9 November 2023
Here, Sanlam Health Solutions outlines some key questions to ask yourself and a trusted financial adviser before you make any moves.
As the year ends, your financial plan should be a focus. Medical aid schemes know this, which is why, during November and December, most allow their members to upgrade their plans. Since the choice to downgrade a plan is often financially driven, schemes usually allow this change throughout the year.
Here are some critical questions to ask.
Did your medical savings account run ‘dry’ mid-year? Did your current plan cover any curveball health costs? Has a family member received a diagnosis that warrants an upgrade to help manage their treatment?
Think about what you need your plan to cover and what you’re able and willing to pay out of pocket.
If you’re a young adult, a basic hospital plan or a network plan with limited day-to-day cover from stipulated providers may be the right match. If you’re planning to grow your family, you may want to upgrade your cover to one with generous maternity benefits. If you have school-going children, you might need a plan with ‘boosted’ dentistry and orthodontics benefits, for example.
Work with your adviser to unpack what’s appropriate for your life stage and unique circumstances.
Contributions should not exceed 10% to 15% of your monthly household income, so a shift in income should come with a re-evaluation of your current policies. It’s a question of value – seek out an option that balances cost with the level of cover you need.
Some schemes, like Bonitas, offer network-based plans, meaning you can save up to around 15% on select, scheme-approved providers.
Most plans offer preventative healthcare and wellness checks, which help to detect prospective issues early on.
Fedhealth’s flexiFED option range offers in-hospital and chronic cover for every life stage and three different ways to structure your day-to-day funding which allows you to determine how much you would like to pay. Additionally, all plans offer free access to Panda, a mental wellness and support platform. Are you making the most of these?
An adviser can do a needs analysis with you to identify any blind spots and help you choose a plan holistically, aligned with your health requirements and financial constraints. For example, if you want to downgrade to save money, but the downgraded plan probably means spending more on a specialist’s fees for a procedure you expect to have next year, an adviser could highlight this.
This builds in another layer of financial protection against prospective out-of-pocket costs for treatments beyond what your medical aid policy will pay. This helps to give you the freedom of choosing the specialist that you have the most confidence in, with reduced worry about their rates.
Gap cover can make a massive difference at times when this is needed most, for example, the Sanlam Gap Cover range offers preferred premiums as well as a seamless claims process with our partnered medical schemes, Bonitas and Fedhealth. Essentially providing you and your family with full medical cover.
Sanlam Health Solutions is committed to empowering clients to live confidently, with peace in the knowledge they have some protection against costly health curveballs.
Need a medical aid quote? Choose from a range of affordable solutions that suit your life and pocket with Sanlam Health Solutions in partnership with Bonitas and Fedhealth.