Medical Aid

XFlorenceX said:
Medical aid seems like a bad idea until you actually have a emergency or a medical problem. My dad had a heart bypass and several stents put in his legs this year, medical aid covered everything. And because my dad used a hospital in their medical aid's network, there was zero co-payments. To all the clever people who feel like medical aid is useless, trust me, you won't feel so clever when you actually get severely sick and require expense treatment. People have a very warped naive view on getting sick. Many people never saw their health problems coming...

As for OP, I am currently on the Discovery Coastal Saver plan. I pay R2400 and for that I get a hospital plan with all the frills and 20% of my premium goes to my Medical Savings Account for any out of hospital payments. That is more than enough to cover my dental visits, medication, doctor visits and optometrist. There is also tons of other plans at Discovery, the main difference being your premium vs your Medical Savings Account. You can consider also just getting a hospital plan and then saving R500 on your own for Out of Hospital expenses which can add up. There is no reason to feel like you must have a medical savings account. If you really want to save, look at Discovery's Smart Plans. VERY competitive rates but you have to go to a hospital in their network (which isn't a train smash imo) .
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My uncle has a plan with discovery. We have two of their hospitals nearby. One is within 2km from my place.
 
When considering medical aid, don't think illnesses only, and don't say 'I am healthy, so I do not need medical cover' ... Accidents happen and trust me, you don't want to wake up at chris hani baragwana with all limbs amputated for no reason - and thereafter recieving disprin...
 
XFlorenceX said:
Medical aid seems like a bad idea until you actually have a emergency or a medical problem. My dad had a heart bypass and several stents put in his legs this year, medical aid covered everything. And because my dad used a hospital in their medical aid's network, there was zero co-payments. To all the clever people who feel like medical aid is useless, trust me, you won't feel so clever when you actually get severely sick and require expense treatment. People have a very warped naive view on getting sick. Many people never saw their health problems coming...

As for OP, I am currently on the Discovery Coastal Saver plan. I pay R2400 and for that I get a hospital plan with all the frills and 20% of my premium goes to my Medical Savings Account for any out of hospital payments. That is more than enough to cover my dental visits, medication, doctor visits and optometrist. There is also tons of other plans at Discovery, the main difference being your premium vs your Medical Savings Account. You can consider also just getting a hospital plan and then saving R500 on your own for Out of Hospital expenses which can add up. There is no reason to feel like you must have a medical savings account. If you really want to save, look at Discovery's Smart Plans. VERY competitive rates but you have to go to a hospital in their network (which isn't a train smash imo) .
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Also look at the new Smart plans, mix of hospital with minimal day to day, it works out better for my family and I cost wise ( Fam of 4 ) and covers everything we need happily. It is very dependent though on you having a good hospital/doctor in the network nearby.

We're on Classic Smart which gives the classic level cover in Hospital ( 200% ) and a R50 copayment for doctors consults with minimal medication cover, about R1.5k less than equiv coastal saver with double the hospital benefit. You can bank the difference in prem and self fund medication ( which is all a MSA really does anyway ).
 
Kosmik said:
Also look at the new Smart plans, mix of hospital with minimal day to day, it works out better for my family and I cost wise ( Fam of 4 ) and covers everything we need happily. It is very dependent though on you having a good hospital/doctor in the network nearby.

We're on Classic Smart which gives the classic level cover in Hospital ( 200% ) and a R50 copayment for doctors consults with minimal medication cover, about R1.5k less than equiv coastal saver with double the hospital benefit. You can bank the difference in prem and self fund medication ( which is all a MSA really does anyway ).
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Tempting and it is within my budget. Well I just checked the network, it ain't bad since the nearest hospital is within 10KM radius
 
Kosmik said:
Also look at the new Smart plans, mix of hospital with minimal day to day, it works out better for my family and I cost wise ( Fam of 4 ) and covers everything we need happily. It is very dependent though on you having a good hospital/doctor in the network nearby.

We're on Classic Smart which gives the classic level cover in Hospital ( 200% ) and a R50 copayment for doctors consults with minimal medication cover, about R1.5k less than equiv coastal saver with double the hospital benefit. You can bank the difference in prem and self fund medication ( which is all a MSA really does anyway ).
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Also on this, works good for me as the doctor visits are unlimited for R50 each time.
 
I would never recommend living without medical aid if you can afford it. Its insurance. If you do the math on the categories it may seem expensive but medical aid's are not so much about the categories as they are about the chronic benefits. You have no idea yet if you or a dependent will pick up a serious chronic issue or need serious hospitalization. I am on a decent medical aid and am so glad I am as I have a daughter with a serious long term issue we picked up on when she was 7. Her monthly medication currently comes to about 10K but if she needs specialized antibiotics that shoots up to 40K per month for a year or so and the medical aid pays it all.

The insurance aspect is why you get it and stay on it as trying to join right after you find out about something like that or cancer etc will mean massive exclusions and you will be utterly screwed in the long run. It is not that difference from car or house insurance. It may feel occasionally like a waste but if you don't have it eventually you will wish you did.
 
nkonzosims said:
Tempting and it is within my budget. Well I just checked the network, it ain't bad since the nearest hospital is within 10KM radius
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The doctors are normally the tricky ones, most of the hospitals are fine. Also get a gap cover as others said ( I'm not a fan of Discoverys, been on Complimed for years with work and they've always paid no fuss for me ).
 
Cius said:
I would never recommend living without medical aid if you can afford it. Its insurance. If you do the math on the categories it may seem expensive but medical aid's are not so much about the categories as they are about the chronic benefits. You have no idea yet if you or a dependent will pick up a serious chronic issue or need serious hospitalization. I am on a decent medical aid and am so glad I am as I have a daughter with a serious long term issue we picked up on when she was 7. Her monthly medication currently comes to about 10K but if she needs specialized antibiotics that shoots up to 40K per month for a year or so and the medical aid pays it all.

The insurance aspect is why you get it and stay on it as trying to join right after you find out about something like that or cancer etc will mean massive exclusions and you will be utterly screwed in the long run. It is not that difference from car or house insurance. It may feel occasionally like a waste but if you don't have it eventually you will wish you did.
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Yup, it only takes one family member going to the hospital for a week to have the medical aid break even.

Or bankrupt you if you don't have it.
 
deesef said:
The medical aids generally also bail when it comes to this type of bill...
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In 2012, I was a healthy 40 year old. BMI well within limits and gymmed 5 times a week.
One simple accident and I spent 9 weeks in ICU, a total of 20 weeks in hospital. Discovery paid every cent (> R3mil) without any fuss whatsoever.
 
This is what I'd do, as I've done most of it:

* Go with Discovery Smart Classic, as it has great benefits:
** Unlimited GP visits with a R50 copayment
** One eye test per year with a R50 copayment
** One dentist visit with a R100 copayment (however, this is nerfed, so you will most likely need to pay more for anything other than a checkup - but it's something)
** MRI and CT scans have a copayment, where on the Coastal Core I was before on didn't
** It covers some OTC meds up to R630 per year
** It covers 200% of the DHR rate, which is more than the Coastal Core I was on before

Then get gap cover to cover any differences (just in case you end up in hospital) and / or get an emergency fund going (I would not invest this in the stock market as someone else suggested. Stock market == long term, a savings account is much more suitable. You could use Tymebanks Goalsave accounts to get up to 9% interest here).
 
mr_norris said:
This is what I'd do, as I've done most of it:

* Go with Discovery Smart Classic, as it has great benefits:
** Unlimited GP visits with a R50 copayment
** One eye test per year with a R50 copayment
** One dentist visit with a R100 copayment (however, this is nerfed, so you will most likely need to pay more for anything other than a checkup - but it's something)
** MRI and CT scans have a copayment, where on the Coastal Core I was before on didn't
** It covers some OTC meds up to R630 per year
** It covers 200% of the DHR rate, which is more than the Coastal Core I was on before

Then get gap cover to cover any differences (just in case you end up in hospital) and / or get an emergency fund going (I would not invest this in the stock market as someone else suggested. Stock market == long term, a savings account is much more suitable. You could use Tymebanks Goalsave accounts to get up to 9% interest here).
Click to expand...

Currently looking at gap cover, which one do you have? Zestlife has been recommended to me.
 
deesef said:
The medical aids generally also bail when it comes to this type of bill...
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This is just plain false.
Speak to anyone who had serious illness or accident, and you will hear that the medical aid paid for everything stated in the contract.
 
backstreetboy said:
This. Until your're 34 atleast. Eye tests and glasses you save up and pay yourself (spec savers etc. is cheap). For dental just take care of your teeth with an Oral b electric toothbrush. For sinus get Cetirizine or Texa allergy at Clicks etc.
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Until a taxi skips a traffic light (or if you yourself drive like an *******), and you end up having to go to a government hospital, or start one of those Facebook petitions to ask for a million rand for medical bills.

Or, as happened to an acquaintance, be diagnosed with leukemia in your late 20s.
 
XFlorenceX said:
Medical aid seems like a bad idea until you actually have a emergency or a medical problem. My dad had a heart bypass and several stents put in his legs this year, medical aid covered everything. And because my dad used a hospital in their medical aid's network, there was zero co-payments. To all the clever people who feel like medical aid is useless, trust me, you won't feel so clever when you actually get severely sick and require expense treatment. People have a very warped naive view on getting sick. Many people never saw their health problems coming...

As for OP, I am currently on the Discovery Coastal Saver plan. I pay R2400 and for that I get a hospital plan with all the frills and 20% of my premium goes to my Medical Savings Account for any out of hospital payments. That is more than enough to cover my dental visits, medication, doctor visits and optometrist. There is also tons of other plans at Discovery, the main difference being your premium vs your Medical Savings Account. You can consider also just getting a hospital plan and then saving R500 on your own for Out of Hospital expenses which can add up. There is no reason to feel like you must have a medical savings account. If you really want to save, look at Discovery's Smart Plans. VERY competitive rates but you have to go to a hospital in their network (which isn't a train smash imo) .
Click to expand...

I've also had no issues with my Medical Aid paying for an emergency that I've had.
 
mr_norris said:
This is what I'd do, as I've done most of it:

* Go with Discovery Smart Classic, as it has great benefits:
** Unlimited GP visits with a R50 copayment
** One eye test per year with a R50 copayment
** One dentist visit with a R100 copayment (however, this is nerfed, so you will most likely need to pay more for anything other than a checkup - but it's something)
** MRI and CT scans have a copayment, where on the Coastal Core I was before on didn't
** It covers some OTC meds up to R630 per year
** It covers 200% of the DHR rate, which is more than the Coastal Core I was on before

Then get gap cover to cover any differences (just in case you end up in hospital) and / or get an emergency fund going (I would not invest this in the stock market as someone else suggested. Stock market == long term, a savings account is much more suitable. You could use Tymebanks Goalsave accounts to get up to 9% interest here).
Click to expand...

This.

When I joined, the Smart Classic + Gap cover was cheaper than a hospital only plan. I save what I would have paid for an MSA and pay my own day to day expenses from that.

Some people don't like this, as they don't want to worry about what things cost. They just want the medical aid to take care of it.
Other than that, others prefer an MSA, as you have your entire years' MSA allowance available at the beginning of the year.
 
mr_norris said:
This is what I'd do, as I've done most of it:

* Go with Discovery Smart Classic, as it has great benefits:
** Unlimited GP visits with a R50 copayment
** One eye test per year with a R50 copayment
** One dentist visit with a R100 copayment (however, this is nerfed, so you will most likely need to pay more for anything other than a checkup - but it's something)
** MRI and CT scans have a copayment, where on the Coastal Core I was before on didn't
** It covers some OTC meds up to R630 per year
** It covers 200% of the DHR rate, which is more than the Coastal Core I was on before

Then get gap cover to cover any differences (just in case you end up in hospital) and / or get an emergency fund going (I would not invest this in the stock market as someone else suggested. Stock market == long term, a savings account is much more suitable. You could use Tymebanks Goalsave accounts to get up to 9% interest here).
Click to expand...

FYI, good gap will re-imburse the MRI/CT copayments too as well as casualty and a few other new benefits.
 
maumau said:
Currently looking at gap cover, which one do you have? Zestlife has been recommended to me.
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I'm ashamed to say that gap cover is the only thing I don't have. But I am looking for something that's reasonable. I do have an emergency fund of expenses go really pear.
 
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