When to re-think your medical plan

The first benefit of medical cover is peace-of-mind, the second is that you will be protected from potential financial ruin should your hospital bill be more than you can manage. It is important to be on a medical plan that suits both your monthly affordability and caters to most of your medical requirements.

Since changing your medical plan or option can be costly, you need to change at the right time and for the right reasons. Here are some tips on what to consider when you rethink the suitability of your medical plans.

Change at the right time

It is advisable to change medical plans or options at the end of the year, so you get to access the full membership benefits for the new year. Changing at the end of the year also does not carry the penalty costs you would have had to pay when changing mid-year, but having said this, many medical plans do not allow for upgrades in the middle of the year.

Check benefit limits

It is important for you to know what your plan covers, especially if you or your dependents have chronic conditions or special medical requirements, but also to know where the limits will kick in. For example, would you be needing new glasses every year? Some medical plans allow for a new pair every year for every member, whilst some will only allow for one per year for the whole family and others will take the cost out of your medical savings.

For more serious conditions, it’s helpful to know if you can claim multiple times in the year and where your limits will start to attract co-payments or no longer be covered by your medical plan.

When changing to a new scheme, make sure that the benefits of the new scheme are a good match for the health conditions you and your family experience or are likely to experience.

Upgrading or downgrading options needs to make sense

Moving to a higher or lower cost option within the same scheme also needs to make sense. It’s wiser to only change to a lower option because you have less risk and the benefits you need are still covered in that lower option, not because you want to save money.

Look for your favourites

As you rethink your medical plan, find out whether visits to your favourite GP will be paid for by you or the new scheme. Check if the GPs and specialists in your area are covered, in case your medical cover only pays for visits to someone across town or far from you.

If you’re feeling overwhelmed with how to make a change (or if a change is even needed), then let’s have a chat and see how we can work together to help you make a better decision.

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