Due to high treatment costs, people often reach their medical aid cap long before the year is over.
In previous years medical schemes offered stated or defined benefits when dealing with day to day care. This meant that members could go to a GP for a specific number of visits, your dentistry, optometry, physiotherapy etc. all had a defined guideline on how many times you could have treatment in a year. With the advent of the medical savings account, the choice and depth of cover is largely defined by the member. This has curbed unnecessary spend for the medical schemes to a degree, as members on traditional medical schemes would try use benefits unnecessarily so they at
least felt they were getting some value for their money.
In January of each year, a member receives an amount of money that is allocated for day to day spend. This is your medical savings account. Due to the high costs of treatment, people often find themselves running out of savings long before the year is over and find themselves dipping into their
own pockets to cover medical expenses. There are ways in which the members can extend their day to day cover and get more out of their savings.
Medical Aid Rates: There are a number of providers who do charge medical aid rates and schemes such as Discovery Health have published a list of doctors, specialists, optometrists, dentists etc. that charge the scheme rates. Before going to the most convenient provider, do some research into what
they charge and check if there is a more cost-effective option. Some schemes have a network of providers who are guaranteed to charge a medical scheme rate. This alone can save thousands of Rands.
Chronic Conditions: If you taking ongoing medication, check with your scheme whether it is covered under chronic benefits. If it is approved, this is covered from the chronic illness benefit which covers 27 prescribed minimum benefits instead of your savings.
Generic Medication: Pharmacists are obligated to offer you a generic version of your prescription medication. Generic medication can cost as little as 25% of the original. Use them when you can, not only for your chronic prescriptions.
Dispensary: Check with your medical scheme who their preferred provider is for dispensing medication, as this also shaves the costs of dispensing fees. Most of the large pharmacy chains are recognised by most schemes.
Preventative Screening: Familiarising yourself with your schemes screening benefits can save you money as certain procedures such as mammograms and blood tests are covered by the scheme. Self-Payment Gap: If your plan has an above threshold benefit, it also has a self-payment gap. In order to minimise the gap, members should not put through over the counter medication or non-accumulating items through their savings account.
These are some ideas of how to stretch your medical savings. It is imperative that members familiarise themselves with the benefits of their scheme and if in doubt, call the scheme or financial advisor.
Greg Katz
Published on Moneyweb 06/May/2018
https://www.moneyweb.co.za/moneyweb-opinion/soapbox/how-to-stretch-your-medical-savings/