Warning - What your medical aid covers!

Hi all,

I had a interesting shift this weekend - in the sense that besides it being quiet, I learnt something.

If you call a ambulance, especially a private ambulance service (like ER24, Netcare 911 and the rest) for things like (but not limited too!)

• headaches (students do this so often!)
• toothaches (students do this so often!)
• vomiting (because you're piss drunk)
• struggling to breath (because you're freaking out about a test tomorrow! - there is a nice medical term for this, but I won't confuse you)
• ear aches, etc

Basically, what we in EMS call "stupid stuff" (how is that for honesty?) you need to find out if your medical aid covers that because I learnt that they do not.
Medical aid covers (when you call a ambulance) "Life threatening emergencies" and if you call a private service ambulance for this - you will end up fitting the bill - all of it.

Obviously, many will fight with their medical aid trying to get them to pay but many will loose, especially if you read the fine print.

I am posting this because I want to educate you guys - I had a forum member call me in complete distress on Friday because his girlfriend is 'unable to breath' and when we chatted, I found out she had a big test on Monday - now besides that, he wanted to call a ambulance 'just to be sure' (which is okay!) but guys, really - just becareful - the 'brown paper bag' suggestion sorted her out, but she already knew that.

Depending on your medical aid, you will end up fitting the bill (we talking easy R2000+) simply because a call (and examples above) are NOT considered "life threatening emergencies"

Now, obviously, if you 'girlfriend' (example here) suffers from Asthma/heart conditions etc and the pump/meds is not working - basically, if the person in question has a history of a medical illness and you really think you need a ambulance, go ahead and call - just becareful that you are not calling because you're in a complete panic like Mr did on Friday (won't mention his name because he will come and kick my gat) he didn't take into account her medical history and the fact that she had a big test (once they chatted, he found out that she generally has this happen before big tests)

Always carry your medical aid cards on you, if you have multiple family members, make sure they have copies in their wallets and that they are valid and told what hospitals to goto.
I think I've mentioned this before in another thread.

Maybe someone can find out if I am correct or not.

Yeah, common sense is pretty useful in these situations... but I hear not everybody has access to that.

Thanks for the heads up! Hopefully some people will pay attention.

• headaches (students do this so often!)
• toothaches (students do this so often!)
• vomiting (because you're piss drunk)
• struggling to breath (because you're freaking out about a test tomorrow! - there is a nice medical term for this, but I won't confuse you)
• ear aches, etc

Click to expand...

Ok I can understand the shortness of breath but the rest :wtf:

Alan said:

Ok I can understand the shortness of breath but the rest :wtf:

Click to expand...

my thoughts exactly

Thanks for mentioning the price.

Why doesn't ambulance just take the stupid kid with the toothache and drop him off in the middle of nowhere. He won't do it again

Damn. My dad had another stroke last night. Went in on him this morning only to find him unable to talk and walk.
Phoned the ambulance and waited an hour before carrying him out to my car and taking him to the hospital myself.
Tho it wouldn't have made a difference. I waited for 5 hours before seeing a doctor anyway, but while we where waiting the ambulances arrived with dumb stuff like a broken finger, and numerous people who walked in looking just fine, joking with the nurses, but they needed an ambulance to get there?

Ranting I suppose. Rough day.

That's awful Madman sorry to hear

I think I would have lost it

Madman88 said:

Damn. My dad had another stroke last night. Went in on him this morning only to find him unable to talk and walk.
Phoned the ambulance and waited an hour before carrying him out to my car and taking him to the hospital myself.
Tho it wouldn't have made a difference. I waited for 5 hours before seeing a doctor anyway, but while we where waiting the ambulances arrived with dumb stuff like a broken finger, and numerous people who walked in looking just fine, joking with the nurses, but they needed an ambulance to get there?

Ranting I suppose. Rough day.

Click to expand...

I'm sorry this happened to you.
Did you call government ambulance or private?
If private, that is really bad.
If government - that does suck, I'm really sorry.

I wish you guys could all see how busy the government services are - it's not funny!
I can't speak for the rest of the country but I know the Western Cape service (Metro EMS) does their best because I work with them alot and I'm proud to be associated with them as a volunteer.

There are too many people compared to available ambulances.

At the end of the day, ambulance services (especially government) have to attend to as many calls as possible.
Communities/people etc are clever and they 'lie' about the conditions of the patients - how many times we get told 'patient unresponsive' or 'bleeding alot' and when we get there - the patient is awake and fine or not even bleeding (scratch) - they know what to say to get the ambulance there faster.

Many times, when we get on scene at a 'broken arm' or something - there are 2/3 cars parked outside and we wonder "why didn't they just take them to hospital"

It's hard to justify / answer and make you understand - the only real way is to go and work in EMS yourself and see the state of affairs and then you'll understand.

Long and short of it - we do try so hard.

I've seen similar cases with the neighbourhoodwatch, while on the topic.
Waiting times on private and government:
Private: 10min up to 30min
Government: I can't remember any of them actually pitching within an hour.

Although sometimes I wonder why (in certain cases in which it is possible to move the patient) they don't transport the patient to hospital... the closest hospital in the area is 3-4km, which will take you 3 minutes if you move fast.

The last I heard, and this with a family member, Netcare charged R3500 for the "callout".

I honestly don't know what the call out costs are, I'm scared to ask.
But R3500 probably isn't far off.

Private ambulance services obviously make their money from either your medical aid or from RAF.

gdiza said:

Communities/people etc are clever and they 'lie' about the conditions of the patients - how many times we get told 'patient unresponsive' or 'bleeding alot' and when we get there - the patient is awake and fine or not even bleeding (scratch) - they know what to say to get the ambulance there faster.

Click to expand...

That's shocking and it should be made a criminal offense.
When the call is made the details of the person calling should be taken and if the call turns out to be a prank they should be arrested/charged since they're actually endangering other people's lives.

Paul_S said:

That's shocking and it should be made a criminal offense.
When the call is made the details of the person calling should be taken and if the call turns out to be a prank they should be arrested/charged since they're actually endangering other people's lives.

Click to expand...

I don't think it can be considered a prank - remember, a prank is when you call for a ambulance or fire engine and nothing is there when the vehicle arrives (no emergency or fire) - that is considered a prank.
These people have a 'problem' they just exaggerate it to get the ambulance there faster.

there was an accident outside my house the other day. shame this motorcycle guy was knocked off his bike. he was a delivery guy. this other guy was speeding along the road and knocked him flying. his arm was broken and he had a huge open wound. i phoned the police and within 5 minutes they were here along with the ambulance. of course there were 5 tow vehicles as well, the flipping vultures they are. don't know what happened i wasn't hanging around, i'm not a person who can hang around someone with injuries like that. but they took him to the hospital once the police had done their thing.

Celine said:

there was an accident outside my house the other day. shame this motorcycle guy was knocked off his bike. he was a delivery guy. this other guy was speeding along the road and knocked him flying. his arm was broken and he had a huge open wound. i phoned the police and within 5 minutes they were here along with the ambulance. of course there were 5 tow vehicles as well, the flipping vultures they are. don't know what happened i wasn't hanging around, i'm not a person who can hang around someone with injuries like that. but they took him to the hospital once the police had done their thing.

Click to expand...

Tow truck drivers are vultures - they can charge something like R2000± to tow your vehicle and if you don't pay, you don't get it back.
They also have access to police radios (how they get it, I don't know) which is how they found out about the accident.

Here in Cape Town, I've heard rumors of how the cops talk about 'fake' accidents just so they can watch the TT drivers run all over the show.

This also brings up another interesting thing;

If you have car insurance, your car can only be towed by a certain towing company - if another company tows your vehicle, you fit that bill completely.

The vultures can't have access to police radios anymore. About 12 months ago the police switched over to FHHS and also added encryption to their setup. Their communications system underwent a complete overhaul.

froot said:

The vultures can't have access to police radios anymore. About 12 months ago the police switched over to FHHS and also added encryption to their setup. Their communications system underwent a complete overhaul.

Click to expand...

That doesnt remove the cops who get a "commission" from a good tip off.

froot said:

The vultures can't have access to police radios anymore. About 12 months ago the police switched over to FHHS and also added encryption to their setup. Their communications system underwent a complete overhaul.

Click to expand...

Trust me, they still have access to the police radios - maybe not up country, but I've seen it myself in Cape Town.

And those who don't have access - they get the tip off from the cops who then pay them 'commission' on the vehicles they do actually tow - so they might get on scene first, but only if they tow the vehicle to they pay the person who gave them the tip about the accident.

gdiza said:

Trust me, they still have access to the police radios - maybe not up country, but I've seen it myself in Cape Town.

And those who don't have access - they get the tip off from the cops who then pay them 'commission' on the vehicles they do actually tow - so they might get on scene first, but only if they tow the vehicle to they pay the person who gave them the tip about the accident.

Click to expand...

I'd seriously like to know how. Those iCom radios (mobile) and Motorolas (handheld) are R25k and R6k respectively. I know one of the few guys to actually program their radios and it's not that easy getting hold of the frequencies. Then you'd need the encryption keys.

My money would be on someone actually telling them about it

froot said:

I'd seriously like to know how. Those iCom radios (mobile) and Motorolas (handheld) are R25k and R6k respectively. I know one of the few guys to actually program their radios and it's not that easy getting hold of the frequencies. Then you'd need the encryption keys.

My money would be on someone actually telling them about it

Click to expand...

Maybe - but when you make as much profit on towing a vehicle as TT drivers do, 25K or 6K gets paid off very quickly.
I remember someone telling me not to long ago that there are almost 100 MVA's (car accidents) a day in Cape Town (that includes just fender benders) so there is alot of money in it.