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Medical Gap Cover Policy, Benefits and Pricing

Most South African medical aid members have faced a further bill after their scheme settles their doctor or other health care professional. Your scheme only pays according to certain tariffs but these days many doctors charge above these rates. As a result the patient...

Medical Aid After Divorce for Ex-Spouse (Husband or Wife)

If you are divorced and wondering how it will affect your medical aid then it is best that you contact your medical aid broker or medical scheme as soon as possible. Many South African main members are unaware that they cannot keep their ex on their medical aid unless...

Change Plan By Year End or Wait Till Next December

Many South African medical aid members are unaware that they can only change plans at the year end. While you can leave your medical scheme and join another at anytime, switching plans within the same scheme can only be done in December. Whether you want to move to a...

Diabetes Cover on Medical Aid, Benefits and Limits

Diabetes mellitus is one of the most common chronic conditions in South Africa these days. The rise in the number of diabetics has practically made it an epidemic in S.A., possibly linked to the rise in the number of middle class South Africans. Diabetes can have a...

Shortfall Payment and Medical Aid Co-Payments

Medical aid pays according the rates as laid out in the National Health Reference Price List (NHRPL). Disruptions with the annual publishing of the list in recent years has led to schemes applying an inflation-linked increase to tariffs. However, the rates a medical...