Medical Aid

[Captain Fastbastard Mayhem]

agreed...and dont take the time to read the documents from cover to cover and understand them...or tget the broker to do their job and explain everything in detail...guilty.

 

problem is we make the mistake of taking out policies with people who we think we can trust or a family friend etc.

 

beware of broker who "adjust" your policies after a period of time...i took out my policies when i started working at 16 on the railways...then at 28 the broker advised that because i had a family etc...it was advisable to make certain changes and additions...to "improve" my policiesF%^&* did he screw me...

 

anyway enough of this...it just gets me worked up because of my own stupidity and laziness...not taking the time to understand what i signed.

Generally speaking, that's the best way to do things - no use selling something that will provide an income after death if you don't have kids / wife etc (for example)

 

However - what you say about the broker explaining things properly - 100%. That's why we get paid commission - to help you understand what you have, and advise you as to the best fit. Some people just sell one size fits all stuff, or chase the commission without a thought of what they're selling. TCF (Treating Customers Fairly) is (hopefully) going to change some of that, but it will be a while before wholesale change comes around. 

 

As for not taking the time to understand what you signed - yes and no. You asked someone to cover a very specific set of criteria and, regardless of who the broker is, they're supposed to ensure the best possible fit given the products they have access to and your allocated budget. If something doesn't fit, they have to explain why, and how it may affect you down the line...

 

Even the most "educated" clients (we get them more and more often now - millennials, who do tons of research themselves) don't actually know what they don't know. And it's a shock to them when we actually walk them through some of the stuff they wanted to put together themselves, and indicate how it actually may not be a good idea to structure things in the way that they thought they should... 

 

Sounds like you got royally shafted though... I see it very very often, and nothing makes me madder than seeing people who are so deep in something that I can't do anything to fix it... 

Edited November 5, 2015 by Myles Mayhew

[Dubbin]

I put my family on Discovery Coastal Saver. Been with Discovery for past 13 years and family had a couple of hospitalisations through the years. (including a daughter showing up 7 weeks prematurely and staying three weeks in prenatal ICU)

 

With every event the amount I had to pay in was basically pocket change. Would recommend Discovery to anyone.

[eccc whippet]

Dubbin my wife would agree with you...we are also with discovery coastal saver...i am told we also have gap cover.

[Captain Fastbastard Mayhem]

Dubbin my wife would agree with you...we are also with discovery coastal saver...i am told we also have gap cover.

TBH, unless you go through more than R 50k per year on out of pocket expenses (day to day) or have one of the chronic conditions that aren't covered by the 27 on Coastal Saver, or you're not on the cancer benefit and claiming for biologicals, this is the best option for most people.

 

Edit: Coastal Saver & Gap cover, that is.

Edited November 5, 2015 by Myles Mayhew

[Long Wheel Base]

TBH, unless you go through more than R 50k per year on out of pocket expenses (day to day) or have one of the chronic conditions that aren't covered by the 27 on Coastal Saver, or you're not on the cancer benefit and claiming for biologicals, this is the best option for most people.

 

Edit: Coastal Saver & Gap cover, that is.

Im on classic saver. Havent had any reason to complain. Is it any good? I dont have gap cover as iv never used all my msa.

Currently just myself, wife and 34 week bump so might need to adjust when he arrives soon.

[Captain Fastbastard Mayhem]

Im on classic saver. Havent had any reason to complain. Is it any good? I dont have gap cover as iv never used all my msa.

Currently just myself, wife and 34 week bump so might need to adjust when he arrives soon.

Gap cover isn't for out of hospital stuff, it's for the gap between the med aid payment rate and the amount specialists charge in hospital, which often goes up to 500% of the discovery health rate (and other med aid rates)

 

 

Without knowing you, I'd actually suggest downgrading to essential or coastal (depending on your location) and add Gap Cover. Less cost, more cover.

[Skylark]

Apparently in the near future Discovery is entering the gap cover market, so I have heard. Anyone that can confirm that?

[Captain Fastbastard Mayhem]

Apparently in the near future Discovery is entering the gap cover market, so I have heard. Anyone that can confirm that?

Nope. Banking, yes.

[Long Wheel Base]

Gap cover isn't for out of hospital stuff, it's for the gap between the med aid payment rate and the amount specialists charge in hospital, which often goes up to 500% of the discovery health rate (and other med aid rates)

 

 

Without knowing you, I'd actually suggest downgrading to essential or coastal (depending on your location) and add Gap Cover. Less cost, more cover.

I'm in Joburg, Does coastal only apply to people living at the coast?

[Captain Fastbastard Mayhem]

I'm in Joburg, Does coastal only apply to people living at the coast?

In coastal provinces, yes. Wouldn't be right for you. If you do go to coastal and have an elective procedure in Jozi, DH will only pay 75% of the discovery health rate as opposed to 100%

[eccc whippet]

medical aid or not....

 

if nothing happens and you could live till 100 and die in your sleep...lucky you.

 

the reality is you not gona be that lucky...

 

no medical aid will mean you have to deal with government hospitals...which could either be a good experience in the case of my granddaughter...or a horrific experience in the case of my father.

 

the scary part you could have medical aid but just not enough cover...which will result in you still being declared bankrupt by the time the hospital is finished suing you for their money....boy do they make sure they get the clothes off your back if you dont pay...with all the tees crossed and i dotted page after page you have to sign before you can be admitted...dont be fooled thinking just because the medical aid gave the go ahead that everything is covered.

 

like all other policies...you will only know how good they are when really need them or the day it is time to collect.

 

my opinion...if you are a young single person who just lives for the day...like i did for many years...who cares...make a plan as life happens...you loose your toys you buy new ones as you recover.

 

if you have people who depend on you...like a wife and children...only an inconsiderate fool wouldnt have medical aid within your budget.

Edited November 6, 2015 by isetech

[Veebee]

I can't agree with your statement Isetech.
Being young doesn't mean that you have to be stupid and take chances with your life and health.

I'm 28, no wife or dependants but had medical aid since I started working @ 20 and was never hospitalized until this past weekend.

I was in for 5 days and had a really pleasant stay, good doctors and nurses which made it much easier.

Without cover, 1 would have to go through hell to get a bed and be treated, not something anybody would want to go through.

If you young and working, can afford to party, eat out and dress well then you should have a medical aid.

I'm waiting to see the final bill from the medical aid but I'm happy that I don't have to fork out $$$$ for a surgeon and anaesthetist.

Edited November 7, 2015 by Vivek B

[Frosty]

Gap cover isn't for out of hospital stuff, it's for the gap between the med aid payment rate and the amount specialists charge in hospital, which often goes up to 500% of the discovery health rate (and other med aid rates)

 

 

Without knowing you, I'd actually suggest downgrading to essential or coastal (depending on your location) and add Gap Cover. Less cost, more cover.

How does one add gap cover to a Discovery medical aid? Essential saver?

 

Is it a separate policy with Discovery, or another insurance company?

[Captain Fastbastard Mayhem]

How does one add gap cover to a Discovery medical aid? Essential saver?

 

Is it a separate policy with Discovery, or another insurance company?

another company entirely. As of next year, the only one we will be using in our practice is Complimed, due to them paying for PMB procedures as well. Their premiums are increasing a bit (to R 200 p/m for a family from R 150) but only due to an extensive period of claims (their claim to premium ratio was 118% for the 2014 / 2015 financial year...)

[Frosty]

another company entirely. As of next year, the only one we will be using in our practice is Complimed, due to them paying for PMB procedures as well. Their premiums are increasing a bit (to R 200 p/m for a family from R 150) but only due to an extensive period of claims (their claim to premium ratio was 118% for the 2014 / 2015 financial year...)

Thanks, I'll have look.

 

As you say, essential is cheaper than classic and R200 is nothing in comparison to cost of not having it.

[eccc whippet]

My father is no longer with us...he began his journey in heaven last night.

 

A tip for people who have elderly family members who dont have medical aid or not on the correct plan...frail care support and a burial policy...prepare yourselves for a long hard journey...please dont dump the old people at a facility and leave them.

 

we have a large family and my father was a kind humble man...he was blessed with the support from family and friends right till the last breathe.

 

My father is the first person of our family to leave us...I had no idea what to expect when he fell last week...man it has been an eye opener.

 

from government hospital care to...

 

trying to organise frail care...

 

body collection fees...best you either have kitty with a few bob or a decent policy to include it...

 

If only one person in the will pass away...best you have a another kitty bigger than the one you had to buy your expensive bike...because the executor estate handling fees are gona bankrupt you or you gona need to sell the property to cover the fees...check the handling fee percentage...apparently they start at 2 % of the entire estate...they send out assessors to valuate "EVERYTHING" the total amount is calculated and the percentage if taken off that value.

 

make sure the person left behind has a separate bank account if they a married in community of property otherwise all the accounts are frozen until the will is sorted out.