Medical Aid

[Dolby]

What is the most important thing to look for in a medical aid ?

I'm on Classic Priority / Vitality (R3,100pm) but I've accepted a job with a low salary, so my plan needs to drop. However - since a few years ago - it seems like the number of packages have exploded!

I'm guessing hospital cover, MSA and chromic meds (I take tabs for heart burn) ?

 

[Dolby]

This is R1,000 cheaper ... seems no MSA but what is the extender benefit that I lose?
What about things like glasses or dentist ?

 

[M@gn3t1c]

I downgraded from Priority to Classic Delta Saver. I save R 1 k per month. Keep in mind that your savings is about R 6 k and you don't have the above threshold benefit. In my position the R 1 k saving makes up for it. Also you can only use hospitals in the Delta network. Luckily I am close to 2.

This is R1,000 cheaper ... seems no MSA but what is the extender benefit that I lose?
What about things like glasses or dentist ?


View attachment 418010

 

[Dolby]

I downgraded from Priority to Classic Delta Saver. I save R 1 k per month. Keep in mind that your savings is about R 6 k and you don't have the above threshold benefit. In my position the R 1 k saving makes up for it. Also you can only use hospitals in the Delta network. Luckily I am close to 2.

Yea I just saw that Delta and thought it looked good.

Do they have a list of hospitals around in the Delta network?
I'm guessing in an emergency, that wouldn't count though ... they'd take you to the nearest?

It says they both put away 25% of contributions for MSA though - can't can't be that different ?

https://www.discovery.co.za/portal/individual/delta-network-list

Ok, Wilgeheawul is there

 

[faniebraai]

Yea I just saw that Delta and thought it looked good.

Do they have a list of hospitals around in the Delta network?
I'm guessing in an emergency, that wouldn't count though ... they'd take you to the nearest?

It says they both put away 25% of contributions for MSA though - can't can't be that different ?

https://www.discovery.co.za/portal/individual/delta-network-list

Ok, Wilgeheawul is there

Go with this one: Classic Saver

I downgraded from a comprehensive package and I have all the same benefits, bar the stupid self-payment gap.

 

[FarligOpptreden]

Go with this one: Classic Saver

I downgraded from a comprehensive package and I have all the same benefits, bar the stupid self-payment gap.

Well, you lose the SPG, but also the ATB. We underwent some expensive medical costs last year and would've appreciated the ATB. It was the one year we decided to downgrade from Classic Priority to Classic Saver. Suffice to say, this year we're back on Priority.

 

[faniebraai]

Well, you lose the SPG, but also the ATB. We underwent some expensive medical costs last year and would've appreciated the ATB. It was the one year we decided to downgrade from Classic Priority to Classic Saver. Suffice to say, this year we're back on Priority.

But priority has those excess payments when you get admitted to hospital doesn't it?

 

[diapason]

What is the most important thing to look for in a medical aid ?

I'm on Classic Priority / Vitality (R3,100pm) but I've accepted a job with a low salary, so my plan needs to drop. However - since a few years ago - it seems like the number of packages have exploded!

I'm guessing hospital cover, MSA and chromic meds (I take tabs for heart burn) ?

The Priority Plans are a waste of money. They state that they have a limited Above Threshold Benefit – that should be EXTREMELY limited. Also, aside from the usual co-payments for scopes, they also have co-payments for several operations.

Regarding Saver plans – the Extender benefits relate to “free” visits to your GP which you are allowed when your savings have been used up (2 visits on Essential and 3 on Classic and Coastal). If you compare the cost of the risk benefit on the Saver plans with the cost of the Core plans, you will find that you are paying for those “free” visits whether or not use them if you are on Coastal or Essential. The difference on Classic is much less.
Far better to control your own savings unless you are likely to need the full amount early in the year.

Heartburn is not listed as a chronic condition.

 

[FarligOpptreden]

But priority has those excess payments when you get admitted to hospital doesn't it?

Most plans have excess payments for certain procedures. Besides, that's why you should have a gap- and co-payment cover. Luckily we have that, as our co-payments for procedures totaled around R10k for last year.

 

[diapason]

Most plans have excess payments for certain procedures. Besides, that's why you should have a gap- and co-payment cover. Luckily we have that, as our co-payments for procedures totaled around R10k for last year.

The big question is whether those co-payments will be covered from next year with the Gap Cover changes. They are already removing the cancer top-up which can often be included.

 

[FarligOpptreden]

The big question is whether those co-payments will be covered from next year with the Gap Cover changes. They are already removing the cancer top-up which can often be included.

Well, that's also why we have the feared illness insurance from Old Mutual. Covers more than 40 feared illnesses (including cancer) and would pay put roughly R4mil in our case. Should be enough of a top-up should one of those illnesses transpire.

 

[faniebraai]

Well, that's also why we have the feared illness insurance from Old Mutual. Covers more than 40 feared illnesses (including cancer) and would pay put roughly R4mil in our case. Should be enough of a top-up should one of those illnesses transpire.

insurance to cover insurance to cover insurance :crylaugh:

 

[FarligOpptreden]

insurance to cover insurance to cover insurance :crylaugh:

Yep, sadly so. All of that for peace of mind.

 

[Dolby]

Ok I'm going to the Delta save - hopefully can change when in 10 months when things settle down. They carry over my current MSA (thought they'd transfer it to me but I Think that's only when you cancel the plan)

 

[diapason]

Yea I just saw that Delta and thought it looked good.

Do they have a list of hospitals around in the Delta network?
I'm guessing in an emergency, that wouldn't count though ... they'd take you to the nearest?

It says they both put away 25% of contributions for MSA though - can't can't be that different ?

https://www.discovery.co.za/portal/individual/delta-network-list

Ok, Wilgeheawul is there

There's nothing wrong with network options. That is the only way many of us can afford decent cover. There is, however, one big BEWARE. Your primary healthcare people eg GP/dentist need to be made aware that you are on a network option. You don't want to be referred to a specialist where you perhaps run up a large bill for something for which you end up needing to be hospitalised, and then find out that your specialist does not have admitting/operating privileges at your network hospitals. As soon as there is any suggestion that you may need a specialist, you need to do your homework.

And, yes, in an emergency, you would be taken to the nearest hospital until you are sufficiently stabilised to be moved to a network option.

 

[diapason]

Ok I'm going to the Delta save - hopefully can change when in 10 months when things settle down. They carry over my current MSA (thought they'd transfer it to me but I Think that's only when you cancel the plan)

They only pay out your MSA balance if you transfer to an option which does not include savings.