Not sure if you’re overpaying for medical aid? It might be time to compare medical aid plans. This guide breaks down:
- When to review your cover,
- What to look for,
- How to find the right fit for your needs – with help from MedXpert’s expert tools and advice.
With rising household costs, tighter budgets, and increasing healthcare expenses, reviewing your medical aid has never been more essential. Many South Africans stick to the same plan year after year, often without realising they could be saving hundreds (or thousands) annually, or gaining better cover for the same price. If you’ve ever wondered whether your plan is still right for you, now’s the time to learn how to compare medical aid plans the smart way.
In this guide, we’ll take you through why comparing schemes and plans matters, the best times to review your plan, what to look out for, and how MedXpert can help you simplify the process.
Why Compare Your Medical Aid?
Life doesn’t stand still, and neither should your health cover. Comparing your medical aid ensures that your plan matches your needs and that you’re not losing money on unnecessary benefits, or worse, left out-of-pocket when you need cover the most.
Here’s why regular comparisons are a must:
- Avoid being over-insured: Paying for benefits you never use? You could downgrade to a more affordable plan without compromising essential cover.
- Avoid being under-insured: If you’re regularly facing out-of-pocket costs, it’s a red flag that your current plan may not be sufficient.
- Maximise value: It’s about balance, getting the right level of cover at the right price
Remember: Needs change over time. Whether your children are growing up, you’ve developed new health concerns, or your financial situation has shifted, your medical aid should shift with you.
When Is the Best Time to Compare?
While you can technically review your cover at any time, some periods in the year offer better flexibility and savings potential:
1. Annual Benefit Review Period (September – November)
Medical schemes typically announce their benefit changes and price increases during this window. It’s the perfect time to assess whether your current plan still meets your needs, and you can switch plans within the same medical scheme without a life changing event to justify the move.
2. After Major Life Events
Had a baby? Kids off to varsity? Health conditions changed? Life transitions often impact your medical needs, and your plan should shift accordingly at the time of or as close to the change as possible.
3. After Unexpected Health Expenses
A few large medical bills can reveal gaps in your cover. It might be time to upgrade or shift to a plan with better specialist or hospital benefits. It might also be time to add Gap Cover to your cover, if you haven’t already done so.
4. When Considering Network Options
Network plans can offer significant cost savings while still providing quality care. If you’re sticking to a specific group of providers already, why not pay less for the same service?
What Should You Compare?
Here are the top areas to look at when comparing medical aid plans:
- Child Dependent Premium Structures
Do you know at what age your child will be charged adult rates? Some schemes change rates at 21, others at 24 or even 26. This can make a big difference to your monthly premiums. Don’t wait until the increase hits. Be proactive and speak to a MedXpert consultant about your options.
- Your Claims History
Check how often you’ve used your plan in the past year. Are you maxing out your benefits or barely using them? Your claims history is a great indicator of whether your plan suits your real-world needs.
- Level of Cover
Don’t automatically assume a comprehensive plan is best. If you’re healthy and rarely visit the doctor, a hospital plan or network option could save you significantly.
- Network vs. Non-Network
Network options can offer similar benefits at a lower cost, as long as you’re comfortable using approved providers. If you already see network providers, this could be an easy switch.
Tips for a Successful Comparison
Ready to start comparing? Here’s how to do it effectively:
1. Review Your Claims
Look back at the last 12–24 months. Did you use your medical savings? Face co-payments? Need specialist care often? Use this insight to assess your needs.
2. Understand Premium Structures
Know the rules, especially when it comes to dependants, students, or chronic benefits. Many members overpay simply because they’re unaware of their options.
3. Use Online Tools
Free comparison tools, like the one on MedXpert’s website, make it easy to see plan benefits side-by-side.
4. Get Expert Advice
Speaking to an accredited, independent advisor like MedXpert can help you uncover value and avoid costly mistakes. Let a qualified, expert consultant guide you through plan structures, waiting periods, and hidden clauses.
MedXpert Can Help You Compare
At MedXpert, we simplify the process of comparing medical aid quotes. Whether you’re trying to avoid overpaying, need better chronic cover, or want a plan that fits your family’s changing needs, we’re here to help. Our free tools and expert guidance
take the confusion out of comparing plans. Our aim is to save you both time and money, while finding the best cover for you.
Already know what you need? Use our online comparison tool to view available medical aid plans. Looking to compare health insurance plans instead? Contact us for personal advice.
Final Thoughts: A Better Plan Starts With a Better Comparison
Comparing your medical aid plan isn’t just about saving money, it’s about gaining peace of mind. Whether you’re trying to cut costs, boost benefits, or simply ensure your plan still suits your lifestyle, taking time to compare medical aid plans can make all the difference.
Don’t wait until you’re hit with an unexpected bill. Be proactive. A few small changes today can lead to major savings and better protection tomorrow.
Alternatively, you can call us on 0860 860 860 or email ask@MedXpert.co.za.
MedXpert, the medical experts on your side.