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A Guide to Medical Cover for Pensioners

A guide to medical cover for pensioners

It’s a given that we need more specialised healthcare as we get older. Pensioners in particular, may be concerned about health cover. Both their age and income constraints can hinder their ability to get appropriate health cover. Given that elderly people are more prone to chronic illnesses and other age-related illnesses, medical care for pensioners can become very expensive. With the high cost of private health services in South Africa, trying to get good quality treatment without medical cover can be very costly. 

For these reasons, medical cover is essential for seniors and pensioners. When choosing medical cover as a pensioner, there are several factors to take into account. For example, you need to consider your medical needs, your current financial situation, and the level of cover that would be the most sufficient. 

In this blog, we’ll look into ways to make the most out of your medical cover if you’re a pensioner.

Things to consider before taking out medical cover for pensioners

Medical cover for pensioners has no age limit

Many South Africans are under the impression that medical insurance falls away after a certain age. Luckily, this is untrue; there is no age limit for the senior citizens to get medical health cover. Also, whether you earn an income or not doesn’t prevent you from getting medical cover. Any person over the age of 18 can get medical insurance if they can afford it.

There may be waiting periods 

Most medical covers have a 3-month waiting period that applies to all new members. The waiting period applies to all ages, income levels and health statuses. During this waiting period, medical insurance will not pay for any healthcare costs. However, the 3-month waiting period doesn’t apply to seniors who were covered by another registered healthcare plan and moved to a new healthcare plan. 

After the three month mark, there may be a 12-month pre-existing condition waiting period. This waiting period applies to any condition or illness that existed before starting your medical cover. During this time, you’ll still have to pay your monthly contributions. However, you cannot claim for any tests, consultations, or treatments related to the pre-existing condition. After the 12-month period, you can enjoy cover for your ailments.

You may need to pay late joiner fees

It’s important to understand that there is a late joiner penalty for any person who joins a healthcare plan after a certain age. The late fee is an additional fee that gets added to the monthly medical contributions. The fee you pay is dependent on age. For instance, someone who is 60 will pay less fees than someone who is 70. This penalty can significantly increase premiums of medical insurance for pensioners. Be sure to find out what the penalty fee is before taking medical cover. Those who join Affinity Health after the age of 54 will be subject to increased premiums.

 You should adjust your risk profile frequently

If you’ve signed up as a medical insurance member in South Africa, it’s a good idea to re-adjust your risk profile on an annual basis. Re-adjusting will ensure that as you age, your cover remains appropriate, given your ever-changing health needs.

What to consider when adjusting your profile:

  •  Chronic illness benefit – Is it sufficient enough, and what conditions and chronic medications do they cover, and at what rate?
  •  Disease management programme – Does your medical cover offer a management programme for your specific condition, and are you registered for this condition?
  •  Emergency and casualty benefit – Is there a blanket cover for emergencies? Do they cover the costs of casualty visits? Is it compulsory to use network facilities, or can you visit any clinic or hospital?
  •  External medical appliances – Are walkers, wheelchairs, breathing devices, hearing aids and insulin pumps paid for in full by your medical insurance?   
  •  Prosthetic devices – Does your medical insurance provider limit the benefits associated with hip, knee and shoulder prostheses, pacemakers, and other internal devices? Are you required to use specific suppliers? 
  •  Home nursing benefit – Does your medical insurance provider cover your home care? For how long do they cover home care after surgery or a medical event?

Affordable Medical cover for Pensioners

Senior Health Cover

At Affinity Health, we’re passionate about helping senior citizens get access to affordable and efficient healthcare. 

We know that medical cover for seniors and pensioners can be quite pricey. Luckily Affinity Health has some affordable medical cover options that you can customise to suit your health needs. 

The Affinity Health Day-to-Day and Hospital plan gives you access to a wide range of benefits. Benefits include unlimited visits to any network GP, basic acute medication, hospitalisation for illness and medical emergencies, and so much more. The Senior plan also caters for dependents and spouses on the same policy.

Senior Health cover options:

Day-to-Day Health Plan

The Affinity Health Day-to-Day plan helps you to cover the everyday costs of everyday health expenses. These expenses include going to the doctor or dentist, and obtaining prescribed acute medication. You will also receive service from any Medical Society Centre for primary medical treatment and healthcare. Basic pathology and radiology are also covered when recommended by your Medical Practitioner. See the full list of benefits here.

Hospital Plan

As one of the fastest-growing providers of Hospital Plans in South Africa, Affinity Health provides you with an affordable Hospital Plan that gives you access to a wide range of features when you need it most. Our hospital plan provides benefits in the event of hospitalisation as a result of an illness, accident or medical emergency.

What’s more is, the Affinity Health Hospital Plan offers a much wider choice of doctors and hospitals than if you were a public patient. See the full list of benefits here

If you’re interested in finding out more about our Senior Health Cover, contact us on 0861 11 00 33. Our agents are happy to take you through the process and answer any questions you may have.