why do you need medical aid?

Every month a big chunk of your income is consumed by your medical scheme contribution. For many people it remains a grudge purchase – that is, until there is a medical crisis in your life and the scheme foots the bill.
The complexities of the medical scheme industry make it a veritable minefield which the average client (or member) finds extremely confusing.

While the schemes’ call centres are generally good in providing you with information, some members seek the assistance of a broker to help them choose a medical scheme, or to understand some of the intricacies once they try and claim from their scheme, or encounter other problems. Your envestpro medical aid brokers will do just that – we will suggest the very best options to our clients and can be instrumental in assisting you to join any of our partner medical schemes and will assist you in choosing the correct option for you and your family and is also suited to your financial and health benefit needs.

why do you need gap cover?

Healthcare providers sometimes charge fees significantly higher than standard medical aid rates – in some cases, up to five times more. Gap coverage is designed to address the shortfall between what your medical insurance covers and the actual costs charged by hospitals and medical professionals. This additional protection shields you from substantial medical expenses during times when your primary concern should be your family’s health and recovery. When you make a claim, gap cover payments are sent directly to you, allowing you to settle any outstanding balances with your healthcare providers without delay.

envestpro medical aid broker support and administrative services:

As your envestpro broker, we will provide you with ongoing advice and servicing and will be available to you throughout your membership for any assistance and queries that may arise; your broker will:

Assist you medical scheme selections and benefit options

We will provide you with quotations on various medical aid options – We are contracted to a variety of schemes (a list of these schemes is included below) and will ensure you can get an independent recommendation that really will suit your needs..

Assist you with your annual renewal/review of your medical plan and benefit options selection

We will also keep you up to date of any changes in benefit structures, changes in options within your scheme, or possible alternatives (possibly on other schemes) which might be better suited to your needs and remind you of the annual option changes and provide you with the necessary information you need to make these changes. We will contact you every year to find out if your needs have changed and to inform you of any changes in the field of medical schemes which are relevant to you.

Review your scheme when your medical or financial needs change

As benefit options and benefit ranges change, so do your health needs and requirements. An entry-level plan might have been fine for you when you are young and healthy, but as you grow older and/or you get a family, your healthcare needs may change.
You can ask us about more affordable options when your financial situation changes. It is a lot better for you to have a basic hospital plan than to cancel your medical scheme membership altogether if this need arises,

Assist you with your claim submissions

We know what your scheme is obliged to pay for according to the Medical Schemes Act and have a thorough understanding of the provisions and legal requirements and the benefits on all the different options. Sometimes members fail to claim for certain medical treatments, simply because they are unaware of the fact that they can.

Negotiate on your behalf

We will negotiate with the scheme on your behalf if there is a dispute about any specific claims as we have an overall and in-depth understanding of the benefit details and which procedures are covered by your scheme.

Advise you on additional cover and reward programs

We provide you with options for Gap Cover and other value-adding benefits for example Vitality through our partners.

envestpro value add for our members

Heath Wellness Days
for our medical aid members together with our wellness day partners, including: Medical Aid Scheme partners, CANSA and HIVSA.
Financial Wellness days
with our partners including: Personal Financial Advisors, Standard Bank for any banking-related queries or questions irrespective of who you bank with, Capital Legacy for your wills and testaments, Your Provident/ Risk Fund Administrator/Liaison, Short term adviser and Medical Aid Broker.
We are always available for you to answer any questions or handle any queries that you might have at the contact details listed below:

our medical aid and gap cover partners

We have contracts with various medical schemes and are therefore able to offer you options from a range of medical schemes to offer clients the best choice of medical scheme and benefit option. 

We are committed to assisting you in finding the best medical aid plan for your needs or helping you make informed decisions about plan changes for the upcoming year. Your health and well-being are our top priorities, and we are here to guide you through the process.

Please take a moment to provide us with some essential information so we can offer you personalized assistance. Your input helps us better understand your unique requirements and preferences. We value your trust and are committed to providing you with the support you need.

contact details

General Medical Aid Queries and Submissions

T: 011 513 2500

E: info@envestprocorpsol.co.za

Director: Corporate Solutions

Carol le Grange

C: 071 675 0482

E: carol.legrange@liblink.co.za

Liberty Group Ltd is an Authorised Financial Services Provider (Licence No. 2409) and part of the Standard Bank Group. Envestpro (Pty) Ltd is an affiliate of the Liberty Group Limited.

All envestpro group affiliates that provide financial services are fully authorised under the FAIS Act. Any legal, technical, or product information provided here should not be interpreted as advice
from envestpro. No guarantees, warranties, or commitments, whether explicit or implied, are made, and envestpro assumes no responsibility or liability..