Captain Fastbastard Mayhem

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Kickstarter

It needs a service...

No, they're not. A med aid is not allowed to show a profit - any additional funds over and above the administration fees (paid to the administrative arm of a company, sometimes a different company entirely) and claims, goes straight to their reserves, which they are legislatively bound to keep at a level above 25% of the entire annual contributions. The administrative company (which administrates the claims, payments, commissions, marketing etc) CAN show a profit. But it's a completely separate entity to the med aid itself. Med aid is simply a moerse large stokvel. You pay in. Your payments are used to cover claims and boost reserves, if necessary Adminstration charges are levied by whichever company administers the med aid (Discovery, Momentum, etc all have their own administrators, and sometimes administer other medical aids as well) No profit within the med aid itself.

1 thing, and 1 thing only... Investigative MRI & CT scan coverage

my bad...

and?

it's most probably down to the fact that they're not governed by the short / long term insurance acts - they're governed by the Council of Medical Schemes. Health Insurance is that product you buy from those other providers governed by the short term insurance act, and pay you an amount per day you spend in hospital (they try to market themselves as Hospital Plans, and then have a disclaimer "Not a Medical Aid" at the end) So no, it's not them, it's just what they're called. Yes, it is a type of insurance, but it's not your traditional insurance where the premium is determined by your risk factors. It's a medical aid plan...

15k actually isn't all that bad for the Factory FIT version. That's still less than a Pike RCT3...

Both cAses were PMB, thus full coverage. In danger of losing life or limb = PMB. Childbirth = PMB. it really pays to have a broker who knows what they're doing...

goodness...

Yep... like profmed, but more selective.

Hadn't heard of them, but a quick Google puts an end to that. Chartered Accountants Medical Aid Fund. Should be cheap and comprehensive due to the controlled client base (actuarially lower risk individuals inclined to claim less and be healthier than the general population) so is probably a good option

Oh... they (ambledown) don't really give that much info out to pvt clients as they place a lot of importance on their broker relationships. Underwritten by Hollard. Combined Complimed and Medilink in a buyout.

Yeah, you do that. Just be sure to check PMB coverage. It gets murky there, but make sure that your broker's chosen one covers it. Even though the Med Aid should

Gap cover shouldn't even be a consideration, imo. Should be mandatory.

You're lucky... For pneumonia in an elderly person, that's a small amount

Eish, Alan... That's not cool. I know what the inside of the NICU looks like and it's not cool to have someone so new, and so small and vulnerable inside there. Having said that - the nurses inside the NICU are some of the best, by necessity

Ah. Yes. Same happened to my wife in her hijacking 3 weeks ago. Cut to the neck, not major enough to warrant admission... Triage determined she was an urgent case, but only outpatient... Couple of stitches and painkillers and she was out. Put it this way - If it's a simple break requiring a cast alone, you'll be treated as an outpatient and pay it yourself. If it's a compound break without deformation, you'll be admitted as it'll most probably need theatre time to sort out the break and get it set with pins etc. The initial x-ray won't be covered as that's an "ïnvestigative" procedure (ïe they need to determine what's wrong before admission) If it's a compound break and your arm is bending in all sorts of unhealthy ways or bones are visible, you SHOULD be admitted straight away if your medical aid details have been confirmed. If you have no med aid, this is the point that you're referred to a gov't hospital as your injury isn't life threatening... Life threatening instances AFAIK they treat you instantly and transferred when stable - you're left with the pieces up until that point. Neck & back treatment - admitted. Pretty much all the time. Here it gets tricky though - if it's you walk in with a complaint of back pain after falling off a ladder, and they give you an MRI - investigative and you pay it yourself. If it's as part of an accident, you can't respond and you're lifted out of there and are admitted, then have an MRI - PMB. You have full coverage.

what procedure was it, if I may ask? That may go a long way to explaining why...

We deal solely with Ambledown (previously Complimed & Medilink) as they're VERY good from an administrative perspective, and offer a vast selection of products. They also cover PMB shortfalls, which very many gap cover providers don't.

If you need help, really - give me a shout. This is me... https://www.facebook.com/pages/Myles-Mayhew-Independent-Financial-Advisor/117954824953364?ref=hl And I deal with Momentum, Disco and Fedhealth. EDIT: Please forgive the lack of activity on that there FB page. The past 18 months have been.... busy.

That's all fine and well, but if that same lady had had even basic hospital admissions before she'd built up a suitable amount, she'd have been ruined. Much easier to say that from a position of already having that capital in your pocket...

they're short term insurance products that rely on people not knowing what they're covered for. Very bad coverage.

Don't touch them with a barge pole. Those are Hospital Plans that pay out a fixed amount per day spent in hospital. Okay if that's all you can afford, but they fall woefully short of providing any sort of meaningful coverage. There are Hospital Plans provided by the med aid companies that are fully fledged medical aids, just without the out-of-hospital coverage, and then there are the "hospital plans" that are flogged to all and sundry as a cheap replacement or substitute for med aid. These latter ones are normally sold with the condition "Product X is Not a Medical Aid"