Topics, Tips & Tools / Family

Medical Aid Must-Knows

14 May 2014

The petrol price is going up, impacting on food and transport costs – add to that high inflation and increasing interest rates, and you’ll find that everyone is feeling the pinch financially.  This means that getting the most out of your medical aid can make all the difference to your monthly budget.  Here are some things to consider before making any hasty cost cutting decisions.

1. Don’t cancel!

We’re all looking to make budget cuts right now, but cancelling your medical aid isn’t necessarily the best option.

There are implications, both financial and health-wise… A sudden illness or accident, if you’re not covered, could result in the kind of medical costs that could cripple you, or you could compromise the level of care you receive because you’re not able to afford the very best treatment.  Without a medical aid, you may face waiting lists for much-needed surgery, and you won’t have the benefits of some of the wellness and vitality options offered by some schemes.

And finally consider whether the extra money in your wallet, if you decide to cancel your cover, is worth the loss of peace of mind?  Don’t forget your contributions are tax deductible.

2. Be smart

There are ways to make the most of your medical cover, and none of them are particularly difficult or inconvenient:

  • Use generic medication which most plans are more likely to cover fully
  • Make sure your doctors and specialists are part of the medical aid network and charge medical aid rates
  • Visit your GP first, before deciding whether you need a specialist
  • Make sure to register your Chronic Medication – if your GP does not complete Chronic Medication forms and supply them to your medical aid provider, the costs of your medication will be deducted from your day-to-day expenses, rather than your Major Medical Funds
  • Stay healthy, have flu jabs, exercise, eat well – prevention is almost always better than cure and certainly cheaper

3. Understand your plan

Assess your circumstances and lifestage before deciding on the plan that’s right for you. Find the best scheme for yourself, based on your health, your age, your day-to-day needs, whether you have a family or are single. Remember that as we age, our medical needs generally increase, so be sure to check your options regularly. Plus, the better you understand your medical plan and its limits, the less likely you are to incur expenses that are not fully covered. Failing to get authorisation for an operation for instance, can be a costly mistake.  And not disclosing pre-existing conditions can result in your medical provider refusing to cover related costs.  

4. Negotiate

Many people don’t know that you can negotiate with medical service providers, like specialists and anaesthetists, for better rates for certain treatments.  Ask whether there is a generic version of the medication prescribed, get an upfront quote on an operation and, if your scheme won’t cover the full amount, ask your service provider whether there is any way they can reduce the cost. 

5. Find out about  ‘gap’ cover

This kind of cover is designed to pick up any shortfall that you may experience in your medical cover.  It could be worth exploring the possibilities if you’d like added peace of mind.

6. Keep track

Hold onto all your statements and all your bills and expenses – you might find that you’re spending so much on out-of-hospital expenses that a simple hospital plan is no longer right for you and a more comprehensive plan would actually save you money… and vice-versa.

Remember, most schemes allow you to upgrade at any time during the year, but you can only downgrade your plan at one certain point in the year – make sure you don’t miss the deadline!

7. Shop around

If you’re reviewing your cover annually, you might also want to check costs against other medical schemes…

Find out what friends and colleagues recommend, go online and do research, get quotes.

Direct Axis can help you by getting you quotes quickly and easily to help you make the best choice for you and your family. Get a quick quote  now from a range of trusted medical schemes which we represent.