1. Use generic medicines wherever possible
You can cut the amount you spend on medicines, especially chronic medication by as much as 30%, by choosing generics rather than the more expensive original if your doctor approves it. Some medical schemes make it compulsory to use a generic if it is available on the market, but check with your doctor first.
2. Don’t use your medical savings for over-the-counter medication
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.
3. Make sure your healthcare provider charges medical scheme rates
Some doctors and specialists charge more than the medical scheme rate. There are plenty of doctors who have agreed to charge medical scheme rates, so shop around. You’ll find doctors who are part of a medical scheme network, such as Liberty Medical Scheme’s General Practitioner (GP) network, which offer more affordable rates. Liberty Medical Scheme’s Specialist Network also gives you access to specialist services at the medical scheme rate and within a reasonable distance of where you live.
4. Ask for a quote
Most specialists are prepared to provide you with a quote for a medical procedure. This allows you to confirm with your medical scheme beforehand what percentage they will cover. This also gives you the opportunity to negotiate a lower fee.
5. Pay cash to qualify for discounts
Find out what types of services are funded out of your savings account – such as dentistry, doctors visits and optometry. Consider paying cash for these and ask the service provider for a cash discount – usually between 5-10%. Then submit the bill to your medical scheme so that the amount (where applicable) 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.
6. Prevention is cheaper than cure
Each year, you should plan to go for tests appropriate for your age, such as cholesterol, insulin, blood pressure, mammograms or prostate checks as well as dental and eye check-ups. Some schemes, such as Liberty Medical Scheme, cover these types of tests from your Major Medical Benefit (MMB), meaning you don’t have to use your savings account to better manage your health.
7. Avoid going to specialists directly
It’s easy to think that only a specialist can treat you, but many more common conditions can be identified and treated by your GP. Certain medical schemes will cover GP visits even if your medical savings are depleted, as long as they are part of the GP network. Liberty Medical Scheme pays for two additional consultations per family at any LMS Network GP from Risk once Savings are depleted or members are in the Self Payment Gap (SPG) on certain options.
Liberty Medical Scheme has a Specialist Network, which gives members on certain options access to specialist services within a reasonable distance of where they live. If your GP recommends that you see a specialist, make use of one in the Specialist Network to avoid out-of-pocket expenses.
8. Register your chronic medication
If you’re on regular medication to treat a chronic illness – from diabetes to hypertension – you could qualify for chronic medication benefits. This means that your medical scheme pays for it from your Major Medical Benefit (MMB), 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 rands a month. If you spend R200 a month on a particular medication, you could save up to R2 400 a year. That money could then be spent on doctors visits or funding other medical costs.
Some schemes, such as Liberty Medical Scheme, make use of a Preferred Provider Pharmacy Network (PPPN) with which they have negotiated preferred dispensing fees. If a member makes use of a pharmacy in this network, no co-payment applies, subject to members obtaining medicine within the applicable formulary.
9. Keep the costs of diagnostic tests low
Few people realise how much they spend on unnecessary blood tests each year. Your GP should keep a comprehensive file of all your visits and test results and build up a holistic picture of your health over time.
Avoid chopping and changing doctors if at all possible, as different doctors may order the same blood tests for the same symptoms. If you do change doctors, pathology labs keep all blood tests on record, so ask your practitioner to check with the laboratory before ordering more tests.
10. Submit your claims
Many options offer an above-threshold benefit. You will need to first reach a threshold level (THL) before having access to the above-threshold benefit (ATB). Your MSF (Medical Savings Facility) will be used to fund these claims logging to the threshold level. Once your savings account has been depleted, you will be responsible to pay for further day-to-day expenses until the threshold level has been reached. This difference between the MSF and the threshold level is known as the self-payment gap (SPG). Remember to submit each claim, even if your savings account has run out, as the amounts from qualifying claims still accumulate to the threshold level and you can then qualify for above-threshold benefits subject to further limits. |
