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Healthcare · Medical Aid

Medical aid and healthcare choices made clearer.

Healthcare costs can be difficult to understand, and choosing between medical aid plans and schemes can feel overwhelming. We help you understand your options and choose cover that fits your circumstances.

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Medical aid & healthcare advice

Healthcare cover that fits your household, not a generic plan.

Our healthcare service includes medical aid membership and gap cover, with advice designed to sit alongside your broader financial planning and wealth management strategy. We look at your household, healthcare needs, budget, existing cover and priorities rather than treating medical aid as a one-size-fits-all decision.

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Understanding your options

Three things worth understanding first.

The terminology alone can be confusing — here’s a plain-language starting point.

Medical Aid Plans

Medical aid plans differ in how they structure hospital cover, day-to-day benefits, networks, co-payments, limits and contributions. The cheapest plan is not automatically the most suitable, and the most comprehensive plan is not necessarily the right choice either.

Medical Aid Schemes

A medical aid scheme offers members access to defined healthcare benefits according to the rules of the scheme and the specific plan selected. OBIN can help you work through the terminology and identify the questions to ask before changing medical aid.

Gap Cover

Gap cover is designed to help address certain shortfalls between what a medical scheme pays and what a healthcare provider may charge, subject to the specific policy. It is not a replacement for medical aid.

Healthcare as part of financial planning

A medical event affects more than your medical aid.

A medical emergency or major health event can place pressure on cash flow, savings and investments.

What we consider

  • Family composition and healthcare needs
  • Hospital and network considerations
  • Limits, co-payments and exclusions
  • Affordability and cash flow
  • Medical aid contributions
  • Day-to-day benefits
  • Gap-cover needs
  • Changes in family or health circumstances

Medical aid FAQs

A few things people ask about medical aid.

Medical aid provides access to defined healthcare benefits according to the rules of the medical scheme and the plan option selected. Medical aid plans can differ significantly in their hospital benefits, day-to-day cover, provider networks, co-payments, limits, exclusions and monthly contributions. Understanding these differences matters because the cheapest plan is not necessarily the most suitable for every household.

 

When comparing medical aid plans, consider how often you use healthcare services, your preferred doctors and hospitals, your family structure, ongoing medication or treatment needs, your budget and your tolerance for out-of-pocket expenses. It is also important to understand the scheme rules and the limits attached to the particular plan.

 

OBIN’s medical aid advice is designed to help clients understand the options rather than simply choosing a plan based on price. The right decision should fit both your healthcare needs and your broader financial position.

Because medical aid benefits and contributions can change, always check plan information against current scheme documentation before deciding.

Gap cover is additional insurance designed to help address certain shortfalls between what a medical scheme pays and what a healthcare provider may charge, subject to the specific policy terms. It is not a replacement for medical aid and it does not cover every healthcare cost.

The potential need for gap cover depends on the medical aid plan you have, the healthcare providers you use, the level of hospital cover, your financial ability to absorb unexpected costs and the terms of the gap-cover policy. For some households, the additional premium may be worthwhile because it protects against certain unexpected medical expense shortfalls.

Before taking gap cover, it is important to understand exclusions, waiting periods, benefit limits and the situations in which the policy will respond. You should also review whether your medical aid plan has changed.

OBIN Wealth Management can help you consider gap cover as part of your wider healthcare and financial planning strategy. The decision should be based on your circumstances and the current terms of the relevant policy rather than a general assumption that everyone with medical aid needs the same level of additional cover.

Choosing the right medical aid plan starts with understanding how you and your family actually use healthcare. Consider your expected healthcare needs, preferred doctors and hospitals, ongoing medication, chronic conditions, planned procedures, family size and budget. Then compare how different medical aid plans structure hospital cover, day-to-day benefits, networks, co-payments, limits and exclusions.

Compare value rather than simply looking at the monthly contribution. A lower contribution can be attractive, but it may come with network restrictions, lower day-to-day benefits or higher potential out-of-pocket costs. Conversely, a more comprehensive plan may not be necessary if the additional benefits do not match your needs.

Medical aid advice can help you work through these considerations and understand the differences between medical aid schemes and plan options. OBIN Wealth Management’s healthcare service brings a practical, personal approach to this decision.

Because scheme rules and benefits change, the final choice should always be based on current documentation and your individual circumstances.

Whether you can change a medical aid plan during the year depends on the rules of the medical scheme, the plan option and the applicable timing and regulatory requirements. Some changes may only be available during specified periods or under particular circumstances, while other changes may have waiting periods or affect benefits.

 

Before changing your medical aid plan, it is important to understand what you have now and what you would gain or lose under the proposed plan. Compare contributions, hospital benefits, provider networks, day-to-day cover, limits, co-payments, exclusions and any additional healthcare cover such as gap insurance.

 

A change in family circumstances, employment, income or healthcare needs may be a reason to review your medical aid. However, changing plans should be approached carefully because healthcare cover is part of your overall financial protection strategy.

 

OBIN Wealth Management can help you understand the considerations involved in reviewing medical aid plans and medical aid schemes. Current scheme rules and product documentation should always be confirmed before a change is made.

Medical aid is more than a monthly household expense. It is part of the financial protection strategy that helps manage the potential cost of healthcare. The right medical aid plan should therefore be considered alongside emergency savings, life insurance, income protection, disability cover, investments and retirement planning.

 

If a major medical event creates significant out-of-pocket expenses, it can affect the money available for other financial goals. Strong healthcare planning can help reduce the likelihood that an unexpected cost forces you to sell investments, reduce retirement contributions or take on additional debt.

 

The appropriate level of medical aid depends on your household’s healthcare needs, budget and ability to absorb unexpected costs. Gap cover may also have a role, depending on your existing medical aid and the specific risks you want to address.

 

OBIN’s medical aid advice takes a broader financial planning view. The goal is to ensure your healthcare decisions make sense within the context of your overall wealth management strategy, rather than treating medical aid as a standalone purchase.

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You don’t need to have all the answers before you speak to us. Start with a conversation, and we’ll help you understand the next step.

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Mi-Jeanne Gerretsen

Administrative Assistant

Mi-Jeanne brings financial administration experience and a strong attention to detail to the OBIN team. She focuses on accuracy, efficiency and care across the administrative side of the client relationship.

Jacky Jordaan

Healthcare Adviser and Administrator

Jacky has experience across medical, corporate and financial-services environments and supports OBIN clients through healthcare advice, administration and operational coordination. Her role helps ensure the healthcare side of the client experience is organised, responsive, and personal.

Johannes Burger, CFP®

Director & Wealth Manager

Johannes founded OBIN Wealth Management in 2017 with the vision of creating an environment where financial planners can guide investors toward financial freedom through objective, independent advice. His financial planning career began in 2010; in 2013 he obtained a Postgraduate Diploma in Financial Planning from the University of Stellenbosch and qualified as a Certified Financial Planner®. As Key Individual and Representative, Johannes is involved in strategy, planning, client engagement and overall management.

Allan Geldenhuys, CFP®

Wealth Manager

Allan began his financial services career in 2012, initially working as a financial analyst before moving into financial planning. He works with individuals, families, businesses and trusts to make informed financial decisions and implement effective strategies. Allan is a Certified Financial Planner® and member of the Financial Planning Institute of Southern Africa.