The advantages of a medical aid scheme are that:
- It protects employees if they suddenly have to pay large, unexpected medical costs and they don’t have to delay their medical treatment because they don’t have any money
- Employees get better medical care because they are looked after by private doctors, clinics and specialists instead of overcrowded public hospitals
The disadvantages of a medical aid scheme are:
- It is expensive and fees are always increasing
- If an employee has dependants in the rural areas it does not help to have medical aid because there are no private health care facilities
- There are often many hidden costs in the schemes and the scheme might only pay a small percentage of the costs and the employee has to pay the rest;
- Some schemes set limits for benefits, for example, a scheme could set a limit of R720 per year for medicines prescribed by a doctor for a single member. If the member needs to buy more than R720 worth of medicines in a year, she or he will have to pay for any costs of medicines above this limit.
- Some medical costs are completely excluded from medical aid schemes. Employees must then pay for these costs themselves even though they are paying into the medical aid fund every month.