Along with renewed resolutions for the year ahead, 2010 also brings medical scheme rate increases for the majority of South Africans. Though experts predict the worst of South Africa?s financial woes to be over, insurance premiums such as medical cover will have to be carefully budgeted for.

Consumer education on all big purchases, whether health or motor insurance, a new home or a second mortgage, is key for the year ahead. Fully understanding complex terminology and legally binding fine print is crucial for consumers to help avoid being the victim of over-payments.

Within the healthcare industry most people have selected their medical schemes for 2010 and medical scheme members have reviewed the options; however, complicated healthcare jargon often adds to the anxiety of what is already regarded as a grudge purchase.

"It is important to fully understand what your monthly premium buys you," comments Medshield Medical Scheme Chairman, Thabo Mabeta.

Whether first-time members or with a scheme for years, consumers need to understand the following terms to ensure they know what they have signed up for:

• Co-payment /Co-insurance

  This term refers to additional costs incurred by you, the scheme member. Some medical schemes offer options that may appear highly competitive, but only provide limited cover and require the member to cover the shortfall.

• NRPL

  The National Reference Price List (NRPL) is a guide published by the Council for Medical Schemes (CMS) as agreed by the National Department of Health to provide reference prices for all medical procedures and treatments. The NRPL keeps consumers informed by listing the proposed ceiling prices.

• PMBs

  PMBs refer to Prescribed Minimum Benefits ? a list of 26 diseases on the Chronic Disease List which the Medical Schemes Act requires all schemes provide cover for. PMBs include conditions such as meningitis, various cancers, cardiac treatment and medical emergencies.

• DSP

  A Designated Service Provider (DSP) is a healthcare provider ? whether a doctor, pharmacist or hospital ? that is the medical scheme?s first choice when members need diagnosis, treatment or care for any medical condition. In many cases, a scheme will not cover medical expenses incurred at service providers other than those stipulated.

• Late Joiner Penalty Fee

  The Medical Schemes Act allows the levying of penalties for consumers joining a medical scheme for the first time after the age of 35. Depending on the number of years the consumer has not been covered by a scheme, the Late Joiner Penalty Fee is calculated as a percentage of the monthly medical scheme contribution.