FAQ

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What is the difference between Medical Aid and Medical Insurance 

They are regulated by two different acts:
– Medical Aid is defined as a medical scheme and is regulated by the medical Schemes Act and   governed by the Council for Medical Schemes. Medical Insurance is defined as a short or long term   insurance and is regulated by the long and short term act and governed by the Financial Sector Conduct Authority (FSCA). Day-2-Day benefits fall under the consumer Ombud.

-Medical Aid pays out a wide variety of benefits to contributing members.Medical Insurance pays out a fixed amount for specific listed events

– Medical Aid is based on tariff codes and procedures. Medical Insurance is based on stated event and  specific procedure costs.
– Medical Aids cannot reject applications due to age or pre-existing conditions and have to, by law, cover certain procedures. This is according to the Medical Schemes Act, Section 29 (3) (a). Medical Insurance can reject applicants due to age and additionally can add on exclusions for specific or high   risk procedures.
– Medical Aid has shortfalls most of the time. Medical Insurance may be used as a gap cover for shortfalls.
– Medical Aid does not have to disclose the amount payable for the procedure they will cover. Medical Insurance provides a person with a defined amount in case a specific event happen

Are your Doctors Network Based 

No. You are able to see any GP. This makes it possible to see your current GP who you have a long lasting relationship with

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Are the Day-2-Day Benefits limited to the family or are they per individual

The benefits per policy are for each individual member on the policy. Therefore, should you be on the Green Day-2-Day plan each member would be allowed 4 GP visits per annum.

What is Acute Medication

This is any medicines prescribed by a General Practitioner

Is your Hospital Plan a Cash Back Plan

No. We provide you with R150 000 per annum per member limited to R300 000 per policy

When will i receive my card

Once we receive first premium which will include a R150 admin fee, we will immediately order your card. You will be contacted prior to card being dispatched to confirm your closest pick up point. The whole process takes approximately 3 weeks from first premium collection

Contact Us

Sales

Tel: 010 140 1517
Info@agshealth.co.za

Claims

Tel: 010 140 1516
Claims@agshealth.co.za

Admin

Tel: 010 140 1516
Admin@agshealth.co.za

AGSHealth Offices

Physical Address

Diaz Office Park
Unit 23, Beach Boulevard West
Diaz Beach
Mossel Bay

6 Kingfisher St
Unit B Horison Park
Roodepoort

Postal Address

Diaz Office Park
Unit 23, Beach Boulevard West
Diaz Beach
Mossel Bay
6506

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