There are broadly two types of medical aids – open and restricted. The latter, restricted medical aids, cater for only specific groups, be it the employees of certain companies, industry workers or those belong to specific organisations. One type of restricted medical aid is that for professionals. This refers to technikon (technical university) and university graduates who have completed a degree encompassing at least 4 years of study. There are several benefits to joining a medical aid for professionals as they are restricted schemes with a very exclusive member base.
Benefits of Professionals Only Medical Aid
The main benefit of joining a medical aid only for professionals is that you get better rates. However, it is important to note that most medical aids in South Africa offer just about the same benefits for the same price so it is not impossible to get the same benefits for about the same price. The medical aid for professionals only in South Africa, that is open to all industry professionals, is Profmed. The noticeable difference in their benefits is that they offer unlimited hospital cover. But so do many other schemes although the premiums may be slightly higher for these better plans.
The other advantage of joining a restricted medical aid is that you are pooling your money along with other professionals. The fact of the matter is that graduate professionals are considered as a lower risk – even life insurance is determined by a person’s educational level. Professionals are less like to participate in risky behaviour, are more likely to seek medical attention when needed and are often more health conscious. This means a healthier member base for the medical aid which can translate into a more stable fund. At a time when schemes are tightening up on claims in an attempt to limit payouts, belonging to a medical aid that caters for a niche group may therefore be advantageous.
Students in Final Year of University
Medical aids for professionals, like Profmed, allow students in their final year of study to join the scheme. In other words a student in their fourth year of study (final year of their degree) can become a member of the medical aid and enjoy all the benefits of cover for professionals. Monthly contributions are more affordable for student members. The advantage of starting up on medical aid earlier is that as a student, who is usually younger, you do not have any pre-existing diseases as yet and can therefore avoid any waiting periods and exclusion criteria.
There is also a tax benefit if you are doing an internship or apprenticeship where you may be earning very little and not enjoying any company perks like medical aid. No matter how small your earning, government may still want a piece of the pie in the form of taxes. However, you can claim back a portion of your medical aid fees at the end of the year by filling out the appropriate tax forms.
Non-Essential Services
There are certain healthcare services that are considered non-essential by most medical aids in South Africa. Fertility treatments are one of them. Some industry medical aids like CAMAF provide annual benefits for the treatment and management of infertility. This is unique as medical aids that cover fertility treatments are practically non-existent in South Africa. Surgery and other fertility procedures are among the most expensive medical services in South Africa and women who are experience difficulty conceiving will quickly appreciate the benefit of having this level of cover from their medical aid.
Up until a few years ago, some very medical aids like those for professionals even offered cover for women who were already pregnant, up to the first month of pregnancy. Although this has fallen away, even among medical aids targeting professionals only, it does indicate the these rather exclusive schemes are able to offer services that most schemes could never imagine including in their schedule of benefits. Medical aid when already pregnant is still highly sought after as some women only realise the importance of cover after finding out about their pregnancy.
As medical aids tighten their belts and reduce benefits for what is deemed “non-essential”, members belonging to a medical aid for professionals are less likely to have these additional benefits fall away immediately.