Medical Aid

[dre]

Anybody here have any experience with the Wooltru healthcare?

 

Wife and I are currently on Discovery Coastal Core hospital plan (have not needed it in the last 2 years, and we don't really go to the doctors ever). 

 

We are thinking of joining the Wooltru healthcare as she is employed by one of those participating companies. Any input? 

[Captain Fastbastard Mayhem]

Anybody here have any experience with the Wooltru healthcare?

 

Wife and I are currently on Discovery Coastal Core hospital plan (have not needed it in the last 2 years, and we don't really go to the doctors ever). 

 

We are thinking of joining the Wooltru healthcare as she is employed by one of those participating companies. Any input? 

Don't. It's expensive for what it is, the medical savings don't roll over to hte next year, they're okay to deal with though. 

 

Just - no. Don't. 

Edited November 9, 2015 by Myles Mayhew

[Pure Savage]

For a family of three, is R6500 pm for full medical aid reasonable ish?

[T-Bob]

So here is the thing, I've had medical aid since moving here. It's a discovery one (coastal core i think) and it's still not exactly cheap, still have to shell out R500 every time we end up at the GP etc. It's there for the bigger things. 

 

So yesterday, I end up in a crash, shoulder is looking bad. Off to Constantiaberg ER happy in the knowledge that I have medical aid I've had for 4+ years and only ever claimed for the births of our rug rats. We've got gap cover as well so that we're looked after. 

So this morning i find out I'm not covered for ER visits & all associated costs. Huh? It's a hospital and the plan claims to have unlimited Hospital cover, but no, only if I stay a night. Apparently being in ER, being treated, xray'd and the rest isn't being 'in' hospital.

Seriously, I've been paying a not small amount for 5+ years. Is this a standard thing across all medical aids? Just a little bewildered (and it's not just the mophine wearing off). Might actually be better to have my aussi $45.00 a year fully comp' travel insurance as a back up as I'm going to end up in ER more times in my life than long stays i'm sure.

[Ed-Zulu]

So here is the thing, I've had medical aid since moving here. It's a discovery one (coastal core i think) and it's still not exactly cheap, still have to shell out R500 every time we end up at the GP etc. It's there for the bigger things. 

 

So yesterday, I end up in a crash, shoulder is looking bad. Off to Constantiaberg ER happy in the knowledge that I have medical aid I've had for 4+ years and only ever claimed for the births of our rug rats. We've got gap cover as well so that we're looked after. 

 

So this morning i find out I'm not covered for ER visits & all associated costs. Huh? It's a hospital and the plan claims to have unlimited Hospital cover, but no, only if I stay a night. Apparently being in ER, being treated, xray'd and the rest isn't being 'in' hospital.

 

Seriously, I've been paying a not small amount for 5+ years. Is this a standard thing across all medical aids? Just a little bewildered (and it's not just the mophine wearing off). Might actually be better to have my aussi $45.00 a year fully comp' travel insurance as a back up as I'm going to end up in ER more times in my life than long stays i'm sure.

I'm with you on this one...it's friggen ridiculous that ER does not count and on top of it you'll get whipped double rates for the doctor being a Sunday and after hours...Infuriating to say the least.

[Captain Fastbastard Mayhem]

For a family of three, is R6500 pm for full medical aid reasonable ish?

I'll be paying 4k next year. Coastal Saver, me wiff and lightie. 

 

Anything higher than that, unless you have a chronic condition that isn't covered by the coastal / essential saver, is just a waste - especially with Gap Cover.. 

[Captain Fastbastard Mayhem]

So here is the thing, I've had medical aid since moving here. It's a discovery one (coastal core i think) and it's still not exactly cheap, still have to shell out R500 every time we end up at the GP etc. It's there for the bigger things. 

 

So yesterday, I end up in a crash, shoulder is looking bad. Off to Constantiaberg ER happy in the knowledge that I have medical aid I've had for 4+ years and only ever claimed for the births of our rug rats. We've got gap cover as well so that we're looked after. 

 

So this morning i find out I'm not covered for ER visits & all associated costs. Huh? It's a hospital and the plan claims to have unlimited Hospital cover, but no, only if I stay a night. Apparently being in ER, being treated, xray'd and the rest isn't being 'in' hospital.

 

Seriously, I've been paying a not small amount for 5+ years. Is this a standard thing across all medical aids? Just a little bewildered (and it's not just the mophine wearing off). Might actually be better to have my aussi $45.00 a year fully comp' travel insurance as a back up as I'm going to end up in ER more times in my life than long stays i'm sure.

yeah, it's standard with all med aids that only cover hospitalisation. Only exception is Momentum on their Custom option, but even then you're paying for it and they'll only cover the cost of the x ray.

 

Essentially, you need to have day to day benefits if you want ANYTHING that isn't considered as "in hospital" - ie: you're booked in and you have that little membership bracelet on you.

 

You may like the option they're putting out next year... It's like the coastal core, but it has cover for MRI & CT scans. Network hospitals (one of which is C Berg) 

 

Attach that to Complimed's new gap cover product which gives you cover for casualty / emergency room benefits, and you're sorted. 

[Grebel]

I'll be paying 4k next year. Coastal Saver, me wiff and lightie. 

 

Anything higher than that, unless you have a chronic condition that isn't covered by the coastal / essential saver, is just a waste - especially with Gap Cover.. 

 

At the moment it's Classic Delta Comprehensive for us (2 Adults and 2 kids) with Stratum Elite Gap Cover.

 

I have been looking at different options to not be confined to the Delta Hospitals for planned procedures but still need the same MSA that I currently have (Think its around R25k P/A)

 

Any ideas? Was planning to go up a notch to Classic Comp to keep a similar MSA (Yes, we go through that much savings in a year).

 

Currently have Chronic meds as well.

[Captain Fastbastard Mayhem]

At the moment it's Classic Delta Comprehensive for us (2 Adults and 2 kids) with Stratum Elite Gap Cover.

 

I have been looking at different options to not be confined to the Delta Hospitals for planned procedures but still need the same MSA that I currently have (Think its around R25k P/A)

 

Any ideas? Was planning to go up a notch to Classic Comp to keep a similar MSA (Yes, we go through that much savings in a year).

 

Currently have Chronic meds as well.

hey bro... done the calcs on this before, and I can do them again if you want me to...

 

Essentially, it only makes sense to be on classic comp if you're going into the ATB every year, and using it extensively. Otherwise, the extra monthly savings from Coastal Saver (which you'd be fine on) would offset the effect of the lower MSA. 

 

Coastal Saver chronic coverage for those 27 PMB conditions is pretty much the same as the Classic Comp, except they have a marginally lower Chronic Medicine Coverage IF you don't use the approved medication for the condition. And by marginal, i mean marginal...

 

Yes, the extra MSA helps if you're not that good at putting money away, but the cost savings (if you don't need it one year) are worth it. 

Edited November 9, 2015 by Myles Mayhew

[Grebel]

hey bro... done the calcs on this before, and I can do them again if you want me to...

 

Essentially, it only makes sense to be on classic comp if you're going into the ATB every year, and using it extensively. Otherwise, the extra monthly savings from Coastal Saver (which you'd be fine on) would offset the effect of the lower MSA. 

 

Coastal Saver chronic coverage for those 27 PMB conditions is pretty much the same as the Classic Comp, except they have a marginally lower Chronic Medicine Coverage IF you don't use the approved medication for the condition. And by marginal, i mean marginal...

 

Yes, the extra MSA helps if you're not that good at putting money away, but the cost savings (if you don't need it one year) are worth it. 

 

So basically in hospital cover from Coastal Saver is as good as Classic comp (If you take the Gap Cover into account). I can go to any hospital in KZN for a planned procedure but I need to be disciplined and put money away each month to make up the MSA shortfall?

 

(My chronic is constantly being switched around by my pharmacist to jump through the Disco hoops so to speak)

[Captain Fastbastard Mayhem]

So basically in hospital cover from Coastal Saver is as good as Classic comp (If you take the Gap Cover into account). I can go to any hospital in KZN for a planned procedure but I need to be disciplined and put money away each month to make up the MSA shortfall?

 

(My chronic is constantly being switched around by my pharmacist to jump through the Disco hoops so to speak)

yes. Classic = 200% Coastal & Essential = 100% but with Gap inflating both to 500% it's no difference at all. 

 

And yes. Only other difference is their cancer coverage, but according to their stats it's only if you are claiming for biological cancer meds that you ever go into the territory that the Classic & Executive plans offer, purely down to the cost of those meds.

[T-Bob]

yeah, it's standard with all med aids that only cover hospitalisation. Only exception is Momentum on their Custom option, but even then you're paying for it and they'll only cover the cost of the x ray.

 

Essentially, you need to have day to day benefits if you want ANYTHING that isn't considered as "in hospital" - ie: you're booked in and you have that little membership bracelet on you.

 

You may like the option they're putting out next year... It's like the coastal core, but it has cover for MRI & CT scans. Network hospitals (one of which is C Berg) 

 

Attach that to Complimed's new gap cover product which gives you cover for casualty / emergency room benefits, and you're sorted. 

 

Thanks for the info. You're a legend! 

[Captain Fastbastard Mayhem]

Thanks for the info. You're a legend! 

only in my own bathtime....

[Bubbles_25]

yeah, it's standard with all med aids that only cover hospitalisation. Only exception is Momentum on their Custom option, but even then you're paying for it and they'll only cover the cost of the x ray.

 

Essentially, you need to have day to day benefits if you want ANYTHING that isn't considered as "in hospital" - ie: you're booked in and you have that little membership bracelet on you.

 

You may like the option they're putting out next year... It's like the coastal core, but it has cover for MRI & CT scans. Network hospitals (one of which is C Berg) 

 

Attach that to Complimed's new gap cover product which gives you cover for casualty / emergency room benefits, and you're sorted. 

What's the name of Complimed's new product that has casualty / ER cover? I'm on GAP elite, thinking it may be worthwhile upgrading if those benefits are not included.

[Captain Fastbastard Mayhem]

What's the name of Complimed's new product that has casualty / ER cover? I'm on GAP elite, thinking it may be worthwhile upgrading if those benefits are not included.

It's on all of them. Also why the increase in premium is higher than you would have expected... 

 

Gap Elite goes up to R 290 p/m

[samson99]

Myles Mayhew,

 

Is Zest gap cover any good?