Seven golden rules to make your medical savings last

Woman Using an Inhaler --- Image by © Royalty-Free/CorbisBy August this year more than half of medical scheme members will have run out of day-to-day savings which means that doctor visits and medication would have to be paid for out of your own pocket.

By managing your medical savings sensibly from the beginning of the year you could just make it to December:

• Never pay for over-the-counter medication or vitamins from your medical aid savings. Pharmacies often offer discounts for direct payment and you don’t use up medical savings you may need for other critical or expensive healthcare services such as blood tests, glasses and GP visits.

• Ask your doctor and your pharmacist about generic medicines. Generics are usually cheaper but always confirm this with the pharmacist as some medications have passed their patent date at which point the price usually falls significantly and can actually be cheaper than the generic.

• Sign up for your chronic cover. Most medical aids require you to register your chronic condition before payment is made from your chronic benefits. If not registered you will continue to pay from your savings.  So find out if your chronic illness is a Prescribed Minimum Benefit (PMB) condition. Registering your condition with your medical aid will save you substantial sums of money as PMB conditions are covered in full by medical schemes (including Hospital Plans) in South Africa.

• Tap into any network arrangements your medical scheme may have. Some medical schemes have network arrangements for GPs, specialists, pharmacies and hospitals. If you sign up for these network options not only could receive large premium discounts, but some medical schemes continue to pay for visits to a doctor on the network even if your savings run dry.

• Find out what your treatment will cost. Patients are often embarrassed to discuss money with their health care provider but when you make an appointment, ask what rates your doctor charges and whether or not you’ll be liable for any co-payments which may eat into your savings.

• Find out what your medical scheme pays from risk rather than savings. Some schemes pay for preventative screening tests like cholesterol, mammograms, dental visits and pap smears from risk so that it does not impact on your savings pocket.

• Find out how much you have available to spend. Family members should know and understand the medical aid rules and annual limits and how much money each person has to spend on for example dentistry, eyewear and physiotherapy, and should try to stick to it.

This article first appeared in City Press.

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