Medical aids

Having worked in a medical practice for a year now, as part of the administration staff, I've learned a few things. There is a lot of stuff that the "lay person" does not know about medical aids. If you live in South Africa, you may want to read this.

Choosing your medical aid: Don't just go for price. 

Make sure that the broker selling you your medical scheme doesn't lead you in a certain direction. The choice they make may not be the best option for you. You medical aid needs to suit your needs. 

We have enough medical schemes in South Africa to choose from. Try "Googling" 'medical schemes in South Africa' and see what turns up.

If you had to ask me which medical aids I would recommend, they would be Discovery Health, Fedhealth, Bonitas, Liberty Medical Scheme, and Bankmed which is for employees of banks and their beneficiaries only.  The reason I suggest these is because most of them pay for in-hospital treatment without too much hassle on either the patient or the healthcare provider's part.

The two largest medical schemes (In my personal opinion) are Discovery Health and Medscheme. 

Discovery has an 80% coverage of medical professionals and hospitals that they are linked to. In other words, most doctors are contracted into Discovery. If you are somewhat fussy about your doctor and/or hospital, this is a good scheme to have to ensure you can get the one you want. Discovery also manages a number of medical aids with large client databases. Discovery however can be a bit tiresome if you are a Prescibed Minimum Benefits (PMB) case as they frequently require forms to be completed by both the patient and healthcare provider. The healthcare provider is allowed to bill you for completing the forms but it may come out of your day-to-day savings.

Don't know what PMB's (Prescribed Minimum Benefits) are? Click here to go to the SpesNet page where you can learn more.

Medscheme, though not a medical aid themselves, do manage numerous other medical schemes such as Nedgroup (For Nedbank employees), Sasolmed, Bonitas, Fedhealth; all of which are large within themselves.

Even though they like their patients, and really don't want to, medical practitioners have to debt collect and yes, they do hand people over to debt-collectors from time to time. So if you get a medical bill, rather pay for it and get a refund later when your medical aid pays out.