Medical Aid

As South Africans, most of us don’t need to be convinced of the importance of being on a medical aid (or hospital plan).

We all know that medical treatment doesn’t come cheap and that accidents and medical emergencies can and do happen when we least expect them.

This is why medical aid is not a luxury, but rather a necessary expense that we must incur so as to ensure we’re covered for emergencies.

When discussing medical aid schemes in South Africa, it’s important to distinguish between network medical aid options and non-network options.

But what’s the difference between network and non-network medical aids?

  • A network medical aid option stipulates that you use a specific network of hospitals and medical practitioners.
  • The medical aid scheme will have a specific payment structure arrangement in place with this medical network.
  • Network-based medical aid schemes generally offer more affordable rates than their non-network counterparts.This is as a result of the medical aid company’s agreement with the network of healthcare professionals and clinics, whereby the medical aid company pays a specific (generally lower) fee with the commitment of sending more patients to them through the network.

All 4 Women Network MedicalWhile network medical aid options are most often cheaper, it’s crucial that anyone wanting to join a network-based medical aid is completely aware of which doctors and/or hospitals are available on that specific network.

On a network medical aid, you will need to make sure you use only the providers in that specific network. You will also need to thoroughly check which conditions and treatments are included in your cover, as there will be restrictions on your benefits.

 Conversely, non-network medical aid members will generally enjoy more extensive benefits with fewer restrictions. Non-network medical aid options are therefore charged at a higher price.

Compare network options for yourself

The moneysmart Community is a leading personal finance and lifestyle blog that focuses a great deal on the subject of medical aid schemes in South Africa.

In a recent exercise, moneysmart compared 4 different network medical aid options from different medical schemes.

The comparison looked at the following:

  •  ·         Monthly premiums
  • ·         Chronic medicine benefits
  • ·         In-hospital benefits
  • ·         Day-to-day benefits

Check out the moneysmart Community for the full comparison and to find out more information about being on a network-based medical aid option.

Author : Nelda Celliers for moneysmart