TIME FOR AN UPGRADE

WE'RE COMING UP TO THE TIME OF YEAR THAT MEDICAL SCHEMES ALLOW PLAN UPGRADES FOR THE FOLLOWING YEAR. THIS IS A CRITICAL WINDOW FOR YOU TO REVIEW YOUR CURRENT COVER.

-  DOMINIQUE BOWEN

Your household budget has had a lot to contend with this year, including the rising cost of everything from fuel and groceries to electricity - not to mention increasing debt repayments. Under and over-insurance on medical cover can both be wasteful, which is why it's more important than ever to find that 'Goldilocks' level of cover.

TAKE STOCK

Cast your mind back over the past 12 to 24 months: did your medical savings account run out too early? Or did you find that your medical aid simply didn't cover certain expenses? The plan you've had for years may need to be retired.

Charleen Rix, head of healthcare consulting at Sasfin, suggests analysing what you and your family spent on healthcare over the past two years. This can help you pick up on trends, and allow you to gauge which benefits you make the most of, and what you spend, on average, on various 'benefit categories'. 'Ask yourself whether your family ran out of day-to-day funds, and how much in out-of-pocket expenses you had to cover,' she advises.

Before you rush into an upgrade, consider the follow-up question as well: do you fully understand how your current plan works? 'Often, you don't need to upgrade,' Rix says.

'You just need to understand how to extract greater value from your current plan.' 

Here are a few ways she suggests to 'unlock' that untapped value:

• Use your scheme's preferred hospital or healthcare provider network to reduce co-payments.
• Make sure your claims are being covered by the correct benefit on your plan. For example, if your chronic condition is covered by your plan, have you applied to have it paid from the risk benefits, in other words not your day-to-day benefits?'
• Buy your chronic medication according to your scheme's current medicine list or formulary.

A LIFE CHANGE