Get the most out of your medical aid this year with these simple tips

Get the most out of your medical aid this year with these simple tips

– Tanya Motlafe (Head of  Cornerstone Healthcare Consulting Services)

A brand-new year is in full swing and for many, improving their health and wellness, including financial wellness, is at the top of the resolutions list. A major part of your reaching your optimal financial wellness, is ensuring that your medical aid is performing at its full potential and that you are getting the most out of your monthly contributions. To help you make 2020 your best year yet, we have put together some expert tips on how to get the most out of your medical aid:

Make sure that you understand your benefits and are aware of any exclusions

One of the main reasons people don’t get their money’s worth out of their medical aid, is because they do not understand their benefits and do not know exactly what they are covered for. You may be paying out of your pocket for treatments and medicine that your medical aid should cover or by simply going to network provider, you may be saving hundreds on co-payments. Furthermore, you may be over insured and paying a massive premium for cover you don’t need and barely use.

If you are unsure what your medial aid benefit option covers, be sure to get in touch with one of our qualified, expert healthcare brokers by clicking here.

Visit the pharmacy instead of the GP

For things like a flu injection, HIV tests, certain vaccinations and over the counter medicine, you don’t need to see the doctor. Most of these services are available at retail pharmacy clinics. By getting these medicines and services from a pharmacy, you’ll end up saving a lot by avoiding the doctor’s consultation fees. Also, check if your medical scheme uses specific network pharmacy, as that will reduce a levy on your prescribed medicine.

Make use of network service providers

This is a great way to save money and make your medical savings last longer, because mostly, healthcare professionals within your medical scheme network will charge medical aid rates which are often lower than private rates. Even if your option plan does not limit you to network providers, you can still save by using them. Your medical scheme will most likely have a list of all its network providers available online to help you locate a healthcare professionals and service providers closest to you and your family.

Get the appropriate level of care

Avoid visiting medical specialists for non-specialist needs. For example, don’t go directly to an Ear, Nose and Throat specialist (ENT) for a simple sinus infection that could have been treated by a GP at a fraction of the cost.

Remember, specialists are healthcare professionals who specialise with a certain or specific medical condition and tend to charge outside of scheme rates. This means that over and above the large chunk that will be taken from your medical savings, you might even be liable for shortfalls. Always make sure that you seek the correct level of care for your needs.

Strongly consider a Gap cover policy

Just as the name suggests, Gap cover has been specially designed to cover the gap between medical aid rates and what healthcare professionals charge for in-hospitals and some out-of-hospital treatments. Many times, medical specialists don’t charge scheme rates which means your medical aid will only pay a portion of the outstanding amount, what about the rest? That’s were Gap cover comes in handy.

Also, contrary to popular belief, you do not have to be admitted to hospital in order to use your Gap cover benefits. Gap cover may cover shortfalls on many out-of-hospital benefits such as accidental casualty, MRI scans or CT scans. Although these procedures are mostly performed in-hospitals, they are often done without the patient being admitted and therefore it counts as an out-of-hospital procedure.

Making the most of your medical aid benefits is a vital part of financial well-being and a qualified healthcare broker can help you along the way. Contact us today to find out more and remember to connect with Cornerstone Healthcare Consulting Services on Facebook and LinkedIn for more interesting content, tips and advice.


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