Posted on November 22, 2007 - by Justin Hartman
What is the point of a Medical Aid?
Hey, it looks like you're new here to my blog! You may want to consider subscribing to my RSS feed and you'll automatically get notified when I post a new blog entry. If web feeds aren't your thing then why not join my email list by clicking here. Thanks for stopping by.
One of my reasons for moving to The Times was the lucrative medical aid offer from Discovery Life. Having not been on a Medical Aid for more than 12 months this was quite a critical issue for me as family medical costs have to be a top priority.
In recent weeks Luke had a minor operation and Colette had an Amniocentesis to test for downs-syndrome in our unborn son.
I’ve just received my medical aid statement for November from Discovery and below is a breakdown of the costs incurred.
You can see that the total cost for both procedures was R9,024.09. Of that I have to pay R4,271.99 and an amount of R2,085.43 was paid directly from my savings account. This means that Discovery’s total liability was only R2,666.67 - the rest is paid using my money.
Now I might be missing the point here but how is it possible that a medical aid company only covers 29.5% of hospital procedures? It’s not like we went to some designer optician and spent R9,000 on matching his and her glasses - these were both hospital induced costs and I find myself paying more than 70% of the total bill.
I’m wondering if a hospital plan is not a better option for me seeing as I pay a fortune for Discovery each month and ultimately end up paying most of bills anyway?
Pathetic!
I am the MD and co-founder of 
Visit My Website
November 22, 2007
Permalink
Dude, we had that exact same problem. Exact same!
We now cancelled the savings (day-to-day) side of the scheme and are only paying for hospitalization (which was much needed yesterday!).
Instead of paying the medical aid, we’re paying it into a savings account instead. Each time we or the kids go to the doctor, we use that to pay for the visits and the meds. Works grand at the moment. At least everything is getting paid and there are no nasty surprises. It also makes you much more conscious of costs…
Visit My Website
November 22, 2007
Permalink
Dude, we had that exact same problem. Exact same!
We now cancelled the savings (day-to-day) side of the scheme and are only paying for hospitalization (which was much needed yesterday!).
Instead of paying the medical aid, we're paying it into a savings account instead. Each time we or the kids go to the doctor, we use that to pay for the visits and the meds. Works grand at the moment. At least everything is getting paid and there are no nasty surprises. It also makes you much more conscious of costs…
Visit My Website
November 22, 2007
Permalink
Discovery are sharks. In fact medical aids are 1 big scam.Seriously.
When we had our daughter in March, I ended up having to pay in 7 Grand. SEVEN. Out of my own pocket. When my eldest daughter had a minor op earlier this year, which involved quatersing some things on her body, they refused to pay, saying it was cosmetic surgery. FRIKKEN 3 years old ? Go figure. I eventually fought with them, and made them realise that it is impossible to have “cosmetic” surgery on a 3 year old.
There is no way around these okes, and its crazy. We just have to end up paying to ensure our families lives are never put at risk, and we are always covered in the unfortunate case of an accident. Sad but true. Look at discoveries profits in their last financial results, thats even more scary
Visit My Website
November 22, 2007
Permalink
Discovery are sharks. In fact medical aids are 1 big scam.Seriously.
When we had our daughter in March, I ended up having to pay in 7 Grand. SEVEN. Out of my own pocket. When my eldest daughter had a minor op earlier this year, which involved quatersing some things on her body, they refused to pay, saying it was cosmetic surgery. FRIKKEN 3 years old ? Go figure. I eventually fought with them, and made them realise that it is impossible to have “cosmetic” surgery on a 3 year old.
There is no way around these okes, and its crazy. We just have to end up paying to ensure our families lives are never put at risk, and we are always covered in the unfortunate case of an accident. Sad but true. Look at discoveries profits in their last financial results, thats even more scary
Visit My Website
November 22, 2007
Permalink
Justin, I feel your pain. We are also with Discovery, and also had a child midway through this year. I pay close to R40k a year on med aid, but even so, since June (when my MSA ran out) I’ve racked up R14 on medical bills.
Something is telling me that we’re taking a beating here…
Visit My Website
November 22, 2007
Permalink
Justin, I feel your pain. We are also with Discovery, and also had a child midway through this year. I pay close to R40k a year on med aid, but even so, since June (when my MSA ran out) I've racked up R14 on medical bills.
Something is telling me that we're taking a beating here…
Visit My Website
November 22, 2007
Permalink
I stand to be corrected here but I remember Vincent Maher telling me that he paid something silly like R30k for his wife’s C-section and that’s despite being on the comprehensive plan with Discovery.
My wife also just reminded me that the Amnio bill is only half the cost. We’re still waiting for the second half of the bill which is around R2500 and I’m sure that’s going to be for my account.
If this is the case then the percentage that Discovery would have paid is a mere 23%…. go figure!
Visit My Website
November 22, 2007
Permalink
I stand to be corrected here but I remember Vincent Maher telling me that he paid something silly like R30k for his wife's C-section and that's despite being on the comprehensive plan with Discovery.
My wife also just reminded me that the Amnio bill is only half the cost. We're still waiting for the second half of the bill which is around R2500 and I'm sure that's going to be for my account.
If this is the case then the percentage that Discovery would have paid is a mere 23%…. go figure!
Visit My Website
November 22, 2007
Permalink
I have to chip in and say ditto. I’m on a hospital plan and my wife comprehensive (we have two young children). I get upset whenever I work out what we are paying out of our pocket, despite paying discovery large sums every month - and we also had to come up with several k for each birth (both were natural, I shudder to think what a C-section would have cost us).
Visit My Website
November 22, 2007
Permalink
I have to chip in and say ditto. I'm on a hospital plan and my wife comprehensive (we have two young children). I get upset whenever I work out what we are paying out of our pocket, despite paying discovery large sums every month - and we also had to come up with several k for each birth (both were natural, I shudder to think what a C-section would have cost us).
Visit My Website
November 29, 2007
Permalink
“how is it possible that a medical aid company only covers 29.5% of hospital procedures?”
You’ll get a satisfactory answer to “What is the sound of one hand clapping?” before you get a satisfactory answer to your question.
Visit My Website
November 29, 2007
Permalink
“how is it possible that a medical aid company only covers 29.5% of hospital procedures?”
You'll get a satisfactory answer to “What is the sound of one hand clapping?” before you get a satisfactory answer to your question.
Visit My Website
November 30, 2007
Permalink
Hello. Have you checked out http://www.thinkmoney.co.za? they have a great medical aid comparison section showing almost all the plans available from comprehensive to hospital.
im finally dumping Discovery!
bel
Visit My Website
November 30, 2007
Permalink
Hello. Have you checked out http://www.thinkmoney.co.za? they have a great medical aid comparison section showing almost all the plans available from comprehensive to hospital.
im finally dumping Discovery!
bel