7 questions to ask your financial adviser about medical aids
The right questions reveal whether your adviser is actually working for you — or just earning their commission.
Choosing a medical aid scheme is one of the most consequential financial decisions a South African family makes — but most people choose based on a brochure, a friend’s recommendation, or whatever their employer offered. A good adviser changes that.
Here are seven questions to ask before you sign anything.
1. Are you tied to one provider, or do you compare across all of them?
Tied advisers earn from a single insurer. Independent advisers compare across all of them. Always ask up-front.
2. How does my current scheme stack up against alternatives?
A good adviser will run a side-by-side comparison: hospital networks, chronic medication coverage, family rates, day-to-day limits, and PMB execution.
3. What’s the average claim outcome for your existing clients?
Anyone can sell a medical aid. A good adviser tracks claim outcomes — how often, how much, and how disputes get resolved.
4. What’s the gap between scheme rate and specialist rate in my area?
This is where gap cover lives or dies. The right answer is a number, not a hand-wave.
5. Will you handle option changes at year-end automatically?
Schemes change benefits and prices every year. A good adviser reviews your option in October and recommends a switch if needed — without you asking.
6. What happens if I’m hospitalised and my scheme refuses to pay?
You want to hear: “we follow up with the scheme and the hospital on your behalf.” If the answer is “you’ll need to call the scheme yourself”, keep looking.
7. How are you paid?
Medical aid commissions in South Africa are regulated and capped. Any adviser who can’t explain their commission structure clearly isn’t an adviser worth working with.
If you’d like a free options-audit on your current medical aid, get in touch.