Category: Momentum Blog

When joining a medical aid, it’s easy to be intimidated by what seems like an endless list of questions. These can range from when you last underwent an operation to whether or not you’re taking any medication. But why so many questions, and so specific?

It is actually quite important, and you want to be 100% honest and thorough when completing these. Ideally, you would want your broker (also known as healthcare adviser) to be present. That way he/she can explain terms you may not understand, or help ensure that you don’t leave something out that you may consider irrelevant.

Why is it important? Firstly, because if you do not correctly and fully disclose your medical history, your claims may be rejected. In fact, you may also get kicked off the medical aid, and may even face fraud charges. Secondly, as you may well know, medical aid members share the same pool of funds. In other words, your contributions go into a savings bank from which all claims need to be paid. Therefore, it is important to avoid a situation where a person waits until they get sick, joins a medical aid and immediately claims for an expensive operation. That would mean that those members who have been contributing monthly, without claiming, have to pay for this new member’s healthcare expenses, without the new member having contributed to the pool.

Based on the disclosure of things like existing medical conditions, medical aid schemes can protect existing members’ funds from abuse by new members, through waiting periods and late joiner penalties. And, as a new member joining, you may be better placed to understand which option you should be joining, once you have completed the questions on the application form.

Can a medical aid refuse to accept you as a member if you do have an existing illness? Nope! South Africa’s strictly controlled medical aid industry is very serious about making sure that despite your age or medical history, you are able to take out healthcare cover and start contributing to a pool of funds which can protect you against future medical expenses. 

Come January every year, you should have a to-do list of quick and easy tasks to tick off for the year. From making sure that your insurer reduces your premiums in line with the drop in your car’s value, to going for your free preventative healthcare check-ups.

On Momentum Health for instance, you get to go for a free health assessment that takes less than 15 minutes, but checks and informs you on your blood pressure, cholesterol, waist circumference and weight. Most members also use this opportunity, while visiting the friendly nurse at Clicks, Dis-Chem or their local qualifying pharmacy, to check their HIV status (the medical aid will pay for this test once every five years).

If you are registered for and earning HealthReturns from Momentum, you can earn between 1 (Custom Option) and 4 (Summit Option) free GP visits. Of course, if there is no need to visit the GP, that’s great, but these free visits come in really handy for most families when, for instance, dad had the flu, then mom stubbed her toe the next week and also had to go, and then little Jimmy got sick again later in the year.

One of the best ways to get the most out of your medical aid is to understand your benefits. For instance, if you are paying a discounted contribution because you selected to use doctors or hospitals from a specific list (often referred to as a network), you can minimise additional out-of-pocket expenses by making sure that you do use these providers. Similarly, when you visit a doctor or specialist, discuss their charges with them, and ask them not to charge above the rate covered on your option. If you are visiting a network doctor, this is usually not required, as they will generally charge at network rates. Again, if you are earning HealthReturns, you can also earn an increase in your Momentum Health Rate for in-hospital specialist treatment.

Click here to download a guide on how to save on your medical expenses.

First there was HealthReturns, a Momentum initiative that rewards active families on Momentum Health with up to R3 000 a month, just for living a healthy and active lifestyle. Now, we have KidsReturns, an extension of HealthReturns, but aimed at helping kids get active, and fostering their love of exercise and being active from an early age.

How many families do you know that are active together? Parkruns have helped a lot, I frequently see a family and their dog doing their 5km outing on a Saturday with gusto, but once a week should only be the starting point. Apart from the physical health benefits, there are enormous mental health benefits to be gained if you can get your family out there doing something fun and physical together – after all, that’s often the best time to chat casually about issues that may have been causing friction at home.

Momentum’s intention with KidsReturns is to start creating awareness around exercise from an early age, and to make them feel “rewarded” for having completed a bit of moderate exercise. Currently available to Momentum Health members on the Incentive, Extender and Summit Options, a qualifying family would be one where they are registered to earn HealthReturns and both parents are indeed earning HealthReturns (in fact, for kids under 16, KidsReturns are based on the activity level of the least active adult on the membership) That should be enough motivation to get the couch potatoes up and moving. For kids 16 to 21, activity is measured using the FitVault app, whether it’s a gym visit, or Parkrun or burning 300 calories in one go.

Medical aid is often seen as something you need in case of an emergency. Modern medical aid providers can, however, give you access to complementary products that could help you improve your health, and enjoy better quality of life!

Click here to download a guide to HealthReturns, or here for a guide to activating KidsReturns.

+HealthReturns/KidsReturns are voluntary complementary products
available from Momentum. You can choose to make use of additional products
available from Momentum Group a division of MMI Group Limited (Momentum), to
seamlessly enhance your medical aid. These complementary products are not
medical scheme benefits. Momentum is not a medical scheme and is a separate
entity to Momentum Health. You can be a member of Momentum Health without
taking any of the complementary products that Momentum offers.

My son is a great believer in the healing power of plasters. And when he hurts something, picking “the right plaster” can be a serious affair. Apparently, the thin white ones with flowers on them work better for skinned knees, while the thick brown ones work best for arms and elbows.

When I had to choose my first medical aid, the process felt similar to his plaster selection. There are so many complex things to get to understand, and some of the terminology seems to require a law degree to decipher. So how do you choose the best medical aid for you to be on, from this jungle of foreign and complex information?

For the majority of consumers, the two primary objectives are affordability and having the cover that fits your needs. A 60-year-old diabetic, for example, would require being on quite a different medical aid option from a mountain biking 21-year-old with no chronic illness.

Why not break your search down into simple questions (let’s use a young, active member as an example):

• Since I am young and not suffering from a chronic illness, would I be happy to pay the lower contribution of a medical aid option that does not have extensive cover for chronic conditions? For example, I may have to get chronic medication from a State facility if I do develop such a disease, rather than from a private facility (keeping in mind that you would be allowed to change options once every year in line with changes to your healthcare needs)
• And, seeing as how I do not frequently visit doctors and hospitals, would I be able to receive a further discount on my medical aid contribution for selecting to use doctors, pharmacies or hospitals from a specific list of providers? Leading medical aid schemes have agreements in place with healthcare providers that can save you up to R1 000 per month on your contribution (this example is from Momentum Health’s Custom Option). And these are not second rate providers, in fact, they have to adhere to strict performance criteria in order to be part of the network agreement
• As an active, sporty person, why not choose to belong to a medical aid that gives me access to programmes that reward me for being active? In the case of Momentum, a family can earn up to R3 000 per month by burning calories or going to the gym frequently.
• As a young person starting out on my journey to success, why not choose to join a medical aid that partners with a group of companies, where, if I have more than one product, I can also pay lower car and home insurance premiums or get discount on life cover at the same time?

At the end of the day, considering that choosing medical aid is not a simple process, consulting a financial adviser with whom you can partner for life would give you access to advice that will make this decision, and those that flow from it, much easier to make. Plus you will have someone on your team that has the knowledge to let you know about important changes and how they will impact on you over the years to come.