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Medical cover: Senior citizens have options

Medical cover: Senior citizens have options, says Affinity Health

 As you age, you are increasingly prone to disease and injury, so it’s important to get the right medical cover when you’re older, says Affinity Health.

The good news is that because of huge advances in medicine people are living longer than ever before. The bad news is that the older you get, the greater the need for quality senior health insurance.

South Africa has a large population of seniors. The latest estimates produced by Statistics South Africa (Stats SA) show that there are roughly 56,5 million people living in SA, of which 4,6 million are aged 60 and older. If you fall in this age bracket, having just one medical plan may not be sufficient to provide the coverage you need. 

With so many different options available – and coverage combinations – finding the right option can be tricky. This is why you should consider several factors when making your choice:

  • Your financial situation: Depending on your financial situation, you may opt for full medical aid cover with savings, or choose a hospital plan only.
  • Facilities close to you: Medical aid providers have a network of private practitioners or hospitals that have to be used by members. This could pose a problem if none of the network’s service providers are close to where you live.
  • Level of cover appropriate for your health needs: Always find out what the prescribed minimum benefits offered are. The government has legislated for prescribed minimum benefits (PMBs). This is a list of 270 conditions which even the most basic of medical aids have to cover. But the list does not cover every single condition. Ask what non-PMB conditions and chronic medications are covered, and at what rate.
  • Penalty fees & waiting periods: If you are over a certain age and intend to join a medical aid scheme for the first time, or have been without medical aid cover for a period of time, you will likely be penalised with a late joiner fee and waiting period. Make sure to find out what the penalty fee and waiting period is before joining a medical scheme.
  • Disease management programme: Does your medical aid offer a management programme for your condition, and are you a registered member?
  • Emergency and casualty benefit: Is there blanket cover for emergency evacuations, how are the costs of casualty visits covered, and do you have to use network facilities, or any hospital or clinic?
  • External medical appliances: Are wheelchairs, walkers, breathing devices, hearing aids, and insulin pumps paid for in full by your medical aid?   
  • Prosthetic devices: Does your medical aid provider limit the benefits associated with knee, hip, and shoulder prostheses, pacemakers, and other internal devices, and do you have to use a preferred supplier?
  • Home nursing benefit: Is your care at home covered, and for how long after an event or surgery?

If you’re still unsure, don’t be afraid to ask an experienced independent agent who will be able to answer your questions about senior medical insurance and guide you as to which insurer would be more suitable for your unique needs.

“Senior Citizens are the backbone of our society and Affinity Health understands the importance of ensuring that as a senior, your health and well-being are taken care of. This is why we have launched the Affinity Senior Plan,” says Murray Hewlett, CEO of Affinity Health.

“The Affinity Health Day-to-Day and Hospital plans provide you with a wide range of benefits including unlimited doctor consultations to any GP of your choice on our network, basic acute medication, hospitalisation for illness and medical emergencies, and much more. The Senior plan also caters for Spouse and Dependants on the same policy.”

About Affinity Health

Affinity Health aims to provide premier quality, affordable medical insurance to South Africans. We strive to give our clients peace of mind and the highest standard of service when they are faced with injury or illness. We work to deliver innovative solutions that are simple, cost-effective and proven, so our cover is structured to ensure that you get exactly what you need. For more information follow us on Facebook, and Instagram.