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Medical aid too costly? 'Medical insurance' is far cheaper and it provides a lot

27 January 2021 9:37 AM

For R397 per month, you get unlimited GP visits and unlimited medication. You also get basic radiology, pathology, dentistry...

Medical aids – even hospital plans – are so expensive, only a minority of employed South Africans can afford them.

They are so expensive, in part, because they must provide members with prescribed minimum benefits (PMBs) which covers 270 conditions and 25 chronic diseases.

“Medical insurance” might come in handy if you are one of the unlucky many who cannot afford medical aid.

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It is cheaper, partly because it does not have to provide PMBs.

However, for the price (they start at R397 per month), it provides a heck of a lot such as (but not limited to):

  • Unlimited GP visits

  • Unlimited acute and chronic medication

  • Over the counter medication

  • Basic radiology

  • Basic pathology

  • Basic dentistry

  • Limited optometry

  • Set amount for specialists

Another benefit of medical insurance it that there are no late-joiner fees such as those charged by medical schemes.

Refilwe Moloto asked Johan Josling (CEO at Episodic Health) to explain the differences between medical aid and medical insurance.

Health insurance offers an alternative to medical schemes. It covers you against unforeseen medical expenses… It’s governed by the Financial Sector Conduct Authority. Medical schemes are covered by the Council for Medical Schemes.

Johan Josling, CEO - Episodic Health

Health insurance solutions are much cheaper than medical aid, but there’s a good reason for it… Waiting periods differ… There are no late-joiner penalties with health insurance products…

Johan Josling, CEO - Episodic Health

Our solutions start at R397 a month, covering you for basic primary care… things such as unlimited GP visits, acute and chronic medication, over the counter medication, basic radiology and pathology, basic dentistry, limited optometry and a set amount for specialists… all that for R397.

Johan Josling, CEO - Episodic Health

You should see health insurance as complementary to medical aid, not a substitute…. A lot of people run out of their savings portion of their medical aid early in the year... For R397 per month, you are covered for unlimited GP visits – it doesn’t matter how many times you go in a year… Also, your acute and chronic meds – that cannot run out…

Johan Josling, CEO - Episodic Health

Listen to the interview in the audio below.




27 January 2021 9:37 AM

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