If you and your family are currently members of a medical aid in South Africa, you may be thinking of making a change. You have a choice to remain on your current medical aid or you may decide to change to another one.
If you remain on your current medical aid, there is no action you need to take (apart from perhaps checking that the medical aid has all your correct contact information on file).
It’s also not a problem if you decide to change to an entirely new or different medical aid, because you can make this change any time of the year.
Deadline for upgrading or downgrading within your current medical aid
However, if you decide to remain with your current medical aid, but choose to upgrade (or downgrade) to another plan that your medical aid offers, you only have a few weeks left to do this. This change can only be done once a year and is effective 1 January.
Here are 3 tips if you decide to upgrade or downgrade:
1. You need to be sure about the change. Study the information on the plans your medical aid offers for 2017 (on the medical aid’s website). This information should be available from about 15 November 2016.
Alternatively, contact your medical aid to obtain the relevant information. Most funds have a document available where they compare the benefits and premiums of the plans they offer.
Study it, make notes and contact the call centre of the medical aid with your questions.
2. When you compare the costs of your existing plan with the new plan that you consider moving to, compare the two plans’ 2017 contributions and not what you are paying for it now.
Your current plan’s contribution will increase in January anyway so it does not help to compare the new plan’s 2017 contribution with the current cost.
3. Check with your medical aid how long your request will take and what their cut-off date is for processing it.
If your medical aid’s cut-off date is 10 December 2016 and they take a week to process the request, you have to send in your request on the 1st or 2nd of December.
Making the actual changes : call or email?
Find out from your specific medical aid how you can upgrade or downgrade. Some medical aids can do this change over the phone and other medical aids require a form to be completed.
With changes done telephonically, make notes of the date and time of your call to the medical aid, who you spoke to, get a reference number for the call (if available) and confirm all the changes at the end of the call.
It is advisable to send a follow-up email after the call to make 100% sure the changes were done correctly.
If you complete a form for the upgrade or downgrade, make sure that it is fully completed so that it will not be rejected.
Also make sure (on the form or by contacting the medical aid) if you need to send in any supplementary documents like a copy of your ID.
Medical aid changes and your budget
What package you will upgrade or downgrade to, will be determined by various factors for example your age, health, medical requirements, budget and the size of your family.
In most cases, it will be a financial decision whether you can afford an upgrade or whether your budget is forcing you to consider a downgrade.