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WHAT ARE MY CHOICES IN 2021?

Medical Schemes continue to find new ways to pass parts of treatment costs on to members. Our recent claims experience also shows a shift towards claims extending beyond the traditional tariff and co-payment shortfalls into hospital sub-limit and oncology shortfall as well as increased instances of members having used “non-network hospitals”, contrary to their particular medical scheme rules, being lumped with 30% of the hospital account.

We obviously want our clients to have the lowest possible risk of being left out of pocket so both the 2021 options cover ALL 4 main categories of shortfalls. The more budget friendly option, COMPACT 300, reimburses these main categories with lower maximum thresholds and excludes some lower frequency events whilst ELITE continues to offer maximum coverage for a slightly higher premium. The latter is therefore our recommended solution.