Medical Aid – Cover Levels
The diagram below shows how medical aid services are differentiated in South Africa. When applying for medical aid you have to consider these three aspects of what your medical aid requirements may be, what the medical aid provider offers in respect of these and the costs associated with providing medical aid cover across the three levels.
- HospitalizationThis is the expensive part of the medical aid, commonly known as RISK.Different medical aids pay different tariffs, ranging from 100%-300%.
- Chronic MedicationThe top 25 commonly known chronic diseases must be paid by all medical aid societies.The more comprehensive your plan, the better the chronic benefits will be.
- Day to DayThis benefit is for all out of hospital benefits, such as Doctors, Dentists, Specialists, Optometrists and prescription medication.In this area we have a Traditional Option (set benefits and what you do not use in the year will fall away), and a new Generation Option (medical savings account from which out of hospital expenses are paid. It is an up front Rand value amount and can be carried over to the following year.)Each of these options is divided into different plans, ranging from Hospital plans to Comprehensive plans.