How to choose the right medical aid for you

How to choose the right medical aid for you

Signing up for a medical aid is something everyone should do as they reach adulthood. A medical aid will help in times of illness or emergency, especially if you are the sole breadwinner of your family. However, choosing one that suits your needs can be difficult. Outlined below are some hints to help you choose the right medical aid for your needs.

Look at your health care needs

The first step you should take to choosing the right medical aid is to examine your health care needs thoroughly. You should ask yourself questions about your medical claims and needs, as outlined below.

  • How often do you and your family visit the doctor during the year?
  • Do you or someone in your family require medicine on a regular basis?
  • Do you or your dependents need to visit a specialist?
  • Do you or your dependents require cover for cancer, renal dialysis, HIV AIDS or any other condition?

Once you have answered these questions, you will be better equipped for choosing a medical aid or hospital plan that suits your needs.

Full cover versus a hospital plan

How much does medical aid cost in South Africa? This can be answered by deciding on whether you need full cover or a hospital plan. If you can afford to pay for day-to-day GP visits yourself, you should look at a hospital plan.

A hospital plan is more affordable than normal medical aid, but you must remember that hospital plans cover you for up to only 25 chronic conditions, and if you suffer from a condition that is not covered you may find your medical bills becoming exorbitant. A hospital plan is ideal for younger people who are just starting out, rather than an older person with an established family.

Have your health checked

If you have ongoing health problems, you may need to opt for medical aid with full cover rather than a hospital plan. If you are still unsure, you should get a full checkup done by a GP in order to ascertain if you have any underlying conditions which may not be covered by medical aid.

If you are generally healthy but have eye or dental problems, it is imperative to look for a plan which covers these. Dental and optometry costs can become exorbitant and hospital plans often do not offer day-to-day visits to these specialists. Medical aids often offer suitable cover for such issues.

Assess your finances

Assessing your finances is vital to choosing the right medical aid or hospital plan. Full medical cover can be highly expensive if you cannot afford it. If your monthly income is R6000, you are likely not going to be able to afford a R2000 a month payment.

If you do decide to join a scheme, opt for one which has rates according to salary, as this may mean you pay an affordable amount each month. If you do decide to sign up for a scheme, be sure to check which ones offer you the best rates for adding your spouse and children as dependents, if you have either. Ask what your monthly contributions would be for a scheme that covers everything you need and work this into your budget.

Newly married or young family?

In order to better decide how to choose the medical aid scheme that is right for you, you will need to consider your current life situation. A hospital plan is ideal for a newly married couple because it is affordable and offers direct control over medical expenses.

For a young family, full medical cover is a better option, especially when you have  babies and toddlers. You will receive cover for serious conditions and more expensive procedures will be paid for. You will also be covered for a set amount of GP visits a year, depending on which medical aid provider you choose, as well as dentistry services.

Visit an independent broker

If you have exhausted all of your options, you can visit an independent broker. These professionals will not sway you by promoting one specific medical aid scheme, but will rather give you advice on which one will best suit your needs.

A broker will be able to explain, in depth, the different benefits and disadvantages of the medical aid schemes you are interested in and can help in dealing with any claims you may make. An independent broker will also ensure that all claims are dealt with swiftly and correctly, whether you choose full medical cover or a hospital plan.


Deciding on which medical aid scheme is right for you is something to be taken seriously. You will need to examine your finances thoroughly, consider your personal situation and undergo a health check in order to choose one which meets your needs. If you are a part of a newly married couple or are single, a hospital plan may be the better option. A young family will need the comprehensive care of full coverage but you will need to be sure to read over all the terms and conditions before signing up for one.

Authored by: Pete Anderson

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