Stretch your medical savings
KNOW HOW BENEFITS WORK
In previous years, medical schemes offered defined benefits when dealing with day-to-day care. This meant that members could go to a GP for a specific amount of visits, and dentistry, optometry, physiotherapy etc all had defined guidelines on how many times annually they could have treatment.
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 to feel as though 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 their 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 have to dip into their own pockets to cover medical expenses.
However, there are ways in which medical scheme members can extend their day-to-day cover and get more out of their savings.
There are a number of providers who charge medical aid rates and schemes that have published a list of doctors, specialists, optometrists, and dentists etc. 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.
If you are taking ongoing medication, check with your scheme whether it is covered under chronic benefits. If it is approved, this will be covered from the chronic illness benefit, which covers 27 prescribed minimum benefits instead of being paid from your savings.
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.
Check with your medical scheme as to 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.
Familiarising yourself with your scheme’s screening benefits can save you money, as certain procedures such as mammograms and blood tests are covered by the scheme.
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 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 their financial advisor to find out.
Greg Katz is an independant financial planner at Oracle Broker Services