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Medical Insurance vs Medical Aid: Which Is Right for You?

Finance & Money

Posted on Thursday, March 31, 2022

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Taking care of your health is important, but it can be pricey. Here’s how to decide if medical aid or medical insurance is the right option for you.

From medical emergencies to trips to the doctor, health concerns can result in your medical bills piling up. This is where medical aid and medical insurance come in. But which one is right for you? Learn the differences to make an informed decision about which option suits you and your finances.


What is medical aid?

Medical aid companies have a range of plans called ‘schemes’. These schemes offer different benefits. Prices vary, but usually the more expensive the plan, the more benefits you will get. Makes sense, right?


All schemes offer PMBs (prescribed minimum benefits), though, which means whichever scheme you choose, you’ll get access to some basic health services. This could mean a certain number of visits to the doctor, pharmacy, etc.


Common benefits you may get include:


  • day-to-day cover for visits to your doctor
  • over-the-counter medication fund
  • in-hospital care
  • optometrist or dental benefits
  • a fund to cover general medical expenses (a medical savings pocket)
  • chronic condition benefits (for certain conditions), for example medication for high blood pressure or asthma

In a nutshell: The extent of these benefits will be different from scheme to scheme. Funds are allocated to specific medical needs.


What is medical insurance?


Medical insurance doesn’t offer as much cover as medical aid, but it’s more affordable. It usually includes fixed amounts for general medical cover. This may include in-hospital stays, emergencies and some day-to-day benefits.


Some of these benefits may include limited visits to your doctor and fixed amounts per day or per year for:

  • death or funerals
  • in-hospital stays
  • accidental injury


In a nutshell: Medical insurance doesn’t cover PMBs but rather has fixed funds for general medical cover.


Which one should you choose?


It’s important to consider your budget when deciding which option is best. Chat to medical aid or insurance experts, who can help you find options to suit your pocket and health needs.


Medical aid may be a good option if:


  • you have a chronic condition
  • you have to cover medical costs for other family members
  • you can afford medical aid, or your employer is going to cover it


Medical insurance may be a good option if:


  • you have a limited budget
  • you are generally healthy and rarely go to the doctor
  • you don’t have to cover costs for anyone else


What to do if you’re undecided


Keep in mind that your mental and physical health need to be a priority. If you’re still on the fence about which option is right for you, it’s important that, while you make up your mind, you ensure you’ll be able to cover the expenses in the event of a health-related emergency. Start a medical savings account by putting away a lump sum of your income every month.


The information in this article is for information purposes only and does not constitute professional advice.



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