Medical schemes allow university or college students to remain on their parent’s medical aid cover until the age of 25 and with proof of registration at a South African tertiary institution. However, this may not be an option for every student. Without the parent option, a student may want their own medical aid cover. Fortunately there are several student medical aid options available in South Africa.
What is student medical aid?
Student medical aid are plans offered by medical schemes that are tailored for university or F.E.T. college students. These plans are usually lower in cost than other options offered by the scheme. It may also be restricted to membership by students only. These plans are ideally suited to young adults on a student budget who want cover but without the full cost that the general public has to bear.
However, it is important to do your homework before making a choice. Student medical aid plans are not entirely without their drawbacks. Most have restricted benefits with small limits. You may be forced to see only designated service providers (DSP) – these are doctors and private hospitals that fall within the plan’s network. Furthermore, certain procedures and treatments may not be covered.
Benefits of Student Medical Aid
There are three benefits to medical aid cover – day-to-day benefits, chronic benefits and in-hospital benefits. A comprehensive student medical aid would include all three, albeit limited to some extent. A hospital plan only student medical aid would cover chronic benefits and in-hospital benefits. These plans do not include day-to-day cover. A student would therefore have to pay for doctors and acute medication out of their pockets.
Most medical aids that offer student plans have similar benefits at around the same price. Some medical schemes have targetted the student market and may offer more extensive cover. However, in most cases this is still restricted to some degree where students can only access services from designated service providers (DSP’s). When you are looking for a student medical aid option, you need to consider some of the following points:
- Does the student plan allow me to attend a private hospital?
- Which private hospitals are an option on my plan and are these hospitals near to me?
- Does the plan allow me to see doctors or other service providers (like physiotherapists) on an outpatient basis?
- Are these medical professionals in and around my residence for more convenient access?
- Does the plan cover acute medication or only chronic medication?
- How much does the plan pay for diagnostic investigations like CT scans and MRIs?
Female students may also want to look at additional benefits such as screening (particularly for Pap smears and mammograms) and pregnancy medical aid cover, with childbirth at a nearby private hospital as an option.
Prescribed Minimum Benefits (PMBs) for Students
Medical schemes are bound by legislation to cover treatments and procedures for certain conditions irrespective of benefit limits. These are known as prescribed minimum benefits (PMBs)¹. This includes 25 chronic conditions, 270 other medical conditions and any emergency conditions. It is important that students are aware of these PMBs as even cheaper medical aid plans are required to cover at least limited services for these conditions.