Between October and December every year, South African medical aid members are given the opportunity to review their plans for the benefit review period. It allows for reflection, comparison, and a little smart thinking to ensure that your healthcare cover still fits your needs.
This blog tells what the review period is about, why it matters, and how best you can use it to your advantage.
1. What Is the Annual Premium and Benefit Review Period?
The review period is when medical aid schemes update their plans for the coming year and allow members to make adjustments.
- Timing: While any updates may start rolling out from late September, most of the schemes’ review windows fall during October to December.
- Effective date: Any changes will take effect on 1 January of the ensuing year.
- Purpose: To bring your cover into alignment with new benefits, cost structures, and your own health needs.
2. Why It’s Important
Your healthcare needs can change dramatically over a year and so can your medical scheme’s terms. The review period is your opportunity to:
- Ensure that your plan evolves with your needs: From managing chronic conditions to maternity cover for growing parents.
- Avoid unplanned spending: Be prepared for changes to benefit renewals, co-payments, and provider networks.
- Get more value for money: Through your contribution, adjust the scale of your cover to the max and keep it within your budget.
3. What to Look Out For
When reviewing your plan, keep an eye on:
- Key Dates: Each scheme has its own cut-off days for different plan changes.
- Scheme Communications: Read any updates sent to you and even keep an eye on trusted advisors, like MedXpert.
- Plan Changes: Check on changes in benefits, co-payment rules, DSP listings, and increases in contributions.
- Personal Health Needs: Plan for upcoming maternity requirements, management of new or existing chronic conditions, and routine preventative care such as screenings or vaccinations. Review any changes in your dependants’ health needs.
4. Common Updates from Medical Schemes
Medical schemes typically announce a combination of cost adjustments and benefit enhancements during the review period. Examples from recent years include:
- Enhanced benefits: Offerings for mental health cover were expanded, better maternity benefits were introduced, and the chronic care list was extended.
- Network and co-payment changes: Where necessary, changes to DSP networks or co-payment structures were made for procedures.
- New programmes: Adoption of various programmes such as geriatric care initiatives and enhanced rewards programmes.
5. How to Stay Informed
Navigating the review period doesn’t have to be overwhelming.
- Bookmark MedXpert’s Benefit Review Page for the latest updates.
- Use MedXpert’s Comparison Tool to evaluate your current plan against alternatives.
- Engage with MedXpert consultants for personalised recommendations.
- Stay Alert for scheme announcements so you don’t miss deadlines.
Final Thought
The annual review period provides an opportunity other than a mundane admin task to be fully involved in shaping your healthcare future. By staying informed and proactive, you can enter the new year confident that your cover still meets your needs and fits your budget.