Essentials to Look out for When Choosing Health Cover

Choosing health cover can be a daunting task, especially if it’s your first time looking for quality health cover that will fit your pocket. Here we will have a look at the essentials of health cover.

Although it may be costly to have health cover, the benefits far out way the disadvantages. In South Africa, there are 26 open medical schemes alone.

The Essentials of Health Cover

It’s often a good choice to use the service of an independent intermediary or healthcare consultant to help you choose the best cover for your needs.

Essentials of Health CoverBut, if you’re set on doing it yourself, it’s important to take note of your specific healthcare needs. Here, research becomes vital. As the next step would be to find out which company can offer you the best option to suit these requirements.

It’s also essential to read the dreaded fine print. As well as about certain limitations, waiting periods and what procedures and medications which do not have cover.

Often, lower-end health cover gives members the most basic cover. Which often leaves members frustrated when they find out simple procedures, such as nasal operations or CT scans, aren’t covered.

Also, some schemes might have waiting periods if you have any pre-existing conditions, such as cancer. They may also state that a new member has to wait a certain amount of months before being able to claim for certain procedures, such as the pregnancy benefits.

All health cover schemes offer different sets of benefits to choose from. Your choice will mainly depend on your needs and your budget.

Fortunately, even the most basic medical aids and hospital plans have to abide by the Medical Schemes Act of 1998. According to this Act, medical schemes must pay for the treatment of an individual list of conditions as well as a list of 270 procedures.

Unlike medical aids and hospital plans, cash out insurance plan does not fall under the Medical Schemes Act and often pays per day that you are in a hospital. That gives you the freedom to use the money to pay for medication, hospital stay or procedures.


The key to finding health cover that works best for your needs is to do your homework. And read the paperwork and ask the questions.

All info was correct at time of publishing