Is a Medical Aid Scheme too expensive for you?
By Kenny Williamson , Discovery Health Consultant.
Being a broker for medical schemes
and risk cover (life, disability, severe illness
cover, etc.), I often come across situations where medical aid cover
is simply too
expensive for people to access.
The problem could be that someone is over 35 and cannot afford the Late Joiner
Penalty that would be imposed on joining a medical scheme
. Maybe medical scheme
is too large a portion of their income to afford. Or, as happens regularly, people
leave their medical scheme cover
until they are older and they realise they are going
to need it, when it is too big a bite out of their budgets to afford.
Especially when they realise they need to catch up their retirement funding.
With a background as a Discovery Consulting Services consultant I have gotten to
know the Discovery Life product range well and sometimes the following solution is
better than not at all.
cover actual cost, i.e. they pay towards the actual cost of
operations, procedures, etc.
A Risk product uses a sum assured approach and is not regarded as a medical
. So, instead of insuring you for an operation you might have, it would insure
you for an amount (you select) on diagnosis of an illness.
Where affordability is an issue and some medical cover is needed, you could:
Lets begin with why do I do this?
As mentioned earlier this approach uses the philosophy that some cover is better
than no cover.
Discovery Lifes minimum premium is R200 and Discovery Healths medical scheme
cover minimum (lowest hospital plan and income below R6800) is R397, up to R2306
for the Executive Plan.
At this point, I would like to make something absolutely clear. That risk cover (in
this case, severe illness cover) is not intended as medical scheme
cover and does not
fulfil the job of a medical scheme.
So what exactly am I saying?
Sometimes it is advantageous to take an Impairment fund (stand alone Severe Illness
Benefit cover) if you can only afford a lower premium and are you need some kind
of medical cover.
Why would I suggest this as an alternative to no cover?
A few years back you could buy what was called Dread Disease cover (you probably
still can with some companies), these products paid out on the diagnosis of a dread
disease. Cancer would be an example.
Then, a company launched a benefit called the Severe Illness Benefit.
This allows looking at the body as a system, an interacting organism, a holistic
The product covers the major physiological and anatomical systems of the body.
Broken down in the following systems:
Heart and Artery Benefit
Nervous System Benefit
Respiratory Diseases Benefit
Urogenital Tract and Kidney Benefit
Connective Tissues Benefit
Advanced HIV/ AIDS Benefit
Ear, Nose and Throat Benefit
Endocrine and Metabolic Diseases Benefit
You are able to get payments for illnesses around these systems from 5% to 100% of
the sum you have insured yourself for.
So this is the closest product to medical scheme cover I have in my financial planning
Another great advantage of the product is that it is possible to get cover up to age 75
(you are underwritten for the product).
A real case:
A female client who is a month away from turning 75 years old. She is on a medical
(hospital type cover). I know from experience that severe illnesses start
becoming more prevalent in your later years. The opportunity to get some sort of
extra cover for expenses that would happen if she contracted an illness and the
medical aid didnt pay the full expenses, would be lost at age 75. She instituted an
impairment fund for R100 000.
She now has more certainty.
Another issue to think about is the contracting of severe illness by your children. At
present time this is rising worldwide. The costs associated are the same for your child
as if the illness happened to you.
You can add your parents and your children to your Discovery Life policy
illness cover. So be certain to look at a few options if you consider the above advice.
As, due to the costing of the product you might find for instance that it is cheaper to
add your parent to your own policy than to take out a separate Impairment Fund
All this being saidremember, if you look at something along these lines as an
option, there is no one size fits all and your broker / agent / planner will need to
play around with various options to determine which fit is best for you.