How to make your medical scheme savings stretch

2017-02-12 06:01

Here are some ways to ensure that you don’t deplete your savings by June:

1. Double-check if it's not the schem's responsibility to pay:

Your scheme must pay for prescribed minimum benefits (PMBs) and cannot apply copayments on these conditions. The PMBs include 27 chronic conditions and 271 hospital-based conditions.

“If you suffer from a PMB condition, understand what benefits are provided as part of a PMB condition and use the service of the designated service provider to ensure that your claims are paid from the risk benefit, rather than from your medical savings account,” advises Ann Streak, senior specialist at Alexander Forbes Health.

2. Pay in cahs or use formulary meds:

If you have a medical savings account, don’t claim for items not normally covered by medical schemes, for example, over-the-counter headache tablets or cough preparations.

Paying cash will help the money in your savings account last longer, so that you have funds available for more serious, more expensive out-of-hospital treatments.

“Alternatively, use medications from the scheme’s formulary, as there is generally no copayment on these,” says independent health consultant Heidi

3. Stay healthy:

This may seem like an obvious tip, but we often overlook the fact that by looking after ourselves we will inevitably reduce the cost of our medical expenses, according to Discovery.

Make use of your scheme’s preventive screening benefits for regular health checks, and engage in a healthy lifestyle through exercise and diet.

4. Make sure you take advantage of networks:

“Use doctors from the scheme’s network, as the scheme will invariably have entered into a payment arrangement with the doctors and therefore they will be paid in full and unlikely to demand a copayment,” says Kruger.

5. Use the appropriate level of care:

Avoid going to a specialist when a doctor’s consultation or advice from a pharmacist will suffice.

6. Get the right scheme:

“Make sure you have one that meets what your family requires.

“People often choose based on affordability rather than needs.

“People who run out of savings in February and March are the ones who have chosen the wrong option,” says Damian McHugh, head of marketing and sales at Momentum.

7. Register all chronic diseases:

“If you’re on regular medication to treat a chronic illness (such as diabetes or hypertension), you could qualify for chronic medication benefits.

"This means that your medical scheme pays for it out of the risk portion of your medical aid and not your medical savings account. All you need to do is register your condition as chronic,” says a Bonitas spokesperson.

8. Consider other products:

Momentum’s HealthSaver, for example, is a complementary product that can be used to enhance your medical aid.

“HealthSaver is only for medical scheme savings – you can’t use it to buy airtime. It allows people to save more than regulations allow them to.

“A significant number of people buy the pure hospital plan and then take the hospital saver scheme. We give you up to R1 000 back for free in the health saver account with the returns benefits,” explains McHugh.

If you end up making savings and there’s something left in the kitty, remember that any unused medical savings balances accumulate year on year and are not forfeited at the start of each year.

So, if you’re savvy, what you save in 2017 can be used in 2018 and beyond.

October 13 2019