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[MEDICAL AIDS]
It’s going to be a long thread but it may be worth your while.
Disclaimer: I don’t work for any medical aid nor endorsing a particular one over the other. It’s my personal views as a GP & experience working in private hospitals.
It’s going to be a long thread but it may be worth your while.
Disclaimer: I don’t work for any medical aid nor endorsing a particular one over the other. It’s my personal views as a GP & experience working in private hospitals.
Before we get to which is the best, let’s first explain a few technicalities.
1.When you’re in casualty, you’re not in the hospital. You’re pretty much at a GP. It’s a different company running casualty and they bill you separately. Casualty visits bill you like a GP
1.When you’re in casualty, you’re not in the hospital. You’re pretty much at a GP. It’s a different company running casualty and they bill you separately. Casualty visits bill you like a GP
Everything done in casualty(bloods, X-ray etc) will be billed as though you’re at a GP and almost always comes from your medical savings.
Stay away from casualty unless you’re really sick. Go to your GP!
Stay away from casualty unless you’re really sick. Go to your GP!
A general GP visit will cost about R500 and maybe a bit more if they dispense meds. A casualty visit is no less than R2000. Both taken from savings.
2. Medical insurance is NOT medical aid. You pay a monthly fee for in case you need hospitalization. Most of them are quite dodgy tbh. They don’t cover GP visits and only start paying once you’re admitted. They literally call the hospital and check how sick your really are.
Most insurances will require a co-payment of 30% from you for everything. Including surgery and casualty. Please stay away from ANY medical insurance. They’re never a good idea.
That 30% co-payment can easily run up to over R50 000 for a single admission in hospital.
That 30% co-payment can easily run up to over R50 000 for a single admission in hospital.
3. Hospital plan is good if you know what you’re doing. It DOESNT cover casualty or GP visits. You have no savings. It’s purely for admission. I’d only recommend it for doctors or if your partner/family is one. Your GP must arrange a direct admission for you whenever you’re ill.
4. Medical aids...
There’s over 80 of them so I can’t go through all of them. 21 are open(anyone can join) and the rest are restricted by the companies. Like GEMS for Gov employees & Polmed for police force.
Some employers force you to take a certain medical aid
There’s over 80 of them so I can’t go through all of them. 21 are open(anyone can join) and the rest are restricted by the companies. Like GEMS for Gov employees & Polmed for police force.
Some employers force you to take a certain medical aid
Medical aid is not a toy. Don’t use it unless you really have to. Need glasses? Rather save up for them & pay cash. Feeling flu-ish? Go to the pharmacy & get some meds, if you’re still unwell go to your GP. use it only for real emergencies. Don’t exhaust your funds by July.
Always check who the administrator of the medical aid is. Discovery, Medscheme & Metropolitan are the biggest ones that come to mind. Most medical aids within an administrators work very similar.
Now every medical aid has plans and this is where a lot of people try & save by going for the lower plans. They’re cheaper because they offer less. Mostly very limited savings(remember everything before admission comes from savings).
Discovery
It has a lot of plans from very basic(Key Care Primary) to executive ones. Your day-to-day benefits come from savings. So if you go get designer spectacles, you may not have enough savings for an emergency later. The lower plans are restrictive.
It has a lot of plans from very basic(Key Care Primary) to executive ones. Your day-to-day benefits come from savings. So if you go get designer spectacles, you may not have enough savings for an emergency later. The lower plans are restrictive.
You go to specific(network) Hospitals & even doctors(a lot of GPs don’t take KeyCare). Discovery is really expensive & unless you’re a real fitness bunny, you rarely benefit from their offers to lower your premium(like vitality).
They have a LOT of exclusions so I’d be weary of picking them voluntarily 
. Of your company is subsiding you, pick it and pick the more executive plans. Otherwise nope.
. Of your company is subsiding you, pick it and pick the more executive plans. Otherwise nope.
Medscheme(they an administrator)
Of the open medical aids they have, I’d pick only 2.
Bonitas & Fedhealth.
Of the open medical aids they have, I’d pick only 2.
Bonitas & Fedhealth.
Bonitas
It’s generally a good scheme. They hardly give issues with payments(to service providers) and hardly ask clients for any co-payments. The standard option is a bit pricy but gives you full cover & peace of mind. I’ve compared the entry level & standard one. Pick standard
It’s generally a good scheme. They hardly give issues with payments(to service providers) and hardly ask clients for any co-payments. The standard option is a bit pricy but gives you full cover & peace of mind. I’ve compared the entry level & standard one. Pick standard
Fedhealth offers quite a comprehensive cover for an affordable price. This would be my pick for best medical aid. If you’re a young healthy individual and need cover for emergencies & other unexpected medical things then this is the medical aid for you.
You can pretty much tailor your plans to suit you. If you don’t mind the restriction of going to specific(network) GPs which they cover unlimited and doesn’t come from day to day & also Hospitals you can expect to pay like 30% less than other medical aids with the same benefits.
They have weird vault-wallet system which isn’t difficult to understand. It’s a pay as you use type of thing.
So I’m terms of cover and price. This is my best pick.
So I’m terms of cover and price. This is my best pick.
I’d say the medical aid you choose depends largely on the plan you take. It’s no use being on Discovery but you get R3000 savings a year which have to cover everything. Read the plans carefully & more especially the exclusions.
Once in a medical aid and you have a chronic condition, check if it’s not one of the 27 that are covered by PMBs so that you’re not paying from savings.
Pick an option where you won’t have to pay out of pocket. It’s painful paying medical aid and still having to fork out money
Pick an option where you won’t have to pay out of pocket. It’s painful paying medical aid and still having to fork out money
Pick a medical aid that covers mental health as a PMB. Most only cover schizophrenia and bipolar mood disorder and not major depression.
Pick a GP that’s clued up on PMBs/chonic list and to maneuver them so you don’t end up exhausting funds.
Pick a GP that’s clued up on PMBs/chonic list and to maneuver them so you don’t end up exhausting funds.
I personally avoid smaller medical aids because dealing with them is a nightmare. Their call centers aren’t 24 hours so you won’t get some things(like scans and blood tests) on the weekend because the hospital can’t get authorization.
