Hospital + Savings Acc vs Comprehensive Medical Aid

[Micdew]

As you can see I'm thinking about medical aid's now and that's always a brain teaser.

My wife and daughter are on Discovery Key Care but it's time to move on as Discovery has increased the fees but decided that they going to pay doctors only R109 per patient so most doctors are moving away from that plan.

Is it really worth while moving over to a comprehensive medical plan? What is the big difference between that and just taking a hospital plan and putting money into a Savings Account?

Any advice would be appreciated...

 

[Garson007]

It all depends on how often you have to see the doctor, or any other medical practitioner.

Comprehensive makes sense if you go there often. Savings otherwise.

Example: I wear specs, so it can get expensive for me to only have savings - however, I never go to the doctor so it balances out. If I was paid more I'd go for one with a threshold.

 

[Frikkenator]

Look into Discovery's Essential/Comprehensive Saver plans, hospital plan with an MSA, works fantastic for me as I rarely have major medical expenses and historically the major ones are in hospital so it is covered by the plan. The MSA sorts out the odd doctor's visit, dentist, those type of things.

I would however put the kid on a comprehensive plan, as orthodontics etc are quite common and you don't want to have to pay that yourself.

 

[TehStranger]

I would however put the kid on a comprehensive plan, as orthodontics etc are quite common and you don't want to have to pay that yourself.

This. Even if you and the wife go only a lower plan, make sure your child is on a comprehensive plan. Things like dental, glasses or unexpected medical issues can leave you out of pocket big time, especially if she get's sick from others at school quite often.

 

[Micdew]

Daughter only 2 years old so still far away from specs and dentist work. Was thinking way not just take a hospital plan and put r200 a month in a savings acc then use that for meds and doc visits. At the moment I cant see the diff between doing that and taking out a comprehensive plan or is there sumthing I dont understand....

 

[Ecco]

If you not making regular trips to the doctor, then a hospital plan should suffice.

 

[Frikkenator]

Daughter only 2 years old so still far away from specs and dentist work. Was thinking way not just take a hospital plan and put r200 a month in a savings acc then use that for meds and doc visits. At the moment I cant see the diff between doing that and taking out a comprehensive plan or is there sumthing I dont understand....

In an effort not to make this thread massively morbid I'll refrain from examples, but there are a lot of things, serious things that can go wrong in a child's life, and if that were to happen you would want them taken care of in the best way possible, so if you can afford a comprehensive plan for the child then do it.

You having less than ideal care if something goes wrong is your choice after a risk calculation, your daughter doesn't have that choice, so rather be safe than sorry.

 

[Garson007]

Daughter only 2 years old so still far away from specs and dentist work. Was thinking way not just take a hospital plan and put r200 a month in a savings acc then use that for meds and doc visits. At the moment I cant see the diff between doing that and taking out a comprehensive plan or is there sumthing I dont understand....

The difference is insurance. It's like insuring a car. Either you just get third party insurance in case you're in an accident or you get comprehensive cover. If you're not in an accident the former is cheaper, but if you are you lose your car in the former (as an example).

It's all about how much risk you are willing to take.

 

[Micdew]

I see your point but as im reading through the scheme's and the msa is basicly money put aside for doctors, meds and test done outside a hospital and if it runs out then I pay the rest.... So how is it diff from me putting money aside and pay for it my self

 

[Garson007]

I see your point but as im reading through the scheme's and the msa is basicly money put aside for doctors, meds and test done outside a hospital and if it runs out then I pay the rest.... So how is it diff from me putting money aside and pay for it my self

If you go for a saver, there is none. The only difference is that you get a year's savings up front - without first having to pay it in.

Comprehensive cover on the other hand has threshold limits. That is, if your savings account and your own out-of-pocket expenses add up to the threshold amount the medical aid will pay the rest. This threshold benefit also has limits, but they're pretty high and if there is a specific chronic condition involved it can be unlimited.

Executive is the only plan with guaranteed no out-of-pocket expenses (unless you're excessive). However, since you're unlikely to use all your savings in a given year (given a good year), the comprehensive plans are also unlikely to ever drive out-of-pocket expenses.

 

[Frikkenator]

If you go for a saver, there is none. The only difference is that you get a year's savings up front - without first having to pay it in.

Comprehensive cover on the other hand has threshold limits. That is, if your savings account and your own out-of-pocket expenses add up to the threshold amount the medical aid will pay the rest. This threshold benefit also has limits, but they're pretty high and if there is a specific chronic condition involved it can be unlimited.

Executive is the only plan with guaranteed no out-of-pocket expenses (unless you're excessive). However, since you're unlikely to use all your savings in a given year (given a good year), the comprehensive plans are also unlikely to ever drive out-of-pocket expenses.

Also, the funds are not available for you to spend on something else. Remember that the money in your MSA stays yours, so if you decide to switch to a plan without an MSA or leave the scheme, the money in the MSA is repaid to you.

 

[JackWhite]

As i understood it not long back, is if i had just the hospital plan and saved the msa into my own account, come the time when i needed to do a ct scan i would have to fork out the full amount from my own savings account

vs

yet if i am on a savings plan (essential saver) and needed to do a ct scan then the first R2500 would come from my hospital plan first and then the balance from my msa

So i gather that the difference between my own savings account vs an msa with discovery is R2500 for every scan