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Most medical schemes offer options with a medical savings account to cover day-to-day medical expenses. By managing your medical savings portion carefully, you could save thousands of rands a year, says Executive Principal Officer of Liberty Medical Scheme, Andrew Edwards. Check out his other tips below.
Think of medical savings as cash in your wallet
Just because you’re contributing to a medical scheme each month, doesn’t mean you should view your medical savings account any differently to cash. Your medical savings account can accumulate from year to year and you can build up a good kitty that you can cash in if you leave a scheme. The aim should not be to spend as much of it as possible each year, but to try and preserve it to fund future medical costs too. That means you won’t have to dip into your other savings to fund unexpected healthcare costs.
Read more: 21 ways to cut your medical costs
Work out the numbers
Find out how much is contributed to your medical savings each month. By law, this amount may not exceed 25% of your annual contribution. This will give you a starting point to help you “budget” which consultations, tests, procedures and medicines you really need. Most schemes fund dentistry, laboratory tests, optometry and medicines out of your savings portion.
Submit all your claims
Many options offer a threshold benefit. Once your savings account has been depleted, you’ll reach a limit and enter a self-payment gap where you will be responsible for any further day-to-day expenses. On some options, the scheme then starts funding your expenses again once you are through the self payment gap – known as above-threshold benefits. Remember to submit each claim, even if your savings account has run out, as the amounts still accumulate and you can then qualify for above- threshold benefits subject to further limits.
Pay for over-the-counter medicines out of your pocket, not savings
For common illnesses, such as flu, your doctor may prescribe over the counter medicines as well as antibiotics to treat your symptoms. When you’re sick, it’s tempting to pay for all your medication on the script from your savings account. But pharmacies charge a dispensing fee for providing medicine on scripts – even for over-the-counter medicines. This means you could end up paying much more than you would if you bought the medicine off the shelf and paid cash for it, helping your medical savings last longer.
Register for chronic medication benefits
If you’re on regular medication to treat a chronic illness – from diabetes to depression – you could qualify for chronic medication benefits. This means that your medical scheme pays for it out of the risk portion of your medical aid, and not your medical savings account. Ask your doctor to motivate for this and by completing a simple form, you could save yourself hundreds of rand a month. If you spend R200 a month on a particular medication, you could save up to R2400/year.That money could then be spent on doctor visits or funding other medical costs.
Read more: 25 chronic conditions your scheme must cover
Pay cash to qualify for discounts
Find out what types of services are funded out of your savings account – such as dentistry, doctor visits and optometry. If you pay cash for these, you could get a cash discount. If you submit the bill to your medical scheme the amount accumulates towards your threshold. You’ll pay less for the procedure and still cover yourself for future medical expenses. If need be you can even ask your medical scheme to refund you for the payment you made in cash.
Preventative care benefits
Some schemes offer preventative care benefits, which are paid from the risk portion of your medical scheme and are not funded from your savings account. Check whether your scheme covers tests such as cholesterol or mammograms. Also check whether you are being treated for a condition classified as a Prescribed Minimum Benefit (PMB) as by law, medical schemes are required to cover these from the risk portion of your medical aid and not from your savings.
Don’t switch medical schemes mid-year
If you deplete your savings before the end of the year and switch to a new scheme or resign from the scheme, you will be required to repay the difference in savings to the scheme. The amount repayable is your monthly savings contribution multiplied by the number of months left in the year.
Think of medical savings as cash in your wallet
Just because you’re contributing to a medical scheme each month, doesn’t mean you should view your medical savings account any differently to cash. Your medical savings account can accumulate from year to year and you can build up a good kitty that you can cash in if you leave a scheme. The aim should not be to spend as much of it as possible each year, but to try and preserve it to fund future medical costs too. That means you won’t have to dip into your other savings to fund unexpected healthcare costs.
Read more: 21 ways to cut your medical costs
Work out the numbers
Find out how much is contributed to your medical savings each month. By law, this amount may not exceed 25% of your annual contribution. This will give you a starting point to help you “budget” which consultations, tests, procedures and medicines you really need. Most schemes fund dentistry, laboratory tests, optometry and medicines out of your savings portion.
Submit all your claims
Many options offer a threshold benefit. Once your savings account has been depleted, you’ll reach a limit and enter a self-payment gap where you will be responsible for any further day-to-day expenses. On some options, the scheme then starts funding your expenses again once you are through the self payment gap – known as above-threshold benefits. Remember to submit each claim, even if your savings account has run out, as the amounts still accumulate and you can then qualify for above- threshold benefits subject to further limits.
Pay for over-the-counter medicines out of your pocket, not savings
For common illnesses, such as flu, your doctor may prescribe over the counter medicines as well as antibiotics to treat your symptoms. When you’re sick, it’s tempting to pay for all your medication on the script from your savings account. But pharmacies charge a dispensing fee for providing medicine on scripts – even for over-the-counter medicines. This means you could end up paying much more than you would if you bought the medicine off the shelf and paid cash for it, helping your medical savings last longer.
Register for chronic medication benefits
If you’re on regular medication to treat a chronic illness – from diabetes to depression – you could qualify for chronic medication benefits. This means that your medical scheme pays for it out of the risk portion of your medical aid, and not your medical savings account. Ask your doctor to motivate for this and by completing a simple form, you could save yourself hundreds of rand a month. If you spend R200 a month on a particular medication, you could save up to R2400/year.That money could then be spent on doctor visits or funding other medical costs.
Read more: 25 chronic conditions your scheme must cover
Pay cash to qualify for discounts
Find out what types of services are funded out of your savings account – such as dentistry, doctor visits and optometry. If you pay cash for these, you could get a cash discount. If you submit the bill to your medical scheme the amount accumulates towards your threshold. You’ll pay less for the procedure and still cover yourself for future medical expenses. If need be you can even ask your medical scheme to refund you for the payment you made in cash.
Preventative care benefits
Some schemes offer preventative care benefits, which are paid from the risk portion of your medical scheme and are not funded from your savings account. Check whether your scheme covers tests such as cholesterol or mammograms. Also check whether you are being treated for a condition classified as a Prescribed Minimum Benefit (PMB) as by law, medical schemes are required to cover these from the risk portion of your medical aid and not from your savings.
Don’t switch medical schemes mid-year
If you deplete your savings before the end of the year and switch to a new scheme or resign from the scheme, you will be required to repay the difference in savings to the scheme. The amount repayable is your monthly savings contribution multiplied by the number of months left in the year.
