Hospital Only Plans

Why are you wasting 5k p/m on medical aid? All you need is a set of surgeons tools, narcotics, tranquilizers and some bandages and sterliser at home.
 
krycor said:
So I’m busy relooking at the plans this year as I’m coastal again after nearly a decade.

One thing I picked up already which I though should be mentioned is that the coastal plans cover less(in cost per procedure) and only do 100% coverage instead of 200% but gives you ability to go to any private hospital.

That basically means your need for gap cover is more and thus need to factor in that cost when comparing plans(don’t use discovery for gap, it’s crap the last time I checked plans and asked around medical specialists).

Still not sure which is best tbh. Meh..

Why change then? Well was looking up docs for some basic things and realized most of the “good” specialists are at off network hospitals in Cpt(Jhb this wasn’t always the case but then there are a lot more group hospitals vs one off private).

Anyway not a thing if you trust in randomly assigned doc though I prefer asking their peers who to avoid.
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Plan + Gap is always going to win out over any plan on its own.

Gap covers costs almost nothing and is less than the difference between plans as well for more benefit.
 
krycor said:
So I’m busy relooking at the plans this year as I’m coastal again after nearly a decade.

One thing I picked up already which I though should be mentioned is that the coastal plans cover less(in cost per procedure) and only do 100% coverage instead of 200% but gives you ability to go to any private hospital.

That basically means your need for gap cover is more and thus need to factor in that cost when comparing plans(don’t use discovery for gap, it’s crap the last time I checked plans and asked around medical specialists).

Still not sure which is best tbh. Meh..

Why change then? Well was looking up docs for some basic things and realized most of the “good” specialists are at off network hospitals in Cpt(Jhb this wasn’t always the case but then there are a lot more group hospitals vs one off private).

Anyway not a thing if you trust in randomly assigned doc though I prefer asking their peers who to avoid.
Click to expand...
Im with Profmed Active Savy plus - Is network hospitals, but they pay 200% rate, and there is a R3000 kitty for OOHE. +-R2K/PM. not sure if you get a discount if multiple dependants.
 
Flywheel said:
Why are you wasting 5k p/m on medical aid? All you need is a set of surgeons tools, narcotics, tranquilizers and some bandages and sterliser at home.
Click to expand...
you can probably get away with a leatherman and a lighter.
 
krycor said:
So I’m busy relooking at the plans this year as I’m coastal again after nearly a decade.

One thing I picked up already which I though should be mentioned is that the coastal plans cover less(in cost per procedure) and only do 100% coverage instead of 200% but gives you ability to go to any private hospital.

That basically means your need for gap cover is more and thus need to factor in that cost when comparing plans(don’t use discovery for gap, it’s crap the last time I checked plans and asked around medical specialists).

Still not sure which is best tbh. Meh..

Why change then? Well was looking up docs for some basic things and realized most of the “good” specialists are at off network hospitals in Cpt(Jhb this wasn’t always the case but then there are a lot more group hospitals vs one off private).

Anyway not a thing if you trust in randomly assigned doc though I prefer asking their peers who to avoid.
Click to expand...

I speak under correction, but just because a specialist is at a specific hospital, doesn't mean that they will cover visits to that specialist. The hospital only really matters when they want to operate, and then the R8 800 co-payment isn't really an issue considering how much you've saved over the years. Gap cover will also sometimes cover the first out of network surgery.
Having multiple surgeries in a year could be a problem though. Touch wood.

Seeing what good specialists charge for an op, I wouldn't want a plan with less than 300% coverage, so you either want a really expensive plan, or you want gap cover anyway. 100%/ 200% are pretty much the same thing imo - not enough.
 
I have discovery coastal core + Stratum Gap cover. Medical expenses in the last year have been just shy of half a million. 99% of it has been paid either by Discovery and the balance by the gap cover.

So I am happy. I was thinking of upgrading my medical cover, but the increase of R2k to R3k per month does not seem to justify it. I rather save an extra bit on the side for the unforeseen.
 
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