How to get the most out of your med­i­cal aid

The Citizen (KZN) - - Personal Finance - Sarah Ni­chol­son

Ex­tremely high med­i­cal costs mean that many South Africans pru­dently sub­scribe to a med­i­cal aid scheme. But how do you make the most of your se­lected pack­age?

Here are 10 tips to help en­sure you en­joy the med­i­cal scheme ben­e­fits to which you’re en­ti­tled.

Read the fine print: You may have stayed with the same plan for many years. Take time to un­der­stand the rules and ben­e­fits, which may have changed since you first signed up.

Max­imise your money: Take up pre­ven­ta­tive health screen­ings and tests, free vac­ci­na­tions, and baby pro­grammes. You may also de­cide to reg­is­ter for a pro­gramme to bet­ter han­dle a chronic con­di­tion.

Ex­plore loy­alty pro­grammes: Ben­e­fits could vary from prod­uct dis­counts to travel and re­tail pro­mo­tions, and sub­sidised gym mem­ber­ships.

Spread out claims: Rather than blow your al­lo­ca­tion early in the year on over-the-counter pur­chases, speak to your phar­ma­cist and health prac­ti­tion­ers about how to best al­lo­cate med­i­cal, op­ti­cal, and den­tal pur­chases. Keep your ben­e­fits for essential medicines and ser­vices.

Choose wisely: Ask your doc­tor to pre­scribe gener­ics which cost less. Whether you are look­ing at over-the-counter med­i­ca­tion, or pre­scrip­tion drugs, gener­ics can cut your bill con­sid­er­ably.

On the record: Be metic­u­lous about fil­ing claims and sav­ing cor­re­spon­dence.

Plan for a pro­ce­dure: If you re­quire an op­er­a­tion or spe­cial­ist treat­ment, ob­tain pre-au­tho­ri­sa­tion. Do your home­work, get a quote from the hos­pi­tal and med­i­cal prac­ti­tion­ers be­fore you are ad­mit­ted. De­ter­mine if there will be a short­fall and plan how to fund this. Check if you can use des­ig­nated health­care providers on your med­i­cal aid’s net­work for cheaper rates.

Back a buddy: On­col­ogy and other treat­ments can make one feel un­der par for a lengthy pe­riod. Ask a fam­ily mem­ber or friend to help you keep track of med­i­cal claims and sub­mis­sions, or of­fer to do the same for them.

Con­flict res­o­lu­tion: If you’re hav­ing dif­fi­cul­ties re­solv­ing a prob­lem with a call cen­tre agent, find out if your med­i­cal aid has a walk-in ser­vice. Deal­ing with some­one face to face can help re­solve a prob­lem quicker.

Sav­ing grace: Should you have prob­lems keep­ing up with pay­ments, speak to your med­i­cal aid about al­ter­na­tive, cheaper plans. Don’t drop your med­i­cal aid com­pletely as med­i­cal bills can be enor­mous.

If you don’t yet have a med­i­cal aid, do com­par­isons on­line or ask for ad­vice from a qual­i­fied bro­ker. This will help you to choose the scheme and plan that of­fers the best pos­si­ble cover for your age and per­sonal cir­cum­stances.

Sarah Ni­chol­son is Just­money’s com­mer­cial man­ager

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