If referring back to the Medical Aid Explained information, you would recall that no Insurer may do the job of a Medical Aid. When we say Medical Aid, or sometimes called Hospital plans, we are essentially purchasing unlimited Chronic (27 conditions) & unlimited Hospital (non-cosmetic) cover. A straight forward cancer recovery claim can reach hundreds of Thousaands of Rands, ICU is around R20,000 per day excluding Specialist visits and extra’s thrown in, that is purely for the ‘bed’ so to speak. We as a brokerage have processed premature new born claims for R1.5M, Vehicle accident claims of also a few Million and loads more all frighteningly expensive ongoing admissions claims.

As an independent financial brokerage, we only market financial product houses/categories that we would spend money on ourselves and health insurance is one of those. If someone absolutely cannot afford Medical Aid at all, we would say that, at the very least, one could take quite cheaply priced health insurance just for the interim until such time as they can afford Medical Aid. At the employer level, both Momentum & Discovery have rather enticing options for companies that offer GP visits and all sorts of health insurance benefits, even some minor chronic benefits and it’s great to be able to see the GP when required, but when it really comes down to it, there isn’t much cover for the really big ticket items such as cancer, hospital admissions, etc.

It’s always a tough decision to make for an employer to roll out a health insurance scheme as opposed to a medical scheme. We at WWFS only offer one simple health insurance package which is a no frills no fuss, good old accident cover with a decent casualty benefit that could catch some nasty conditions (accident related) in a Private facility. Even with this policy though, a State Hospital would most likely be involved for follow-up surgery or non-accidental conditions, and of course we don’t want this for the client, but that’s the difference between Medical Aid and Health insurance.

There is a day-to-day option with GP visits and even some chronic condition cover that one can add, but we don’t assist with it as it’s simply too much that can go wrong. Our focus is Medical Aid hospital and chronic claims and motivations from hospital and/or PMB benefits dealing directly with the providers when Gap cover is involved.