It is essential to have medical insurance to give you peace of mind that you will be covered should you require emergency or planned medical care. Private medical care in the forms of doctors, hospitals, clinics, dentists, specialists and more are incredibly expensive and not many people can afford their fees out of their own pockets.

Even if you are able to afford day to day medical costs like doctor and dentist appointments and medicine, if you or someone in your family should develop a chronic disease or be involved in an accident of some kind, you will probably not be able to afford the medical expenses. It is important to be prepared for any eventuality in life. You do not want to be left without care should something befall you or one of your dependants.

Why Discovery Health?

Discovery Health Medical Aid is one of the largest, most well-known medical aid schemes in the country. Apart from a range of really good packages, Discovery Health also has several additional benefits like Discovery Vitality. Discovery Health promotes good health all around and offers discounts and specials for clients that choose healthy food and exercise regularly. Discovery Health has a large number of satisfied, happy customers.

How to compare Discovery Health plans

The best way to compare these plans is on the Discovery Health website. If you go to www.discovery.co.za and choose the ‘health’ option on the left hand bar, you will be able to access the ‘plans we offer’ option. You can then download the PDF summarising and explaining the different health plans and compare which plan is best for you. You could then contact Discovery Health for more detailed information if you require it.

A brief summary of the different plans Discovery Health offers

Discovery Health medical aid has six categories of medical aid with one to five different plans in each series.

1. Executive Plan

This plan has the most extensive cover and costs R3 365 per main member, a further R3 365 per adult dependant and R638 per child dependant.

1. Comprehensive Series
   1. Classic Comprehensive Plan

This plan costs R2 760 per main member, R2 609 per adult dependant and R552 per child dependant.

1. Classic Delta Comprehensive network option

This plan costs R2 485 per main member, R2 350 per adult dependant and R494 per child dependant.

1. Essential Comprehensive Plan

This plan costs R2 320 per main member, R2 191 per adult dependant and R463 per child dependant.

1. Essential Delta Comprehensive network option

This plan costs R2 088 per main member, R1 972 per adult dependant and R417 per child dependant.

1. Priority Series
   1. Classic Priority

This plan costs R1 850 per main member, R1 457 per adult dependant and R740 per child dependant.

1. Essential Priority

This plan costs R1 590 per main member, R1 249 per adult dependant and R635 per child dependant.

1. Saver Series
   1. Classic Saver

This plan costs R1 652 per main member, R1 300 per adult dependant and R660 per child dependant

1. Classic Delta Saver network option

This plan costs R1 320 per main member, R1 038 per adult dependant and R529 per child dependant.

1. Essential Saver

This plan costs R1 312 per main member, R982 per adult dependant and R524 per child dependant.

1. Essential Delta Saver network option

This plan costs R1 049 per main member, R787 per adult dependant and R418 per child dependant.

1. Coastal Saver

This plan costs R1 277 per main member, R957 per adult dependant and R513 per child dependant.

1. Core Series
   1. Classic Core

This plan costs R1 229 per main member, R967 per adult dependant and R491 per child dependant.

1. Classic Delta Core network option

This plan costs R984 per main member, R773 per adult dependant and R393 per child dependant.

1. Essential Core

This plan costs R1 056 per main member, R791 per adult dependant and R422 per child dependant.

1. Essential Delta Core network option

This plan costs R844 per main member, R633 per adult dependant and R339 per child dependant.

1. Coastal Core

This plan costs R892 per main member, R669 per adult dependant and R356 per child dependant.

1. KeyCare Series
   1. KeyCare Plus

There are several options ranging in price from R485 to R1 211 per main member, R485 to R1 211 per adult dependant and R129 to R324 per child dependant.

1. KeyCare Core

There are several options ranging in price from R465 to R894 per main member, R465 to R894 per adult dependant and R117 to R202 per child dependant.

The costs of these plans do change over time so it is best to look up the price list to ensure that you have the up to date list.

Why is it necessary to have a medical aid?

It is impossible to predict when illness or injury will occur, but you can be sure that at some point in your life you will be in need of professional medical assistance. Even if you are healthy and have never been sick a day in your life, you cannot be sure that you will never be the victim of an assault, bitten by an animal, involved in a car accident or a myriad of other incidents where you could be hurt. Emergency hospital fees are incredibly expensive, and should you require surgery or other specialist treatment or care, you could owe a huge amount of money. If you do get sick one to several times a year, visits to your doctor and the cost of the medicine he or she will prescribe can be expensive. Medicine that you might take regularly, like the contraceptive pill, pain killers, anti-nausea tablets, throat lozenges and many more, can also rack up a hefty bill.

It is also important to visit the dentist regularly which can also cost a lot of money. If you have a chronic illness like Rhinitis, Diabetes or a heart condition you will most likely need chronic medication and treatment for a long period of time. The costs for any of the above will be high, and you can be sure that at some point you will need some sort of medical assistance. If you have children, you will need to be sure that their medical fees will be covered should something happen. It is better, after all, to be safe rather than sorry.

Is it better to go for a hospital plan instead of a medical aid?

Medical aid packages can cost anything from a few hundred to several thousand per month, depending on what package you choose. This can be very expensive, especially if you are paying for several dependants’ medical insurance as well. Another option, if you cannot afford a full medical aid package, is a hospital plan. This option is generally much cheaper than a medical aid package. A hospital plan will cover emergency hospital treatment, but generally nothing else. This plan will give you peace of mind in that you know that if you are ever involved in an accident of some kind your hospital costs will be covered. Unfortunately, you will have to cover the costs of your dentist and doctor’s appointments, your medication and any planned hospital procedures.

If you are not a sickly person and do not require any medication regularly, this could be a good option for you. However, a medical aid package will give you more reassurance that your health will be looked after.

Choosing a good medical aid provider

There are many different medical aid providers to choose from including but not limited to the following:

• Bonitas
• Discovery Health
• Momentum Health
• Fedhealth

It is important to choose a medical aid that is reputable, has many happy clients and that you can trust. Bonitas is a company with a long standing reputation for being a good medical aid provider.

Choosing the right medical aid package for you

There are many medical aid packages to choose from. Most package cover emergency hospital procedures and then offer other benefits like appointments with health professionals, some or all medication, chronic medication and planned hospital procedures. The right package for you depends on your needs and the needs of your dependents. Some medical aid packages give you the option of a savings portion which you can spend on whatever medical assistance you would like, and then emergency hospital cover. There are a myriad of different options, and the Bonitas Bonsave medical aid package could very well be the right package for you.

Everyone requires medical assistance at some point in their lives and the costs are usually very high. Even a hefty savings account could be too little to cover a serious medical emergency and should you develop a chronic illness, the medication would be a regular cost which you might not be able to afford. If you have children you definitely want to look after their health in the best possible way. Applying for medical aid is a responsible choice in a world where accidents happen indiscriminately.

There are many medical aid schemes available and each has different processes, ways of doing things and options for the client. The best medical aid for YOU is really dependent on your specific needs and the needs of your family, but a list of those considering the top medical aids in the country could be helpful to narrow the list down.

According to a survey by independent rating company Global Credit Rating, the top five medical aids in terms of their ability to pay claims are:

1. Discovery Health Medical Scheme
2. Fedhealth
3. Bonitas Medical Aid Fund
4. Oxygen
5. Spectramed

Discovery Health Medical Scheme is arguably the biggest and most well-known medical aid and it has the extra benefits of the Vitality Club, which allows the user discounts on gym membership, healthy food and fees on certain sporting events.

According to health professionals in the industry, Gems is another large and well-known medical aid. Although it is not on Global Credit Ratings list, it is the only scheme in the country big enough to compete with Discovery Health Medical Scheme.

Choosing your medical aid

These top medical aids might narrow down your options from the many different companies available. Do some research on each scheme and have a look at what they offer and how they do things. Also, ask family, friends and acquaintances about their medical aids and how happy or unhappy they are with their schemes. You might receive some useful advice about which companies to avoid and which have better track records with their customers.

When you have done this, you should think carefully about what your and your families medical needs are and, of course, how much you can afford to spend on a medical aid scheme. Talking to agents from medical aid companies you are interested in is also a must. They will usually come to you if you make an appointment and you can discuss your needs, what you can afford and the benefits and downsides of each scheme.

When you do start looking at one specific option, things to look for when deciding which medical aid to choose include:

• Their day to day benefits
• What their hospital cover includes
• The chronic medication they cover
• The premiums that you would have to pay for the benefits that you need

Other options

If you do not require day to day benefits and medication, you could consider a hospital plan. Hospital plans are considerably cheaper than most medical aid options and only include hospital cover for emergencies. This is the perfect health insurance for you if you are not a sickly person and if you only really want peace of mind from the expense of emergencies. However, if you do visit the doctor often or require certain medications, a hospital plan is not suitable for you and you should definitely rather choose a medical aid plan.

Whatever your needs are and whatever you are able to pay, there will be a medical aid scheme or hospital plan that is right for you and your family. Knowing who the top five medical aids in South Africa are will give you a good base from which to start your search.

What is a waiting period?

A medical aid’s waiting period is a time period in which a medical aid beneficiary has to pay the normal monthly contribution but is not yet entitled to make a claim for any of the scheme’s benefits. Medical aids are allowed by law to enforce this waiting period. There are two main types of waiting period:

1. A general waiting period that lasts up to three months. During this time, neither you nor your dependants may claim form the medical aid, aside from the prescribed minimum benefits. When choosing a medical aid scheme, look for one that includes these prescribed benefits.
2. A condition-specific waiting period lasting up to twelve months. If a member has pre-existing medical conditions, the beneficiary is not entitled to medical aid benefits for a condition for care, treatment, advice or diagnosis that was received or recommended within a period of 12 months ending on the date the beneficiary made the application for membership to the medical aid scheme. This condition applies to both you and your dependants.

When can a waiting period be applied?

In accordance with the Medical Aid Schemes Act of South Africa, a medical aid company may impose a waiting period of three months in the following circumstances:

• If the applicant has not been a member of the medical aid scheme for a time period of no less than 90 before that date of the application.
• If the applicant was a previous beneficiary of a medical aid scheme for up to 24 months, ending less than 90 days before the date of the application.
• If the applicant has had previous medical aid coverage for over 24 months but chooses to join another medical aid scheme selectively, on a voluntary basis.

When does a waiting period not apply?

Although there are not many medical aids with no waiting period, there are circumstances in which a waiting period will not apply:

• For a child dependant who is born during the membership period
• For members who change from one benefit option to a different benefit option within the same medical aid scheme. This does not apply if the member is still subject to the waiting period on their current benefit option. If this is the case, the remaining period will apply when the member changes benefit options.
• If an employer chooses to terminate or change to medical aid scheme of its employers, this transfer should take place in the beginning of the financial year, or the medical scheme must be given reasonable notice. In the other word, of the change to a different medical aid is not the choice of the employee (but rather the choice of the employer) the waiting period will not apply.

Tips to avoid a long waiting period

Medical aids impose harsher waiting periods on people who join medical aid schemes with having belonged to another medical aid scheme in the past. Longer waiting period are also given to people who have had a break between memberships. This is to avoid people from only joining a medical aid scheme when they are sick and need the benefits. To avoid incurring these longer waiting periods, join a medical aid as soon as you can afford to do so and ask your employer if they will assist you with medical aid payments. Don’t wait until you fall ill before joining medical aid as it is intended to be used as a preventative measure.

If you change medical aid schemes voluntarily before the waiting period (particularly a condition-specific 12 month waiting period) is up, the new medical aid scheme can impose its new waiting periods as well as adding the remaining amount of time left on the waiting period from your previous scheme.

Where are Life Health Care hospitals situated?

Life Health Care offers a range of healthcare services throughout the country, with hospitals in 7 of the 9 South African provinces. Life Health Care facilities can be found in the most populated metropolitan areas, including Pretoria, Johannesburg, Durban, Cape Town, Port Elizabeth, Bloemfontein and East London. The range of facilities operated by Life Health Care includes multi-disciplinary hospitals with the latest technology, stand-alone facilities and community hospitals. Each facility is adapted to meet the local needs and demands in various regions countrywide.

The Life Health Care Hospitals provide services to the medically insured market. The acute care hospital network includes general hospitals of various sizes with high care units, intensive care units, emergency units, operating theatres, cardiac units and maternity units. There are a number of other specialized facilities that also provide either outpatient or inpatient services, such as:

• Acute rehabilitation
• Mental healthcare services
• Chronic renal dialysis
• Radiation and chemotherapy oncology

Healthcare services

Life Esidimeni is a healthcare service that provides long term chronic and acute hospitalization services to state patients. The Life Occupational Health service also provides occupational and primary healthcare services to employer groups in the sectors of industry, commerce, parastatels, correctional services and mining.

Life Health Care Hospital Division

There are 7665 beds in the Life Health Care network, situated all over South Africa as well as in Botswana. The hospital network also has a support bases consisting of over 2700 specialists and doctors.  Hospitals generally provide inpatient treatments for emergency care and elective care. Within the hospital are a number of specialized departments:

• Life rehabilitation: Life Health Care has 6 adult units and 2 pediatric units dealing with acute rehabilitation services. This is the country’s leading provider of private rehabilitation services, operating almost 50% of South Africa’s private acute rehabilitation beds (229 beds). The units offer cognitive and physical rehabilitation for patients who have been disabled by brain or spinal trauma, strokes, or other disabling injuries and conditions.
• Mental health units: this specialized care is provided in 6 healthcare treatment facilities around the country, with a total of 172 beds. Facilities are bases in Gauteng, the Eastern Cape and Gauteng, either stand-alone or within acute care hospitals.
• Renal division: This service offers 40 dialysis stations through a network of 5 facilities in Gauteng and the Eastern Cape, providing chronic and acute renal dialysis services.

The private hospital facilities are complemented by related health care services:

• Life Esidimeni: Meaning place of dignity, this subsidiary operated 4171 beds under 12 facilities that provide long-term care for chronically ill, indigent patients. Life Esidimeni locations deal with frail care and mental health care patients who require chronic rehabilitation. One district hospital also provided acute care for indigent patients.
• Life Occupational Health: With 289 on-site clinics, Life Occupational Health is South Africa’s leading provider of primary and occupational healthcare services on-site to large employer groups in a range of industries, including government correctional service facilities, parastatals, industry, mining, and commerce.
• Life College of Learning: This higher education institution has over 1350 students enrolled in it. The college was established 12 years ago to offer certified nursing courses and tertiary academic degrees. The Life College of Learning also offers training courses to upgrade service standards and practical nursing as well as courses to improve clinical skills.
• Life Healthcare Foundation: This organization was established in 2007 and is managed as a trust with independent and company trustees. The Life Healthcare Foundation provides different resources in the wellness and health arenas as part of Life Health Care’s social investment contribution. The foundation provides hospital and nursing services as well as other financial sponsorships.

With over 106,000 members, Medihelp is South Africa’s 3^rd largest medical scheme. Medihelp offers an electronic claims system (on which 84% off all claims are received), helping the company to process claims efficiently and quickly.

There are 7 benefit options provided through Medihelp, aiming to provide varied medical coverage to different income groups. These options are; Unify, Necess, Dimension Prime 1, Dimension Prime 2, Dimension Prime 3, Dimension Elite, and Medihelp Plus. Here are some further details about each option so that you can choose the medical aid scheme from Medihelp that is best suited to your circumstances.

• Necesse

From R744 per month (if you earn under R7500 per month), Necesse is Medihelp’s most affordable medical aid scheme. Most of the healthcare services or provided by network doctors or providers that have been previously specified by Medihelp. The network Necesse option is operated by a service network of optometrists, GPs, pharmacists, specialists, dentists and hospitals. Necesse includes cover for medical emergencies and a hospital plan (subject to an overall limit of R800,000 annually per family).

• Dimension Prime 1

This hospital plan will cost from R930 per month and also includes selective day-to-say services. This plan is best suited for healthy individuals who needs peace of mind that he or she is covered in case of an emergency. In this scheme, the value of preventative care can go a long way in keeping your medical aid costs to a minimum.

• Dimension Prime 2

This plan will cost from R1308 per month and is catered to healthy families and individuals who need comprehensive cover against hospitizalation or medical emergencies. In this option, the funds in the medical aid savings account can accumulate if they are not used for day-to-day medical expenses.

• Dimension Prime 3

For day-to-day benefits and a hospital plan, Dimension prime 3 will cost from R1560 per month. This comprehensive  scheme allows for cover of hospitalization, medical emergencies, as well as the insurance of day-to-day benefits.

• Dimension Elite

The comprehensive cover provided under the Dimension Elite plan (the top of the Dimension range) will cost from R2394 per month. This scheme offers extensive day-to-day healthcare as well as cover for hospitalization and medical emergencies.

• Medihelp Plus

From R4278 per month, Medihelp Plus is the most comprehensive scheme offered by Medihelp. This plan covers diverse day-to-day healthcare needs as well as excellent medical emergencies coverage and a private hospital plan.

These days, you simply cannot afford to be without some kind of medical aid cover, particularly in the case of an emergency or if you need hospitalization. If you earn enough to do so, it is important to budget for some kind of medical coverage to stand you in good stead. Medihelp provides enough medical options for you to choose according to your health and budget. To find out which scheme best suits your needs, it is best to contact an experienced Medihelp consultant who will be able to give you invaluable advice. Who knows, it could even save your life one day?

Contact Medihelp

For further information about a medical aid scheme from Medihelp, the company can be contacted via a number of means. To get hold of the Medihelp Head Office, call (012) 334 2000 or email medihelp@medihelp.co.za. You can also visit the Medihelp website on www.medihelp.co.za. To visit Medihelp in person, you can go to 84 Beatrix Street at Arcadia, or contact Medihelp via post on PO Box 26004, Arcadia,  0007.

CMSA stands for The Colleges of Medicine of South Africa. This institution acts as a custodian of South Africa’s quality medical care and has 28 constituent medical and dentistry colleges. CMSA was founded in 1954 by professionals in the medical industry and in 1955, CMSA was registered as a non profit-making company. CMSA is unique in the way it contains all dental and medical specialities within a single representative framework.

Of all the various medical schools in South Africa, there are 6 universities that are recognised as the best among the rest:

• The Faculty of Health Sciences at the University of Cape Town (UCT): This is the oldest of South Africa’s medical schools. UCT offers both postgraduate and undergraduate courses for a variety of healthcare disciplines. UCT’s Department of Medicine also is a leader in medical research and education.
• The Faculty of Health Sciences at the University of Limpopo. This school developed as the University of the North and former Medical University of Southern Africa merged into one institution. The Faculty of Health Sciences’ School of Medicine has departments that are accredited by the Health Professions Council of South Africa (HPCSA).
• The Faculty of Health Sciences at the University of Pretoria: This faculty has both national and international recognition as a leader in research, clinical service and health professionals. The University’s Faculty of Medicine was established in 1943 and the School of Medicine was formed from this. The following degrees are offered: MMed; MMilMed; MBChB; MPharm Med; MPhil; MPH; MD; PhD; MEIC;BSc (Hons); MSc; and a Postgraduate diploma in Family Medicine.
• The Faculty of Health Sciences at Stellenbosch University: This faculty is known for its top academic training and international contribution in the field of health sciences.
• The Faculty of Health Sciences at the University of the Free State: This is one of the oldest universities in South Africa, providing postgraduate and undergraduate education in Schools of Medicine, Nursing and Allied Health Professions.
• The Faculty of Health Sciences at the University of the Witwatersrand: Here you can do undergraduate degrees in physiotherapy, occupational therapy, pharmacy, nursing, medicine and dentistry.

Other well known medical schools in South Africa are:

• The Faculty of Medicine at the Medical University of Southern Africa (MEDUNSA). Medunsa can be contacted at P.O. Box 210, Pretoria 0204, via phone on +27 12 529 4321 or via fax on +27 12 529 5811. Their website is at: http://www.ul.ac.za/.
  
  
• The University of Kwa Zulu Natal’s Faculty of Medicine. For more information about this school of medicine, you can visit the department’s website on: http://www.nu.ac.za/. The department can be contacted on Umbilo Road, Private Bag 7, Durban, 4041, Kwa Zulu Natal, you can call them on +27 31 260 4232, or fax on +27 31 260 4410.
  
  
• The Faculty of Medicine and Health Sciences at the University of Transkei (UNITRA). Situated in the Eastern Cape, this department can be contacted on 2 East London Road, Private Bag 11, Umtata 5117, Eastern Cape. For more information you can also contact UNITRA on +27 471 302 233, fax on +27 471 302 235.

A profession in health care is both challenging and rewarding. To apply to study at one of these South African medical schools is very competitive (some medical professions more than others) and you need to have excellent matric results, as well as show your desire to pursue a career in medicine.

If funding is a problem, there are a number of bursaries offered at the different South African medical colleges that you can apply for to get funding for your studies.

Any kind cosmetic dentistry is an expensive procedure, available only to a wealthy few without financing. Unfortunately, most medical aids do not support claims for you to get the celebrity smile of Matt Damon or put forth a mouthful Halle Berry would be proud of. There are, however, a number of private lenders who will offer medical payment plans for cosmetic procedures.

As dental procedures go, the most common cosmetic processes are:

• Veneers to improve the appearance of your smile
• Tooth Extracting for problem teeth
• Dentures
• Restorative Dentistry
• Teeth Whitening to get your teeth shining
• Orthodontics for straight and regular teeth
• Bridges
• Implants for missing or removed teeth

Which companies offer Finance for Cosmetic Dentistry?

• First Health Finance are connected with thousands of cosmetic medical doctors all over South Africa. To apply for cosmetic dentistry finance with First Health Finance, you just use the online application form which shouldn’t take more than 2 minutes to complete. Once First Health Finance have had a chance to review your details, a consultant will assist you through the rest of the process and come up with a payment plan that suits your unique circumstances. You can contact First Health Finance on 0800 212 537.

• Another South African financer for cosmetic dentistry is Cosmetic Makeover, who offer free online consultation. To apply for this service, visit http://www.cosmeticmakeover.co.za/cosmetic-dentistry  and fill in the consultation form, attaching any relevant x-rays, treatment plans and reports.  You are also free to ask any questions you may have.  The Cosmetic Makeover team will review your application and find you an appropriate dentist. After the dental practitioner has provided a quote, Cosmetic Makeover will review the quote and ensure that you are getting a good price on the cosmetic treatment.

To get your financing on the go, simply fill in an application to get started. Other documents you need along the way are a copy of your identity document, a bank statement of the last 3 months, proof of your salary and employment, and proof of your physical address.

You also have the option of approaching a general credit company to finance your cosmetic dentistry, but the downside of this is that these companies are not specialist cosmetic dentistry financers and may not have the same connections and knowledge as a specialised institution.

What are the benefits if using a cosmetic dentistry credit provider?

• Aside from the obvious financing service, financing companies are also experienced industry and know the costs that are involved in cosmetic dentistry procedures, ensuring that you can get the best price for your procedure.
• The lending company can also take care of all your appointments and consultations for you, so leave the admin to them. A representative from the company will be available for any queries or needs you have and can assist you both throughout and after the procedure.
• Most cosmetic procedures require maintenance and post-dental care, and the financing companies will be able to give you the relevant advice in this regard, making sure that you heed the instructions of the dentist.
• You will usually have 6, 12, or 24 months to pay for the treatment you receive.
• You can be offered the option of paying for your procedure in part, and have your financing company cover the rest.
• After you have applied for a loan online, your loan can be approved in as little as 12 hours.
• In most cases you can receive as much as R40 000 for your cosmetic dental procedure, although more money can be negotiated.

Who is eligible for dental finance?

Fortunately, most employed South Africans will be able to afford cosmetic dentistry financing which means that they can have the procedure done quickly, rather than having to save up over time to pay for the dentistry that medical aid won’t cover.

Having a gleaming smile means your confidence can glow from within, and you can finally take pride in your pearlies!

This means that they are generally working for private institutions which are too expensive for the general public to afford. As a result, in order to receive the best medical care, people are being forced to join medical aid schemes. What is unfortunate is that many people are unaware of their rights when they join medical aids and as a result get taken advantage of. So in order to give you a general understanding of what your rights are, carry on reading this article.

Your rights:

1. You cannot be unfairly discriminated against because of your age, sex, race, gender, marital status, ethnic or social origin, sexual orientation, disability, or state of health.
2. Your dependants have the right to be covered by your scheme. This means that your spouse, any children under 21 years old who are dependent on you, or children over 21 who are disabled, and basically any family member that you are liable for their car and support, can be covered by your medical aid scheme. In addition to this, dependants have the right to continue their membership of the scheme should they wish to. What is extremely important to note is that should the main dependant die for any reason; the medical aid must cover them until they leave the scheme as long as they can afford the monthly payments.
3. If you claim against your scheme, they have to pay you out timeously – 30days from the claim being received to be exact. Should it take longer than 30 days for the medical aid scheme to pay you out, you have the right to make a formal complaint against them.
4. You cannot be charged based on your health. The only variables that come in to play when calculating your monthly instalment is your income, and your number of dependants. Should any medical aid scheme try and charge you more because for example you have contracted HIV/AIDS or have discovered a chronic condition, you can report them. The only time they are allowed to charge you more is when you join for the first time in order to provide you with the basic set of benefits known as the Prescribed Minimum Benefits that will cover any chronic condition that you may have for the first year of your membership.
5. You are entitled to receive statements from your medical scheme on a regular basis. These statements need to detail all the information surrounding any expenses that you are incurring.
6. You have the right to question a declined claim or not paid you in full. Should this occur and they have not informed you within 30 days of why they are not paying, you can  report this to the medical aid board.
7. Your medical aid cannot share your medical history with any other party without your permission. If they do so, it is a breach of your right to privacy and therefore can be taken to court.

You have the following responsibilities:

1. Be honest on your application as any false information supplied may result in you losing your membership and criminal charges can be laid against you.
2. Never submit a fraudulent claim
3. You have to declare any chronic conditions or pregnancy when applying for membership. Many people do not do so due to the fact that many schemes will make you endure a waiting period before they cover the specific condition that you have. Should they however find out that you are hiding a prediagnosed condition they have the right to report you.
4. Pay your instalments timeously

It is for this reason that Absa has come up with a range of services to help the management of businesses effectively bring about workplace productivity through adequate health care and wellness for their employees. This may be the strategic move that your company needs to move you in to the next phase and help you be the best in the market.

If you are now wondering exactly how the Absa Medical Aid Scheme will help you become more productive, then here are a list of some of the services that this scheme offers its customers:

1.  Absenteeism management solutions

This service will not only monitor the amount of absenteeism that an organisation has, but they will analyse why this is occurring and will provide your organisation with planning and training on how to deal with this. This includes training management to review sick notes as well as get the absent staff back up to speed with what happened whilst they were ill.

2. Acturial integrated risk analysis and reporting

There is no point in having a strategy in place for you business if you cannot adequately assess the effectiveness of the strategy. For this reason, Absa will provide you a report that shows you the effectiveness of the planning and strategy, as well as the return o investment which it is providing for your organisation. This is important, especially in small businesses where the initital outlay of funds needs to be proven as a sound investment.

3. Aids management solutions

Unfortunately in South Africa, we have one of the highest HIV/Aids rates out of all of the countries in the world. What is more is that employees are not legally obliged to make their employees aware of their status. This means that many organisations in South Africa regularly have to deal with absenteeism due to HIV/Aids related illnesses.

What is more is that many organisations do not have the proper procedures in place to help their employees with the disease. For this reason, Absa has developed a service which helps management and employees deal with the disease. This includes voluntary counselling and testing programmes, workshops, and surveys in order to tailor programmes for those employees and their specific risk profiles. One of the most common downfalls in businesses is that they do not know how to deal with the stereotypes that surround the disease and how to manage these stereotypes. Absa will provide businesses with the means to do so through their medical aid scheme.

4. Health care and corporate wellness strategy development

One of the biggest things that South African organisations lack in internal communication plans to help develop employee loyalty. It is therefore a service that Absa offers in order to develop an integrated health and wellness programme that will be beneficial to all employees of the organisation and will help improve employee loyalty.

5. Intermediary services

Should your business be looking for a medical aid scheme and are not sure of which scheme is best suited to meet the needs of your business, then Absa will help you find the best medial aid solution for your organisation.

These are merely a few of the great service which this medical scheme has to offer. For more information, you should contact Absa today to help you with your medical aid programme.