Updated 12.06.2021

Step-by-Step Guide to Choose the Right Medical Aid for Parents

There’s no doubt about it: our elderly parents need excellent health care.

However, there’s an overwhelming variety of medical plans available in South Africa. On top of that, retirement leaves many elderly people with little disposable income, and whatever healthcare they do settle for falls far short of their needs. Many people are left wondering: how can I know I’ve picked the right plan, and will it cover all the bases when we need it the most?

It’s crucial to understand what the options are. In this post, we’re going to detail a step-by-step guide for picking a reliable medical aid plan that will provide for your parents’ medical needs.

Step 1: Write up a list of your parents’ healthcare needs

To pick a healthcare plan that will thoroughly cover your parent’s medical bills, you need a detailed idea of what they will require in the coming years. Here are some questions to ask to help you figure that out.

  • What conditions do your parents have?
  • What chronic medications are they on?
  • What are their family histories – are there any further conditions they are at risk for?
  • What equipment (such as walkers or hearing aids) might they need in the coming years?
  • Do you picture any surgeries – such as eye surgery or a hip replacement – coming up?
  • Will they need home care at any point – for example, post-surgery?

Step 2: Decide how to finance the medical aid plan

Before you start shopping around for a healthcare plan for your parents, you’ll need to figure out your budget. Sit down with your parents and have an open chat about their options.

  • Can they contribute to the plan? If so, how much?
  • Will you contribute? What monthly sum can you realistically afford?
  • Are there any other family members who are able to contribute?

Ideally, multiple family members may be able to chip in and help to fund a high-quality plan for your parents. At the very least, you’ll end up with a solid idea of what you – and they – can expect.

Step 3: Check if your parents qualify for becoming beneficiaries of your plan.

If you’re the principal member of your own healthcare plan, you may be able to add them to your medical scheme as beneficiaries. This means that they can pay a reduced rate. However, to do this you’ll need to be able to prove that they are dependent on you financially. If they have their own source of income or draw a pension, they won’t qualify. And if they do qualify, they simply receive the same benefits that you do. If your parents need extensive care, it may be time to upgrade your plan.

If you’re on a savings plan, an important factor to keep in mind is that once they become your beneficiaries, your parents are eligible for using your savings. Make sure you have planned for this and are prepared for any loss of savings on your medical aid scheme.

Step 4: Consider your options

If your parents won’t be joining your plan as beneficiaries, here are some more options for picking their healthcare plan.

Option 1: Full Medical Cover

On a full-coverage plan, most elements are paid for. Your parents will be covered for hospital visits, chronic medication and other day-to-day expenses, medical equipment, and possibly even dentistry and optometry.

Do keep in mind, though, that full coverage plans still vary widely. Read through the entire plan before subscribing, and make sure it ticks all the boxes. If it doesn’t, shop around for something better. This type of plan is the most expensive, so make sure you get your money’s worth by picking a plan that really does everything you need it to.

Option 2: Basic Hospital Plan

A hospital plan covers around 90% of hospital procedures, but won’t cover other expenses such as medication, equipment, or doctor’s visits. This isn’t ideal for an elderly person, as day-to-day medical expenses can mount up. However, it is a highly affordable option, and will still cover surgeries, tests, and all the other pricey procedures that take place in a hospital.

Option 3: Hospital Plan with Gap Coverage

On a hospital plan, you’ll generally still have to bear some of the costs yourself. A gap cover is an insurance product that helps to pay this difference. It doesn’t cost a lot and can make a huge difference in a crisis.

LARN ALSO: GEMS Medical Aid Scheme – Everything You Need to Know

Further points to keep in mind.

  • Your parents will probably have to wait for 3 months before they will be eligible for payouts from their new scheme.
  • On most schemes, they will have to wait a full 12 months before their medical aid will pay for chronic medication.
  • If your parents have never had medical aid, or haven’t had for a while, they’ll need to pay a monthly late joiner fee, which is a percentage of their medical aid payment.
  • No medical aid provider may refuse to provide your parents with a plan.
  • A good medical broker will have a thorough knowledge of the options available and will probably be able to direct you to the best policy for your needs.
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