Presented by Bonitas

Healthcare cover, no matter what your age

 ·3 Jun 2024

Lee Callakoppen, Principal Officer of Bonitas Medical Fund, offers advice and insights around medical aid planning, whether you are facing retirement, studying or entering the job market.

He says the challenge is finding the right plan to suit your healthcare needs and one you can afford. ‘The importance of healthcare has been at the forefront of several socio-economic trends at a global and local level, with those on medical aid faced with a number of choices on a daily basis. Brokers and financial advisors are well-versed in the intricacies of various healthcare plans and their expertise is vital in helping corporates and individuals navigate complex industry jargon and processes,’ says Callakoppen.

Lee Callakoppen, Principal Officer of Bonitas Medical Fund

Why is medical aid planning for retirement necessary?

Healthcare is important and having access to the right care, when it is needed is essential if you want to live your healthiest and best life. Bonitas data shows that members experience a 2% increase in health claims with each year they age.

As you age, you are more likely to experience conditions such as hearing loss, cataracts, back and neck pain, osteoarthritis, chronic obstructive pulmonary disease, diabetes and dementia. It is therefore essential that when doing financial planning for your future, you factor in the necessary medical aid and funds to access the level of care required.

Should members consider alternative plans as they age, such as downgrading to more affordable options?

Callakoppen warns that sometimes the relief from higher monthly costs can be short-lived when unexpected medical events occur. 

‘Members need to understand what benefit limitations may exist on the option or plan they are considering downgrading to,’ he says. ‘These limitations can include annual limits, co-payments and the use of network healthcare providers, so this needs to be considered and balanced against realistic healthcare needs.’

Downgrading may lead to a medical aid plan with more exclusions, which is why it’s important to know what, if any, procedures or services are and aren’t covered. This is particularly important as you get older. For example, knee and hip replacements become more likely: An MRI on your knee can cost around R15 000 and costs can increase rapidly when you factor in treatment, medication and procedures if you don’t have any healthcare cover. 

What advice should be given to university-aged children. Is there a ‘right time’ for dependents to move to their own medical plan?

Our advice is for younger members to join a medical aid as a main member as soon as they are able to. This allows them to choose a plan to meet their specific needs. Our Edge plans, for example, are designed specifically for younger individuals. They are technology driven, offering access through virtual integration and digital intervention, as well as benefit structures.

Joining earlier, also means they have access to preventative care benefits and screenings. So, if a healthcare concern or non-communicable diseases – such as high cholesterol or diabetes – is detected early on, proper interventions can take place.

The earlier you join a medical scheme, the more likely you’ll avoid late joiner penalties, which will mean paying additional premiums.

We all know that life is unpredictable and people are feeling the pinch financially. What happens if members want to cancel their medical aid?

The bottom line is that you cannot compromise on your health. The cost of private healthcare can be financially crippling, especially in a case of a severe illness or surgery.  Medical aids allow access to quality healthcare when needed, which is vital in cases of an emergency.

If you resign from your medical aid to save money, you may incur additional expenses in the form of late-joiner penalties or face other underwriting consequences, such as waiting periods, should you decide to rejoin.

The reality is that the public healthcare system is already overburdened and despite the NHI Bill being signed, it’s a long way away from being implemented. This means access to the level of care required may not always be available. ‘We advise members to rather consider a hospital plan to ensure they have cover for emergencies and chronic conditions should they be faced with financial pressures.’

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