ChrisF Posted May 23, 2017 Share Which plans from Discovery and Momentum does not a have limit when lying in ICU? not an easy answer to this. Most plans pay the "hospital" account - which can run up if you are in ICU ... BUT, the bit that hits YOUR pocket is doctors charging more than the "medical aid rate" .... For Discovery you may want to go from "Essential" to "Classic" - OR, better still investigate their Network options. I am currently on one of their Network options, Panorama is my Network hospital. You really need to speak to a medical aid broker to get PROPER advise, and comparison of the different packages and Medical aids. I have a brilliant broker in Bellville, also a serious cyclist, so understands our needs. Let me know if you want her contact details. PS - medical aid consultants premiums are already included in the premiums. NO savings by cutting out the consultants ! Might as well speak to the professionals and get the right advise. Link to comment Share on other sites More sharing options...
ChrisF Posted May 23, 2017 Share cool - thanks my wife is on chronic meds...that's probably why I was told this fact interesting situation ... As Myles said - PMB must be covered from day one. So she should get her chronic meds. BUT they WILL implement the 3 month waiting period on everything else to cut their losses .... Link to comment Share on other sites More sharing options...
Captain Fastbastard Mayhem Posted May 23, 2017 Share Gap Cover: The law has changed regarding the amount they're able to pay and also the category into which the cover falls (i.e. short term insurance and or other form of cover) - I'm not 100% clued up on the ins and outs of the cover but my guy told me that you can have quite a long waiting period to get the cover.Waiting periods can be either 3 month general (excl emergencies, mostly) and 12 month or lower for condition specific stuff. 3 month is standard for everyone, 12 month is only if you have a pre-existing condition. At for the cap - what they (the detractors) don't say is that more than 99% of claims are UNDER that cap. So even though there's a cap, it's still bloody worthwhile to get GAP cover. Link to comment Share on other sites More sharing options...
Captain Fastbastard Mayhem Posted May 23, 2017 Share not an easy answer to this. Most plans pay the "hospital" account - which can run up if you are in ICU ... BUT, the bit that hits YOUR pocket is doctors charging more than the "medical aid rate" .... For Discovery you may want to go from "Essential" to "Classic" - OR, better still investigate their Network options. I am currently on one of their Network options, Panorama is my Network hospital. You really need to speak to a medical aid broker to get PROPER advise, and comparison of the different packages and Medical aids. I have a brilliant broker in Bellville, also a serious cyclist, so understands our needs. Let me know if you want her contact details. PS - medical aid consultants premiums are already included in the premiums. NO savings by cutting out the consultants ! Might as well speak to the professionals and get the right advise.See my response on P2. Link to comment Share on other sites More sharing options...
ChrisF Posted May 23, 2017 Share Is there something I should know about Medihelp? Going back pre-94 .... Medihelp was the "white" medical aid for government employees. Later it was "opened" and private people could join it. These were the good days. Then GEMS started up .... gradually more and more government staff were nudged then forced to move over to GEMS. MediHelp is SMALL in comparison to what it was. Sadly mostly older sicker people that remained behind ... NOT a good formula ..... The writing is on the wall for this medical aid. PLEASE - I am not saying it is a bad medical aid. Just its life-cycle is coming to an end .... In this highly competative field it has little chance of turning this around. Link to comment Share on other sites More sharing options...
ChrisF Posted May 23, 2017 Share My guess is "meh"LOL, seems only Discovery and Momentum don't receive "meh" For better or worse medical aids cover are very similar ..... one only notice the differences when you have a special medical situation. The way in which their admin works is what makes up the bulk of our "experience" ..... Think Myles was clear enough in who figured out how to keep their client base happy .... Link to comment Share on other sites More sharing options...
Hennie VR Posted May 23, 2017 Share Going back pre-94 .... Medihelp was the "white" medical aid for government employees. Later it was "opened" and private people could join it. These were the good days. Then GEMS started up .... gradually more and more government staff were nudged then forced to move over to GEMS. MediHelp is SMALL in comparison to what it was. Sadly mostly older sicker people that remained behind ... NOT a good formula ..... The writing is on the wall for this medical aid. PLEASE - I am not saying it is a bad medical aid. Just its life-cycle is coming to an end .... In this highly competative field it has little chance of turning this around. Thanks for the reply. I did not know much about Medihelp's history and you have raised some interesting points. I have been very fortunate that I have never needed any serious medical treatment and for the odd doctor's visit they seemed good enough. I have not been to a doctors office in the last 3 years and neither have I used my medical aid in the same period. I must admit that I have been a bit slack in the sense that I have not checked up on my benefits in the last few years and perhaps it is time to have a look at it and make a change should it be necessary. Link to comment Share on other sites More sharing options...
RyanD Posted May 23, 2017 Share Discovery med aid. No issues. Momentum life cover. Recently joined Multiply and frustrated. Went for the health assessment at Dischem, every reading in the green but the nurse did a typo and entered me as a smoker. I have never smoked in my life. I cannot get it changed and now my heart score is amber which bugs me. I have contacted the nurse. She has sent me a corrected submission, I have mailed Multiply. My broker has been on to them. Still no correction after two weeks. I have also found that my active days calendar is not giving me every active day I generate. My garmin account shows my training and multiply is showing about 30% less active days than I should have. I am thinking of telling them to stick it. Link to comment Share on other sites More sharing options...
Long Wheel Base Posted May 23, 2017 Share Discovery med aid. No issues.Momentum life cover. Recently joined Multiply and frustrated. Went for the health assessment at Dischem, every reading in the green but the nurse did a typo and entered me as a smoker. I have never smoked in my life. I cannot get it changed and now my heart score is amber which bugs me. I have contacted the nurse. She has sent me a corrected submission, I have mailed Multiply. My broker has been on to them. Still no correction after two weeks. I have also found that my active days calendar is not giving me every active day I generate. My garmin account shows my training and multiply is showing about 30% less active days than I should have. I am thinking of telling them to stick it.I queried that just yesterday with them via the online chat. Its slightly delayed. If it doesn't correct at month end then query it.As to the smoking story, Yeah that sucks because green means you score all the way. Link to comment Share on other sites More sharing options...
RobertWhitehead Posted May 23, 2017 Share Discovery med aid. No issues.Momentum life cover. Recently joined Multiply and frustrated. Went for the health assessment at Dischem, every reading in the green but the nurse did a typo and entered me as a smoker. I have never smoked in my life. I cannot get it changed and now my heart score is amber which bugs me. I have contacted the nurse. She has sent me a corrected submission, I have mailed Multiply. My broker has been on to them. Still no correction after two weeks. I have also found that my active days calendar is not giving me every active day I generate. My garmin account shows my training and multiply is showing about 30% less active days than I should have. I am thinking of telling them to stick it.Exactly why I decided to cancel, just too much red tape but, if I can get takealot vouchers super seeding what I'm paying on a monthly basis then that's a win for me Link to comment Share on other sites More sharing options...
Neverfit Posted May 23, 2017 Share I did not have GAP cover until reading through the messages and advice.... Promptly got hold of Disco and all sorted...The hub actually helped with sound advice...who would have guessed Thanks Myles (and the others) for helping with this.. Link to comment Share on other sites More sharing options...
ChrisF Posted May 23, 2017 Share "meh" ..... comes to mind .... Did a certain gent not clearly state who is best at their admin ..... Sadly a wide gap between "good cover" and a "good experience". Enough that provide decent cover ... not many that provide a decent experience. PS - NO, I am NOT affiliated to any medical aid .... just had to do some serious homework to ensure my family gets the best cover due some medical conditions ...... Link to comment Share on other sites More sharing options...
Captain Fastbastard Mayhem Posted May 23, 2017 Share I did not have GAP cover until reading through the messages and advice.... Promptly got hold of Disco and all sorted...The hub actually helped with sound advice...who would have guessed Thanks Myles (and the others) for helping with this.. Aiyeeeeee. Not the disco gap. It's a mockery of standard gap cover options. Will message you later and get you sorted. It's not in their best interests to offer comparable benefits to the likes of Complimed, Stratum and the other legit gap providers as it would result in downgrades for those healthy enough to do so. Link to comment Share on other sites More sharing options...
GLuvsMtb Posted May 23, 2017 Share We switched from Discovery to Momentum in January (with GAP cover, so Myles can relax ). We opted for the private hospital cover combined with State chronic cover (we have no chronic issues, so why pay extra?). Currently on Silver and getting anything from R600 to R1200 back into our medical savings every month (depending on how much my wife gets to train, as I hit my max every month). Our reasons for changing was:- Above CPI increases combined with decreased benefits meant Discovery was effectively trying to price us into a plan with less benefits.- Vitality's constant moving of the goal-posts in terms of rewards created confusion and if anything just became a nuisance after a while. Multiply is simple. 300 Calories per workout / 10 000 steps a day constitutes an active day "en klaar!"- Vitality benefits ended up costing us way more than what we needed to pay. You end up joining the Gym and going twice a month, because lets face it: Its way more fun to go out riding. We had cover from day 1 (we would not have moved if they did not waive the 3 month exclusion period) and for the first time since my wife and I are together, we still have a sizable amount in medical savings left, and its almost June! Momentum also pay for more scans and gynae visits when your wife is pregnant (I didn't listen to that bit, as I am never getting pregnant). We have saved over R1000 in premiums a month and have accumulated around R4 000 in additional medical savings, By the end of the year it will be well over R20k, so Discovery and Vitality can keep their smoothies, we're quite happy with Momentum and Multiply at present. Link to comment Share on other sites More sharing options...
JohanC Posted May 23, 2017 Share Bit off topic but which life insurance and income protection service provider does bikehub recommend? #YOLO IMO Sanlam or PPS. Simple, straightforward (comprehensive) cover. Sanlam's claim process more efficient and turnaround time quicker. PPS - Profit Share Account. Link to comment Share on other sites More sharing options...
Grebel Posted May 23, 2017 Share My mother in law is with Momentum. She suffers with Multiple Sclerosis. Not 100% sure what plan she is on but it is a hospital cover plan with a small savings attached for day to day. A few years ago she encountered some complications and her specialist admitted her to St Augustine's Neuro ICU where she stayed for a while. After ICU she went into Highcare. Total stay in both was just shy of 40 days. Momentum payed everything in full including the Ambo transport from her frailcare to the hospital. That's the only interaction that I have had with Momentum. It was a big one and they handled it well. My family is with Disco. We have Chronic meds as well as having had our (my) fair share of interactions with specialists. I was on the Classic Comp for a while but finances got tight so we moved to the Classic Delta Comp plan. I had to have shoulder surgery and was confined to the Delta group of hospitals (Funny thing about specialists is that they will only (well mostly) work in their hospital of choice) No gap cover but luckily my guy charged Classic rates. Needed to have another op so decided to go Classic Priority so I could choose freely who was going to fix me up. Gap cover in pace and the op went ahead. No issues with the account payments (Although the co-payments are a topic for another discussion) and the Gap did it's job. As already mentioned, a bit of admin prior to makes life a LOT easier as does understanding what your medical aid covers. I have no issues with Disco. I can choose between Medihelp and Disco at work and the Disco choice for me is a no brainer. Link to comment Share on other sites More sharing options...
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