Medical Aid

medicnick83

Paramedic
Joined
Aug 23, 2006
Messages
21,158
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565
Location
CBD, Cape Town
Hi all,

Something I want to share with you.

While working on ambulances over the last few months, I've seen a few interesting things with regards to "medical aid" and I wanted to share this information with you guys - you will either know these things or not know, which in that case, you'll know and can do something about it.

1. If you have medical aid and your family is covered, you need to get medical aid cards for each member of the family.

Too many times the wife/husband is involved in a car accident and say, you know you should be taken to X hospital because you are covered by Y medical aid.
We take you to X hospital and X hospital refuses to treat you without your medical aid card but funny enough, the partner/spouse has the card which is bad thing, because it delays treatment.

Now, having said that, if you are in such bad condition that you need to be stabalized and such, then X hospital has to do that so you're okay there but still, once you are stabilized, you will then get transferred to a government hospital unless your partner/spouse arrives with the medical aid card - so... if you have multiple members, get them their own cards "just in case" - if there is an extra fee - just pay it! Peace of mind as far as I'm concerned so you and your family etc get best definitive care ASAP.

2. Check your medical aid and re-check it!

We had a patient last night who we took to X hospital because they told us to take the father there because they were covered by Y medical aid.
We got there and they told us "sorry, that medical aid plan is not covered by this X hospital" - our poor patient then had to be transferred to Z hospital (government) to be treated - 2 hours wasted while things were checked / confirmed / people were called etc etc

Having said that, the medical aid plan WAS covered, but they cancelled the cover 2 days prior! So the point of this argument is, things change! So re-check, get it in writing from the medical aid saying "it covers this and that and you can take them here and there"

Know your medical aid, what it covers, what it doesn't cover, who it doesn't cover and who it does - and know what hospitals we (EMS personal) could take you too should we need to (closest ones!)

3. Ambulance services (when calling for help)

Know the closest ones, so if you live around the corner from a Netcare 911 base, but you know it's private service - do not be scared to call them!!! Time is serious, the longer you delay definitive care, the worst your condition will be at the end of the day.

Also, if you phone X service, help the controller, say you live around the corner from the Y base, most call centers are not in the area and they dispatch what THEY think is the closest ambulance but it's actually very far away.

I had a call one day with Netcare 911 when they dispatched the town ambulance because according the a map in the control room, we were closest, but actually, we were the furtherest away!

Also, don't by shy to call multiple services - call X first, then call Y - whomever gets there first is best ;)

Remember, a private service has to help you - end of the day, it will be a 'non billable call' if they submit the forms to medical aid / RAF and they say no for whatever reason. :)

My biggest thing I want to bring to everyones attention is your medical aid and your medical aid cards... I see so many issues while on the ambulance with this - no card, no treatment! (unless you're basically dying!!!)

More tips to follow (If I can think of any!)

Hope you have a safe festive season guys!

I love being a volunteer with Metro EMS ;)

:p
 
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Slight OT. Should it be Medical Aids business how much I earn? They are now putting people on higher tarrifs unless they can prove that they earn less than X amount per month.
 
My Discovery member card has a emergency number on it. I take I need to phone that for a ambulance? I am also guessing that you need to have the ambulance approved or else you gonna pay through your @rse for it. Nowadays, you need approval from your medical aid first before you can die even. tsk tsk.
 
Slight OT. Should it be Medical Aids business how much I earn? They are now putting people on higher tarrifs unless they can prove that they earn less than X amount per month.

Yeah!!!!! I got the same thing a month ago. Discovery wanted me to send my IRP5 to prove that I earn what I say I earn. If I earned a R100.00 more per month I would have been moved up to the highest premium on the KeyCare Plus option! Bastards!
 
Yeah!!!!! I got the same thing a month ago. Discovery wanted me to send my IRP5 to prove that I earn what I say I earn. If I earned a R100.00 more per month I would have been moved up to the highest premium on the ****** option! Bastards!

Not sure if u worry about these sorts of things, but you are prob giving away ur earnings with this post
 
My Discovery member card has a emergency number on it. I take I need to phone that for a ambulance? I am also guessing that you need to have the ambulance approved or else you gonna pay through your @rse for it. Nowadays, you need approval from your medical aid first before you can die even. tsk tsk.

This might be very true, but that is why I said you must phone your MA and check! and then obviously let your family members know so that if things happen, they know to let people know.
MA's that are petty about what ambo service transports you to hospital are just ***! :(
 
Slight OT. Should it be Medical Aids business how much I earn? They are now putting people on higher tarrifs unless they can prove that they earn less than X amount per month.

Hi Redeemed, they only ask for proof of income for plans that are "cross subsidized" meaning they are overcharging the higher earners to subsidise the lower earners. Look on the bright side if you are a higher earner:) or get on a medical aid plan that isn't cross subsidised.
 
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