Of the few South Africans who are fortunate to have access to a medical aid, most seem to have depleted their savings by the middle of each year. Most of the big medical aids such as Discovery offer a member savings account (MSA) as part of their benefits.
The MSA is a percentage of the contribution that is set aside for day-to-day medical expenses such as doctor's consultations and prescriptions. While the initial amount in the MSA might sound like a lot of money, it's inclined to disappear very quickly. Medical care is expensive, and savings are depleted quickly.
Unfortunately, medical needs don't stop at the same time that savings run dry. Medical aid members now face the challenge of continuing to pay their contributions while funding medical expenses as well.
What are your options?
- Exploit your benefits
In addition to medical treatments and savings accounts, many medical aids offer preventive care that the scheme funds. For example, you might be entitled to a Pap smear, PSA test and flu vaccine dose, among others.
Making use of these benefits makes the early diagnosis of medical conditions possible. Early intervention will cost less than the price of advanced stage.
Get the flu vaccine for free and you're likely to avoid a trip to the doctor and an expensive prescription.
- Know what you're entitled to
While you still have savings, be clear on what is going to be deducted from them. For example, some medical aids deduct the cost of radiology and pathology from the savings account, while others do not.
When you receive the benefit guidelines for the year, read through it carefully. This strategy allows you to budget to make sure you aren't going to deplete your savings too soon.
- Treatment of PMB conditions
Prescribed minimum benefits (PMBs) dictate that certain conditions must be treated whether you have savings or not. It includes several common medical conditions such as diabetes and hypertension.
Consultations for these conditions will be paid for despite a lack of savings provided they are billed correctly by the consulting doctor. There is usually a form you and your doctor need to fill in to get a PMB authorisation.
After approval, your consultations are deducted from a separate fund, not from your savings.
- Child benefits
Your medical aid may offer payment for consultations for children even if you've depleted your savings. The coverage varies from one medical aid to another. Refer to the benefits guide or contact your medical aid directly.
- Chronic medication
Depending on your plan, your approved chronic medication should be deducted from a separate fund. Make sure you and your doctor have filled in the necessary paperwork.
If you don't, chronic medication costs are deducted from your savings. You will continue to get your chronic medication without having to pay for it provided you don't exceed the maximum benefit your medical aid offers.
- Upgrading your plan
You might want to investigate upgrading your medical aid plan to get access to more savings. However, the cost of your contribution will increase. Weigh up the extra money you'll pay against the added savings.
It might be worth your while to invest the difference in a savings account of your own. You can access the funds once you've exhausted your medical savings account.
- Generic medication
Always check whether your prescribed medication has a cheaper generic version. Use generics wherever possible, while you have savings and after you don't. It saves you money either way.