Medical Aid screw over

[Belix]

OK, so discovered that our current medical aid does no reimburse foreign medical expenses other than emergency cover. Frankly can't see why - not asking them to pay up front, just to pay what they would effectively pay any anyway locally. Planning to make a trip overseas and will have some medical done there.

So found a medical aid that does. Now, first issue is a three month waiting period. Could understand if I'd not been on a medical aid, but I have been. They say it's to stop people changing to a medical aid with cover for an item not covered by their own medical aid, but since you can change your own medical aid package to a higher level seemingly without a waiting period, this does not wash with me. Seems like a great way to effectively kill competition between any medical aids. Why would you swap over and pay full rate for only PMB?? What a rip off.

So thought well I'll take cover with the new medical aid, but keep the old medical aid in place for the three months. Guess what? NOOOO that is not allowed either! It "unjustified enrichment". I mean, WTF!!! So the only option is the cancel the current, wait three month with hardly any cover at full price? Am I the only one that has issue with this?

 

[F1 Fan]

You sure you pay for the 3month period? Or is it prohibited to join a new medical aid within 3months of leaving the previous one?

 

[ToxicBunny]

You sure you pay for the 3month period? Or is it prohibited to join a new medical aid within 3months of leaving the previous one?

You pay, but are not allowed to claim.

 

[SoulTax]

I have major issues with everything in SA's medical aid department. From the medical "Savings" scam, to the issue outlined in the OP.

 

[The_Unbeliever]

medical aid = legal get-rich-quick scheme...

 

[F1 Fan]

You pay, but are not allowed to claim.

Is that certain or all schemes? My wife had been able to use her medical aid from the very beginning for doctor visits etc.

 

[LazyLion]

Why don't you just purchase once off Travel Insurance. I think they call it shortfall insurance or something like that.
Should cost about R500 to R1000 for the trip.

 

[Belix]

Don't think they cover pre-exisiting conditions, only emergencies. I would think my wife's being pregnant would not be covered. She will give birth while we are away if all goes to plan.

 

[AlmightyBender]

There is a waiting period to prevent you from abusing the system. The whole fundamental basis of insurance is uncertainty in terms of what will happen or when or both. In your case you know exactly what needs to be done and when. In that even the fair price of insuring you for that event will be the actual cost of the event i.e. insurance is pointless. Also you cannot be insured for the same thing twice because that goes against the fundamental aim of insurance: to put you in a situation that you were before the insured event.

These rules are in place to prevent you from freeloading off the contributions of other members of the scheme.

 

[SoulTax]

There is a waiting period to prevent you from abusing the system. The whole fundamental basis of insurance is uncertainty in terms of what will happen or when or both. In your case you know exactly what needs to be done and when. In that even the fair price of insuring you for that event will be the actual cost of the event i.e. insurance is pointless. Also you cannot be insured for the same thing twice because that goes against the fundamental aim of insurance: to put you in a situation that you were before the insured event.

These rules are in place to prevent you from freeloading off the contributions of other members of the scheme.

Or from taking away the profits of the shareholders you mean.

 

[F1 Fan]

There is a waiting period to prevent you from abusing the system. The whole fundamental basis of insurance is uncertainty in terms of what will happen or when or both. In your case you know exactly what needs to be done and when. In that even the fair price of insuring you for that event will be the actual cost of the event i.e. insurance is pointless. Also you cannot be insured for the same thing twice because that goes against the fundamental aim of insurance: to put you in a situation that you were before the insured event.

These rules are in place to prevent you from freeloading off the contributions of other members of the scheme.

Except that you are never ever ever in the same situation. I have yet to meet someone that was in the same or in a better situation.

Perfect Example: I bought a car 55k(book value at the time of the accident). Someone drove into me and car was written off. I got paid out 55k less 5k excess = 50k. that excludes the premiums I paid to them for two years.

Same situation? I think not.

 

[Belix]

Don't see how I'm abusing the system. The birth will be after the three month waiting period if all goes to plan anyway. I AM currently on one medical aid, so it would be covered locally.
What I don't see if why I pay FULL fees for the three months, and get the minimum cover. I'm not expecting anything to happen in those three months. But that's the point of medical aid, is it not - to cover those unexpected medical bills.

If you can't change from one medical aid to the other without a penalty, there is not much incentive for competitive changes, are there?

I'm also not insuring for the same thing twice, as I get almost zero cover on the one insurance for the 3 months!!

 

[akescpt]

u want baba to have the foreign country's nationality?

 

[ToxicBunny]

Relatively clever if you ask me, esp if you're planning on travelling anyway.

 

[Hosehead]

Why don't you just purchase once off Travel Insurance. I think they call it shortfall insurance or something like that.
Should cost about R500 to R1000 for the trip.

Those are the biggest rip. You have to call them from overseas and they tell you to pay your bills yourself and they'll reimburse.
I tore mine up on the spot. That's the whole point cover if you need a clinic and not worry about payment.
This particular Co was run by a one man band out of JoZi and it was either absorbed by another co or it closed because back in 2003 there were just too many complaints.

 

[Cius]

medical aid's do not normally cover stuff abroad. That is covered by your travel insurance. We took out travel insurance when we went touring Europe and the US a few years ago and it was very useful as my wife had an old cap on a tooth break off in central park while eating something. We had to get a dentist to sort it out there and travel insurance paid out the whole lot. We got via AIG I think. Credit cards also have it.

 

[LandyMan]

Don't think they cover pre-exisiting conditions, only emergencies. I would think my wife's being pregnant would not be covered. She will give birth while we are away if all goes to plan.

Dude, not to be funny here, and I am not a fanboy of Medical Aids at all (I myself only have Hospital plan, as I think it is rip off), but from reading this, the measures are put in place to stop EXACTLY what you are trying to achieve here: Medical doesn't cover you, for a planned BIRTH overseas of all things. Now you want to change to someone that will cover, just so you can have your child overseas, and now you are unhappy that they won't allow you to do it?

Sorry, but IMHO I would tell you the same thing if I was the Medical Aid

 

[Belix]

er, yes, except that some medical aids DO cover overseas expenses. Mine DID, but does not any more. And if you read it, you would see that they WILL cover it - it is over three months away. What they WON'T cover is the three months after I change.

 

[LandyMan]

er, yes, except that some medical aids DO cover overseas expenses. Mine DID, but does not any more. And if you read it, you would see that they WILL cover it - it is over three months away. What they WON'T cover is the three months after I change.

Yes, they did cover, and not anymore, and now you want to move. Fact remains that the new Medical Aid is covering themselves, like you said yourself in a previous post.

 

[ChocolateBadger]

medical aid = legal get-rich-quick scheme...

Speak for yourself. Our medical aid covered all my mothers cancer costs which went well into the millions. I would rather have medical aid then not. Just stay far far away from Discovery.

ON TOPIC:

Over seas costs are usually covered depending on the package you're on, hence if you can't afford good medical aid, you can't afford to travel. Also I think you're thinking of medical insurance which pays out cash for you to spend on medical treatment. Medical aid pays the expenses directly.