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Aagh, I Don’t Need Critical Illness Cover, I’m On A Medical Aid

Are you 100% sure your medical scheme is going to provide you with sufficient cover if you get really ill? If you can say you’re 100% sure they will then don’t worry about reading the rest of this article.

But you probably are going to read the rest of this post because you know that treatment costs of dread diseases are really expensive and your medical scheme has definitely put Rand caps in place on the amounts they are prepared to cough up.

Let’s take cancer as an example. Any medical scheme you belong to has an oncology benefit limit. What is your annual oncology benefit limit?

Our guess is that you probably don’t know. I mean, you join a company, they have a group medical aid scheme in place, you pick a plan that suits your pocket, pay your 50% share and never really take the time to dig into the benefits of the plan beyond how much medical aid savings you have. And it’s not just you, 90% of us never take the time to actually look at what our medical schemes cover us for.

So back to your annual oncology benefit limit?

Is it R400 000 per year? R200 000 per year? R100 000 per year?

Perhaps now is a good time to phone up your medical aid scheme and check on those oncology benefits.

These are the questions you need to ask your medical scheme:
  1. Will my medical aid plan offer me more than simple PMB oncology cover? (that’s the base line cover everyone enjoys)
  2. What is the overall annual Rand amount of oncology coverage I will enjoy?
  3. Does my medical aid pay that benefit in full or is there a co-payment?
  4. Will my medical scheme cover the cost of more advanced and expensive oncology treatments?
Then these are the questions you need to ask yourself:
  1. What are the financial implications of being diagnosed with a critical illness like cancer?
  2. If my medical aid is going to only pay X could that put me seriously out of pocket?
  3. How big is the ‘out of pocket’ figure?
  4. What are my employer’s policies if I get seriously ill?
  5. Do I need critical illness cover?
We are going to answer the last question for you! You do need a certain level of critical illness cover because, for most of us, belonging to a medical aid scheme is really expensive. That forces us to choose mid-range medical aid plan types that suite our budget. Unfortunately mid-range plans come with mid-range benefits. Sure, get ill and land up in hospital for a few days and your medical aid plan will probably do Ok for you.

But what if you land up in hospital for an extended period of time and rack up hundreds and thousands of Rands in cancer treatment costs? Do you think your mid-range medical aid plan is going to do enough for you then?

It isn’t. Nobody’s medical aid plan will. The only alternative is to top up with some comprehensive critical illness cover. Get diagnosed with a critical illness like cancer, expect a policy pay-out and that’s at least going to ease the financial burden.

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The iHound