What's up with Medical Aid?

S

st3ve

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Parkview, JHB
We pay R2600/month for discovery hospital plan, 2 adults 2 toddlers, been to the doctor a few times this year for colds and stuff, now all of a sudden we've run out of funds and have to pay. Milpark hospital just told us we'd have to pay them R600 to consult our feverish child.

WTF?

Am I missing something here?
 
Discovery is a ripoff st3ve - how do you think all those nifty vitality benefits are paid for? I'm on Nimas (http://www.nimas.co.za/) and it costs me R590 a month. For this I get a decent hospital plan and unlimited access to a medicross centre of my choice. I can go there and visit GPs and get medicines without paying a dime.

The same plan (Quantam Plus) will cost you R1500 from Nimas (you, spouse and 2 kids).

No I'm not a medical aid salesman. I just hate Discovery.
 
lukev said:
Discovery is a ripoff st3ve - how do you think all those nifty vitality benefits are paid for? I'm on Nimas (http://www.nimas.co.za/) and it costs me R590 a month. For this I get a decent hospital plan and unlimited access to a medicross centre of my choice. I can go there and visit GPs and get medicines without paying a dime.

The same plan (Quantam Plus) will cost you R1500 from Nimas (you, spouse and 2 kids).

No I'm not a medical aid salesman. I just hate Discovery.
Click to expand...

Thanks lukev I've sent them a mail to see what they can offer.
 
Hi St3ve

Discovery is a mess as Lukev has indicated. I pay R 3k per month and guess what, they did not even want to pay a general checkup (after 6 month's payment and no claims). After many phone calls and HelloPeter they admitted they were at fault, but again did not pay. Same story again, then they paid. I think their plan is simply...take the clients money, don’t pay anything. I wish I could move, but I am stuck with them due to my employer…

Try HelloPeter though…they respond quickly.

Regards,

RPM
 
Interesting.

Always thought the Discovery Plan was the Rolls Royce of Medical Schemes.

I am with Momentum. So far so good.
Originally it was called Pulz which amalgamated recently as Momentum Health.
At the time of our entry into the Pulz Scheme there were only 6000 odd members who were all medium to low medical risk clients.

I am paying R1500 per month for a family of 4.
For this I have a 15% savings for day to day bills and "Unlimited Cover" at Afrox Hospitals and Chronic Medicine via a State Institution.

How this would all pan out if we all got very sick is an unknown factor.
We have only had to claim once for Hospital Care when my daughter had her tonsils removed recently and the Scheme paid the Hospital Bill.
And they settled the day to day Medical Bills from the savings with no hitches.

As I said, "So far so good"

Edit.
Almost forgot to mention this.
Momentum used to sell Discovery's Schemes until Discovery decided to go it alone. It was at this stage that Mementum decided to start there own Scheme and Pulz was the result.
http://health.momentum.co.za/live/content.php?Item_ID=838&Session_ID=2ea41ac65a84b570f99b0f90bda1d464
 
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A friends of mine's mother is a nurse and she swears by momentum.
I swear by putting money away every month instead of paying a medical aid but thats IMHO. :)
 
hmm dunno about putting money away every month, my neighbour had leukaemia, now he swears by medical aid. Could your monthly stash cover such expensive medical costs?

Nimas medicross option looks good for my family with the two toddlers coz all we ever do is go to the doctor, but the hospital plan is there if we need it. Medicross costs R1755 per month and all medicross visits and (selected) medicine from their pharmacy is free (after 6 visits per member we pay R30 per visit)

Seems a heck of a lot better than the R2600 discovery hospital plan.

Anyone here sell gym membership (or know someone who does) in the Parkview Rosebank area? My wife is so impressed with the vitality gym membership thing but to buy membership is so cheap anyway.
 
Ploempie said:
A friends of mine's mother is a nurse and she swears by momentum.
I swear by putting money away every month instead of paying a medical aid but thats IMHO. :)
Click to expand...

I did the same until just before I turned 40 at which stage I decided to join a Scheme before the premiums got "loaded".
There are penalties on a sliding scale for new joiners after the age of 35 or 40. Not sure if it is 35 or 40, but the premiums are more after this age.
So if you leave it until you are 60 or 70, unless you are a rich person, you may not be able to afford a Medical Aid the way I see it.
 
60 - 70 is a looooooooooooong way away for me so I'm not worried at the moment. I haven't seen a doctor in about 7 years so I just put money away for emergencies etc. I cannot justify paying so much money for so little back.
 
I AM GOING TO SAY THIS ONLY ONCE.
SPECTRAMED...talk to: DOLORES EEKHOUT.011-621-7750-or better still 082-795-2843
www.spectramed.co.za
i pay 2600,no limit for two of us...have look see:D :D
 
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rpm said:
Hi St3ve

Discovery is a mess as Lukev has indicated. I pay R 3k per month and guess what, they did not even want to pay a general checkup (after 6 month's payment and no claims). After many phone calls and HelloPeter they admitted they were at fault, but again did not pay. Same story again, then they paid. I think their plan is simply...take the clients money, don’t pay anything. I wish I could move, but I am stuck with them due to my employer…

Try HelloPeter though…they respond quickly.

Regards,

RPM
Click to expand...
You don’t know half of it; I was on chemo for about 6mounths and every thing looked fine was in remission. On the 21/10 I went for a checkup and was told it has spread to my left hip. Had to go for treatment the next day, only to be told that they don’t cover the 2nd C growth .I was told(after I made a scene)why don’t I pay for it myself as they know I can afford it. I changed medical schemes, and pay for this particular treatment myself. Discovery sucks big-time.
 
interesting .. I am on momentum ... really good so far .. was thinking of going to discovery for the added vitality benefits ... but if they are really that bad ... no way am I joining them .. thanx for the heads up guys :)
 
Guys i have a really good friend who is a broker and he told me that Discovery as of next year will be the best plan in the country (classic comprehensive). He also told me that the others dont like paying too much. I truly believe that for medical care you must have the best plan available.
 
craigsa said:
GHe also told me that the others dont like paying too much.
Click to expand...

Sounds like discovery to me. I pay them R4000.00 per month for a family of 4. That R48000 per year and I have loads of crap from them.

We are always "out of funds" by November and they also (when we have funds) will short pay one of our doctors by R3 per consultations - what a schlep to make a eft for R3. They claim that he does not charge standard taffis and thus won't pay him even though it comes out of our alleged savings plan.

They even refuse to pay for my tinted lenses as they say dark glasses are a luxury when in fact they are tinted prescription lenses.

I had no **** when I was on Polmed a few years ago.
 
Polmed was the best but now under the new gvt they are bankrupt but yes polmed was excellent. I suppose we have to just shut up and take it up the bum.
 
Ploempie said:
A friends of mine's mother is a nurse and she swears by momentum.
I swear by putting money away every month instead of paying a medical aid but thats IMHO. :)
Click to expand...

I hope you save craploads , cause if u ever need an IC unit , all those savings will evaporate like theres no end.
 
I was on Discovery up to September of this year but couldn't take all the hassles any longer. I reported them on HelloPeter twice and they were very apologetic but never rectified the situation. I've moved to BestMED and experienced no problems to date and the service is great.
 
My advice is that you contact IFG. http://www.ifg.co.za/contactus.asp
They're brokers, and they will get you the best possible medical aid for your needs, at no cost. My whole family is on Munimed thanks to them, and we're very happy with them.
 
Just saw my GP and asked him about the Nimas Medicross option, he held up his A3 medicross chart to show me what medicines he would have to prescribe on that option, saying that the stuff was all archaic generic medicine and that he wouldn't be able to prescribe any of the newer drugs that are more effective. He's also on Discovery and runs out of funds around July evey year.
 
craigsa said:
Guys i have a really good friend who is a broker and he told me that Discovery as of next year will be the best plan in the country (classic comprehensive). He also told me that the others dont like paying too much. I truly believe that for medical care you must have the best plan available.
Click to expand...
This is what I am on. They simply don’t pay anything unless you hassle them, independent of your funds etc. Unfortunately I am stuck with them, just like with Telkom…
 
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