It’s about this time of the year that medical schemes across the country start rolling out their 2020 plan options. The one thing you can guarantee is that your medical aid membership fees are going up (probably as much as 10%) and that means that you will need to cough up at least a few more thousand Rand, over the course of the year, for private healthcare cover.

Should you stay on your current plan? Or should you upgrade or even downgrade?

That really depends on how this year has gone for you healthwise.

The best way to pick your medical aid plan for 2020 is to do a quick audit of your medical aid contributions for 2019 vs your claims.

The debate is always whether to try and self-fund your day-to-day expenses.

Most of us belong to medical aid schemes to cover the worst-case scenario, which is landing up in hospital for an extended period of time and being saddled with crippling debt we will probably not recover from.

But then there is also the day-to-day stuff like GP and dentist visits.

While expensive, these expenses aren’t necessarily going to break the bank.

Most people who can afford to self-fund these day-to-day medical expenses generally do, which leaves them with a couple of questions they need to answer before making a plan choice for next year:

  • Do I need Gap Cover to cover the portion of my hospital stay my medical aid isn’t going to pick up?
  • Would I consider a hospital network option to reduce my premiums?

Now if having a medical aid savings account is important to you, these are the types of questions you need to ask yourself:

  • Did I run out of medical savings this year?
  • If no, perhaps I have too much savings, in which case perhaps I should downgrade my plan for 2020?
  • If yes, then at what point did I run out of savings and is that an indication that I’m underinsured and need more medical savings in 2020?
  • Would an above threshold benefit be something I might consider so that my medical aid can pick up the expenses when I’ve exhausted my savings?

When you need your medical aid to cover day-to-day expenses, things get a little trickier.

In a perfect world you would run out of medical savings on the 31st December and as the New Year rolls in, your account would be automatically reloaded.

If you have kids, you know this simply isn’t the case.

Running out of medical savings way too early in the year, every year, probably means you don’t have enough savings and you should consider a plan upgrade or a plan with an above threshold safety net.

The above threshold safety net kicks in once you have pushed through your own savings and a self-payment gap. Your medical scheme then picks up the costs for the balance of the year.

Managing your private healthcare needs isn’t easy. We don’t have a crystal ball, so we don’t know what’s around the corner. The best we can do is look objectively at how things have played out over the last year or two. Then take a look at what medical aid option we can afford for 2020 and make a decision based on that.

Start with making sure that you have your bases covered. By that we mean comprehensive hospital cover. Those are the costs that can break the bank.

Until next time.

The MoneyShop Team