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Who benefits most from healthcare cover in South Africa?

Article provided by Medshield Medical Scheme

Many South Africans have their doubts about joining a medical aid plan. They assume, often without thinking about it, that because they are young, fit or in good health, they do not need to look into medical schemes. The advent of the pandemic has somewhat changed the minds of staunch critics of private healthcare since it brought to the fore how quickly one’s health status can change. Besides the current struggles related to COVID-19, South Africa is a known hotspot for crime and road accidents, and has high incidents of chronic conditions.

Requiring urgent, extensive treatments and life-saving surgery can become costly, especially when a hospital stay is required. It is in the case of those emergencies that members of medical schemes in South Africa are most grateful for their private healthcare cover.

Young adults (singles and couples)

Young adults are often most prone to neglecting their health and health cover. This is because being younger means that one’s body is fitter, recovers faster, and does not show signs of ageing yet. There are still, however, many incidents of younger people in need of emergency care, or the treatment for the onset of life-threatening conditions. Because uncertainty is part of everyone’s tomorrow, partnering with the right medical scheme today is beneficial.

Young families looking to grow

If you are planning to expand your family, then medical aid coverage is essential. When looking into private healthcare, it is important to find out about plans that offer pre- and post-natal maternity benefits and have family general practitioners on their network service providers list. Also remember that young, school-attending children might come into contact with viruses and bacteria more often, and thus require better day-to-day benefits.

Adults with or without families

As our bodies begin to age, it is not uncommon that more health issues arise. While it is vital to care for oneself through the right diet and exercise, having comprehensive cover whenever the need arises offers much peace of mind. It is far better to invest in your own health by paying monthly contributions to a scheme than to fret the day you require urgent care.

The elderly

Older adults have an increased risk of developing certain conditions, and screenings, assessments, and treatments of such can rack up a hefty bill. Individuals currently approaching or living in retirement, especially, can benefit most from a plan that offers extensive hospital cover and day-to-day benefits.

Individuals with chronic conditions

Medical schemes in South Africa must, by law, cover the diagnosis, treatment, and care of a predefined list of chronic conditions called Prescribed Minimum Benefits (PMBs). PMBs include any emergency medical condition, a set list of about 270 conditions, and up to 25 chronic conditions. Individuals without a medical aid who currently pay out-of-pocket for their medical expenses will benefit most from a suited plan.

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