Understanding how your medical aid works can be difficult. But if you want to make your benefits last as long as possible and avoid additional medical expenses, follow these top tips.
Use network GPs and specialists
We negotiate special rates with doctors and specialists on the network so you receive quality care at lower rates. This helps you to avoid co-payments and helps your savings and day-to-day benefits stretch further.
Go to preferred providers
You can avoid co-payments and get more value for money by using preferred providers and designated service providers. Choose to use these providers so you receive the best in medical care.
Get advice from your pharmacist
Pharmacists can provide sound medical advice on problems such as rashes, colds and sicknesses which are not severe. You buy over-the-counter medicine and treat less serious illnesses yourself.
Check for benefits paid from risk
Benefits paid from risk are additional to your other benefits. They give you more value for money, without using your savings or day-to-day benefits. On most plans, you can receive maternity consultations, wellness benefits, preventative care benefits and dentistry paid from risk by us.
Manage your chronic medicine correctly
Register your chronic condition with us so payment of your medication can be made from risk and not your savings. Try to use the medication on your plan’s formulary and obtain this from a network pharmacy or a designated service provider.
Get with the programme
Join one of the managed care programmes related to your condition. These programmes have been specifically created to help you manage serious conditions such as cancer, diabetes and HIV/AIDS. They help you use your benefits correctly and get the best of care.
Submit all your claims
If you can, try to pay for over-the-counter medication out of your own pocket and not out of your medical savings account. This way your savings will go further to cover more of your medical costs.
Pre-authorise your hospital stay
Pre-authorisation is required for all hospital admissions so your hospital stay will be covered. Ask if there are any co-payments or sub-limits that will apply and what you can do to avoid these. Call 0860 002 108 or email email@example.com to get a pre-authorisation number.
Get a specialist referral
If you need to visit a specialist, make sure you have a referral from your GP to visit the specialist. You may visit a gynaecologist, ophthalmologist or oncologist once a year without a referral.
Call ER24 in an emergency
ER24 is our contracted provider for medical emergencies. In an emergency, please call 084 124. Place the ER24 stickers you receive in your welcome pack on the window of your car so that you can get assistance in case of emergency. The ER24 number is also shown on your membership card.