Why choose Perspective Advisory for your healthcare needs?
At Perspective Advisory, our commitment to you goes beyond the ordinary. As your dedicated healthcare broker, we take a personalized approach to guide you through the intricacies of medical aid, insurance, and gap cover. Think of us as your reliable partner, ready to tackle the challenges presented by every healthcare provider.
We stand by you when it matters most—during the crucial moments of claiming. Our real value shines through as we actively participate in ensuring a seamless and efficient claims process. Whether you’re representing a corporation or seeking individual coverage, our team is here to transform your healthcare journey into a straightforward and stress-free experience.
Choose Perspective Advisory for a healthcare partnership that prioritizes your well-being, providing unwavering support precisely when you need it.
How do we get involved?
You can either appoint us to manage your medical product – see below for a list of providers we make use of.
Or if you do not have any medical or healthcare provider, we can advise one for you based on your needs and affordability.
Please see our resources in this section on choosing a provider and/or moving from your current one. Note that at no time does your cost increase by appointing us as your brokers. We do, however, earn from your premium as it is already being paid.
Choosing the right healthcare provider for your needs
Selecting a healthcare provider is a nuanced decision, requiring your thoughtful input. Affordability is certainly a factor, and while various medical aids and insurers offer a range of options to align with your budget, the key lies in understanding your specific healthcare needs.
We initiate a thorough process of comprehending your requirements, offering tailored suggestions from the providers we’ve partnered with. It’s essential to recognize that there isn’t a universally defined ‘best medical aid or insurer.’ Instead, the focus should be on choosing one that aligns with your unique needs and has a practical presence in your area. Fortunately, most medical providers have extensive coverage across South Africa.
What sets us apart is our commitment to long-term sustainability. We exclusively collaborate with larger providers, ensuring they have the resilience to endure industry changes and the test of time. This approach guarantees that your chosen healthcare scheme remains steadfast and reliable amidst potential shifts in the healthcare landscape.
Deciding or moving between healthcare providers can be tricky, with a number of decisions that you may need help with.
Our personalized approach ensures you find the perfect fit among leading providers, focusing on your needs and long-term sustainability. We have created a couple of documents to help you make sense of two of the most prevalent questions.
Medical Insurance vs Medical Aids
The major difference between a Medical Insurance (MI) product and a medical aid, like a Discovery plan, is that you have NO cover for elective procedures. MI does not cover you for in-hospital, planned procedures that you know about or that come about after you are on these schemes (elective).
What are Waiting Periods and Late Joiner Penalties?
When you apply to join a medical scheme, they can (in terms of the Medical Schemes Act) apply waiting periods and late joiner penalties (LJP). This legislated structure is meant there to provide medical aid schemes some measures through which to protect their risk pool & solvency.
It is important to know that no medical aid can refuse a person entry. They may, however, make it difficult through an underwriting process that will investigate your disclosures including contacting previous schemes.
Gap Cover
All medical aids encourage the use of a network of providers to offer full cover. This is for everything from Hospital-based surgeries or procedures to seeing a GP or Specialist. If you choose to go and see your regular provider of service and they are not on your medical aids network, then you are liable to pay for a hefty chunk of that bill – especially if this is for something done in-hospital OR even their own rooms/practice.
This is where a GAP then occurs – this represents the difference between what your medical aid is willing to pay for said procedure and what this provider charges for their services. So, unless you have Gap cover, you are going to pay for this out of your own pocket.
If you are willing to negotiate with your providers, then you can likely get away with not having this product. However, it is often that even in an ‘emergency’ situation, where Gaps my occur, and it is then that you may not be able to do this negotiation. Also, sometimes you really don’t want to have this extra hassle and for how low these premiums are, to us, they provide immense value.
How does it work?
Top-up or gap is a short-term insurance product from which you claim after a procedure has been carried out. It pays to you, and you settle each bill with providers used.
Waiting periods & exclusions
There are pre-existing condition exclusions for the first 10 – 12 months of a policy. There is also, generally, a 3-month general waiting period from inception for elective procedures (they may cover accidents depending on provider). There are also certain specific procedures that are completely excluded from cover. These waiting periods and exclusions are listed on any brochures that you receive and are important to note!
An example of this would be anything that your medical aid doesn’t cover. Remember that if your medical doesn’t cover it then there can’t be a ‘gap’ to cover.
Get in Touch
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