Jakkals. Posted January 22, 2014 Share i am on a classic saver, hit a tree square in the hip about 6 or so months ago at 50 odd km and hour, was completely trashed, went to sandton mediclinnic and was seen in the casualty, everything came out of my MSA till there was nothing left and then the bills started coming, total for the visit was R7300 and some change. MSA covered about half of that. i had to pay the rest. so wat die *** betaal die medies nou eintlik? Link to comment Share on other sites More sharing options...
rudi-h Posted January 22, 2014 Share Hi there, I'm on Discovery Keycare Plus. It is the lowest plan they have. I don't really need anything more. I need to know if the medical aid will pay for injuries that occurs while I'm mountain biking or should I get additional cover? I'm new to this. Thanks Be careful... I also thought so, had an accident followed by a knee operation. I had a basic hospital plan and I had to fork out R15k (almost 50% of the total bill) in the two weeks following the operation and another R3k for fisio / rehab afterwards that wasn't covered. Specialists typically charge 3X the standard "medical aid" rates, so if you have a costly procedure, you will end up paying 2/3'rds of the fee for the consultation, operation and aneaesthesiologist yourself on a basic plan... For a big accident with multiple fractures, rehabilitation etc. this bill could easily exceed R100k from your own pocket. edited... Edited January 22, 2014 by rudi-h Link to comment Share on other sites More sharing options...
Captain Fastbastard Mayhem Posted January 22, 2014 Share so wat die *** betaal die medies nou eintlik? Key word there was "casualty" - means he was never actually booked into the hospital, and was just treated as an outpatient. All med aids treat outpatients pretty much the same - it comes out of your available savings / day to day allowance etc. If he had been booked in, that would have been a different story... Link to comment Share on other sites More sharing options...
Jakkals. Posted January 22, 2014 Share hoekom ek vra is: by my nuwe werk moet ek na discovery toe skuif, of is dit n moet? eks tot dusver baie en meer as te vrede met Bonitas. al die planne van discovery is zef duur en om die een beter as die uit t wys is n groter kopseer!!! Link to comment Share on other sites More sharing options...
Captain Fastbastard Mayhem Posted January 22, 2014 Share hoekom ek vra is: by my nuwe werk moet ek na discovery toe skuif, of is dit n moet? eks tot dusver baie en meer as te vrede met Bonitas. al die planne van discovery is zef duur en om die een beter as die uit t wys is n groter kopseer!!! Jy moet met jou werk se makelaar praat. Dis sy responsibility om vir jou die verskillende options te wys, en vir jou te advise. Bonitas is 'n goeie mediese fonds - niks vout daarvan. Maar as jou werk se jy MOET op Discovery wees... Edited January 22, 2014 by cpt armpies mayhem Link to comment Share on other sites More sharing options...
Jakkals. Posted January 22, 2014 Share Jy moet met jou werk se makelaar praat. Dis sy responsibility om vir jou die verskillende options te wys, en vir jou te advise. Bonitas is 'n goeie mediese fonds - niks vout daarvan. Maar as jou werk se jy MOET op Discovery wees... thanks, ek sal biqi uitvind. Link to comment Share on other sites More sharing options...
stringbean Posted January 22, 2014 Share I'm sorry to say but medical aid and a good medical aid is the most important investment you can make in SA.No I'm not a broker but am in the medical field.As with everything in life you get what you pay for.Too many people skimp on the cheapest medical aid,don't bother to read the fine print and then bitch when they coupe K out of pocket.It all became a realization to me earlier in the year when my 8 year old daughter needed a emergency op for a twisted ovary.Luckily I could choose the best hospital to go to( wasn't told where I can or can't go as in many cheap medical aids).As I'm in the medical field a quick few phonecalls was all it took to find out who was the best surgeon and everything was sorted.No medical aid telling me " sorry he's not on out preferred list etc"A bad fall on your bike needing extensive orthopedic work can cost you easily up to half million rand.Not a place to skimp IMO. Link to comment Share on other sites More sharing options...
GhostSixFour Posted January 22, 2014 Share hoekom ek vra is: by my nuwe werk moet ek na discovery toe skuif, of is dit n moet? eks tot dusver baie en meer as te vrede met Bonitas. al die planne van discovery is zef duur en om die een beter as die uit t wys is n groter kopseer!!! What you can do, is, change the main member on your medical aid to your spouse - if you have one- then just become a dependent on her medical aid. Mostly companies just say you have to be there if you main member otherwise you have to prove you are on spouses medical aid. Link to comment Share on other sites More sharing options...
DKS Posted January 22, 2014 Share A buddy of mine took a spill over the weekend, and was sorted out in casualty (wasn't admitted or anything). Did X-rays and all kinds of scans, and ended up having to clear his MSA.... The rest of the costs (substantial) he has to carry on his own. Fine print is a bugger, know what you are covered for to avoid (or lessen) the shock and disappointment. Yip, that was me. Earned myself a dislocated shoulder. Cleared out the MSA (essential saver plan on discovery) then had a follow up visit on Monday with more X-rays and a sling, all had to come out of my pocket. So moral of the story try get admitted if you can. And make sure you know what you are covered for. Link to comment Share on other sites More sharing options...
Cassie Posted January 22, 2014 Share so wat die *** betaal die medies nou eintlik? GROOT ongelukke...soos wanneer jy in die hospitaal moet oorbly; ICU ens...die R100 000 rekeninge...dit die ENIGSTE voordeel..enige iets anders betaal jy maar self!!! So, hospitaal plan + versekering is dalkjk betre opsie... Link to comment Share on other sites More sharing options...
Maximis Posted January 22, 2014 Share I'm sorry to say but medical aid and a good medical aid is the most important investment you can make in SA.No I'm not a broker but am in the medical field.As with everything in life you get what you pay for.Too many people skimp on the cheapest medical aid,don't bother to read the fine print and then bitch when they coupe K out of pocket.It all became a realization to me earlier in the year when my 8 year old daughter needed a emergency op for a twisted ovary.Luckily I could choose the best hospital to go to( wasn't told where I can or can't go as in many cheap medical aids).As I'm in the medical field a quick few phonecalls was all it took to find out who was the best surgeon and everything was sorted.No medical aid telling me " sorry he's not on out preferred list etc"A bad fall on your bike needing extensive orthopedic work can cost you easily up to half million rand.Not a place to skimp IMO. Couldn't agree more Me and the mrs are on coastal saver through discovery. We get great savings aprox 14k for doc visits and meds ( a portion of which carries over to the next year ). My proudest investment however is a premium gap cover policy which covers ALL shortfalls and all co-payments. In total this sets me back about 3k a month but knowing that I am comprehensively covered by far out weighs the cost. Link to comment Share on other sites More sharing options...
kees21 Posted January 22, 2014 Share Couldn't agree more Me and the mrs are on coastal saver through discovery. We get great savings aprox 14k for doc visits and meds ( a portion of which carries over to the next year ). My proudest investment however is a premium gap cover policy which covers ALL shortfalls and all co-payments. In total this sets me back about 3k a month but knowing that I am comprehensively covered by far out weighs the cost. I second the importance of a GAP cover. I had a small OP two years ago and the anesthesiologist charged a ridiculous rate. Luckily I had GAP cover and the portion I claimed from them equaled 3 years of GAP cover premium payments. Edited January 22, 2014 by kees21 Link to comment Share on other sites More sharing options...
NOFX Posted January 22, 2014 Share Your first mistake is Keycare but you will only realize that when you want to use it and can't find a hospital that is suitable Link to comment Share on other sites More sharing options...
stringbean Posted January 22, 2014 Share With a medical aid you have some bargaining power with the hospitals.Patients with hospital plans are seen as private patients by the hospitals and are charged accordingly.Sometimes 3x more than someone on medical aid. Link to comment Share on other sites More sharing options...
Cuppa Bru Posted January 22, 2014 Share With a medical aid you have some bargaining power with the hospitals.Patients with hospital plans are seen as private patients by the hospitals and are charged accordingly.Sometimes 3x more than someone on medical aid. How does that work? Hospital plan = medical aid?! Link to comment Share on other sites More sharing options...
stringbean Posted January 22, 2014 Share The brokers here can tell you more but hospitals see hospital plan as a type of insurance.The big hospital groups and big medical aids have agreements to what they will charge and pay.Smallfry insurance company with hospital plan got no bargaining power like the big medical aids so going to get shafted a bit.If you did a bit of research into what costs per day in private hospitals are and procedures cost you will see how huge the shortfall is with hospital plans. Link to comment Share on other sites More sharing options...
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