• Optimum Group

What exactly does your health-related assistance product offer you?

Updated: Jun 27

Medical Aid. What does this word actually mean? Let’s take a closer look at definitions of the two separate words.  Medical means health-related and Aid means assistance.  Your Medical Aid is therefore supposed to be health-related assistance.  So what exactly does your health-related assistance product offer you?  There are too many clients that answer this question with “I am not sure”.


There’s a lot of consideration that needs to go into choosing a medical aid option, whether it be to decide to only take a hospital plan or a more comprehensive plan which includes a personal medical savings account (PMSA).


You need to know the answer to the questions below before making your final decision regarding your Medical Aid:

  1. What percentage does your medical aid plan offer for in-hospital cover?

  2. Am I on a network option or a non-network option?

  3. What is a DSP (Designated Service Provider) and what will my co-payment be for using a non-DSP?

  4. How much are these co-payments?

  5. When does my treatment become an in-hospital claim?

  6. How is a casualty visit paid for?

  7. Do I have doctors’ visits, where is my medication paid from and how much is paid by the medical aid scheme?

  8. Why do doctors’ have different rates and why do I need to take out GAP cover? What is covered by GAP cover?

  9. What are chronic conditions and how are they covered?

  10. What is prescribed minimum benefits?

From the questions above you can see that you need professional help to determine the right Medical Aid option. We really listen to our clients to assist them to tailor-make a medical plan that suits their needs, circumstances, and pockets.


If you are interested in more information regarding these questions and more, please contact us. We really want to help you understand the benefits you have on your plan.


By Mariëtte Thomas – Optimum Medical Adviser

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