What to Consider when Changing Medical Aid Schemes

January 4, 2016

Changing medical aid schemes is possible at any time of year.  Medical schemes review their benefits annually. They encourage their membersto re-evaluate their medical cover. And then they must decide to either up- or down-grade to a different option or to actually change schemes altogether.

Reasons for changing a medical aid are mostly because of cost, with people looking for a more affordable option. They want to know what they are paying for. And they want to be sure they aren’t paying for benefits that they don’t need.

They know the wisdom in down-scaling to a cheaper medical aid option. That is, rather than not having any kind of medical insurance at all.  A lower cost option will at least provide some form of cover in an  emergency.

Changing Medical Aid Schemes – Assess Your Health

Members should assess their health, taking into account their age and their health status and select an option accordingly which will cater for their unique level of need.

Things to Consider When Changing Medical Aid SchemesPeople also change medical schemes because they want a plan which offers value added benefits which their current medical aid does not. They may also find that the limits on certain healthcare practitioners with their current medical aid is too restrictive.

Changing Medical Aid Schemes – Read Your Current Scheme’s Cancellation Policy

It is a good idea to make the change at the end of the year. If you join a new scheme during the year, the benefits will be adjusted for the year that is left.

Always read the fine print to understand your medical scheme’s notice period. By reading your scheme’s ‘rules’ you’ll find the notice period there. You must adhere to this period if you want to avoid cancellations fees and penalties.

You must just remember that with a new scheme comes the possibility of a new waiting period of up to 3 months. This means you will still be required to make your monthly contribution, but you won’t be able to enjoy benefits during this waiting period.  However during this 3 month waiting period, Prescribed Minimum Benefit (PMB) as well as emergencies are covered.

Changing Medical Aid Schemes – A Medical Plan in Keeping with Your Lifestyle

When changing a medical aid scheme, shop around and do research because there are many medical aid options available as well as affordable hospital plans. Certainly a couple wanting to start a family would want to consider a more comprehensive plan that covers all doctor’s visits.

Before you make a change to another medical scheme, understand your heath risk profile. Once you know your health risks, you can decide what plan will best suit your needs. Are hospital costs 100% funded for instance and are there co-payments? What about the scheme’s financial stability?

Find out what the global credit rating on the scheme is and what their claims-paying abilities are. The bottom line is that you want a medical aid scheme and plan to suit all the stages of your life.

Changing Medical Aid Schemes – Understand All the Rules so You Aren’t Vulnerable and at Risk

Moving over to a new medical scheme is easy –  the medical aids of South Africa know that people can no longer afford a comprehensive medical scheme contribution. They know that toward the end of the year, members re-assess their medical aid and decide whether the benefit structure is worth their monthly premium.

Many members are downgrading to an affordable hospital plan. The scheme application form needs to be submitted. Make sure that your current medical scheme doesn’t have a notice period of possibly as much as 3 months. This will prevent you from joining another medical scheme in this period, leaving your vulnerable to a medical emergency.


All info was correct at time of publishing