Choose Your Medical Scheme Wisely
It’s that time of the year again when medical scheme members, through their principal members, must decide whether they want to remain on their current benefit option or medical scheme or switch to another option or scheme.
As with most medical scheme rules, this decision should be made by the end of November or early December. Many people also consider joining a medical scheme as their necessity for private healthcare increases. Prospective and current medical scheme members are encouraged to choose wisely when selecting their medical scheme and benefit options for 2024.
- Choose your benefit option or medical scheme according to your healthcare needs and affordability.
- Read all information material published by your selected medical scheme/s on essential changes to options for the upcoming year. If unsure, call the scheme and request information on any changes, limits, benefits and other relevant information.
- You may use a Broker (intermediary), but it is not compulsory. If you do, ensure that they are accredited by the CMS and that your selection of a scheme and benefit option is based on informed consent.
- Familiarise yourself with any network arrangements a particular benefit option might have. This is designed to save you and the scheme money in the long run.
- Determine how close Designated Service Providers (DSPs) are to your home and place of work, as well as what co-payments will apply for voluntary non-use of DSPs.
- Find out what late joiner penalties or waiting periods may apply to you.
Existing medical scheme members who wish to move to another scheme should please note that waiting periods may apply. This is a design of the Medical Schemes Act (131 of 1998) to prevent scheme hopping, where members move from one scheme to another too frequently.
Download our comprehensive guides on choosing a medical scheme