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How to save money on your medical expenses

Nov 19 2014 11:43
Susan Erasmus

A Fin24 user wants to save money on health costs for her and her three children. She writes:

I am a 43-year-old woman with three children. Please advise me on how I can save money on health.

Health journalist * Susan Erasmus responds:

It’s really expensive to get sick – and it’s getting more and more expensive as time goes by. Worldwide, medical inflation is outstripping normal inflation, and consumers are feeling it everywhere.

In South Africa the choice is stark: either you foot the bill for a private medical scheme or hospital plan, or you could be at the mercy of a state hospital if you get really sick. Some state hospitals are great, and others are dodgy, to say the least. You don’t always get to choose.

A woman of 43, who has three children, has written to Fin24, asking how she can cut down on the family’s medical expenses.

Here are a couple of ideas that might also be useful to you:

Look after yourself and your family

In short, you and your family should do what you can to stay healthy. Exercise, a healthy diet, not smoking, enough sleep and good stress-release mechanisms can go a long way to prevent health-related problems. Join a wellness programme and save money on gym fees.

Register your kids as dependants on your scheme

Child dependants always pay much less than the principal member, or even an adult dependant does. Children generally have low claim rates, which is why schemes can do this. Some schemes only charge for the first three kids – thereafter it’s free.

Go for screening tests

Most medical funds will pay for quite a few screening tests (out of your annual limit, not out of you medical savings account). In this way, you can detect something such as a high blood glucose or high cholesterol level early.

The earlier something is discovered, the easier and more cheaply it can be treated. If you wait until something has become a crisis, it is going to cost more to treat.

Go to network doctors

If your scheme has a network of doctors who will charge medical scheme fund rates, use them. In this way you will never have to make a co-payment when seeing a private doctor. If it means driving a few extra kilometres, it’s worth your while to do it.

Check your home for hazards

Get rid of slippery loose carpets, check obstacles such as extension cords and kids’ toys, and put a non-slip mat into the bath or shower. Use the right tools when doing DIY (if you don’t have the right tools, get someone to do it for you).

Many adults and children get injured seriously while in their own homes, and this can be a costly exercise. Also make sure that hazardous chemicals and any medication is kept out of reach of the children.

Ask your doctor about generics

Generic medication contains the same active ingredients as brand medication does. Try them – and if they work, they could end up costing you as much as two-thirds less than the original brand.

Follow dosage instructions

Many, many people do not take their medication as and when it has been prescribed. If it says ‘Take in the mornings” or ‘Take after meals’ and you take it in the evening on an empty stomach, it probably won’t work, and you will have wasted your money.

Go to pharmacy chains

The bigger the business, generally the lower the prices, because they can buy stuff in bulk.  Their mark-ups are also lower on non-prescription goods, such as headache tablets and plasters.

You can also check whether your scheme has a medication delivery service. Stock up on basics and keep them at home. After-hours pharmacies generally charge a premium.

Choose your scheme option carefully

If you and your kids are healthy, you possibly don’t need a full medical scheme – a hospital plan might do. Remember that hospital plans will pay for chronic medication for 26 Prescribed Minimum Benefits, such as diabetes, asthma and high blood pressure.

The more cover you have, the better, but not if it means you can’t pay your rent.

Register your chronic conditions with your scheme

Once you do this, your chronic medication will be paid from your chronic medication limit or your overall annual limit – and not your medical savings account.

Use your pharmacy’s nursing services

These visits to the nurse are much cheaper than going to the GP and a myriad of tests/treatments can be done here, such as blood pressure monitoring and vaccinations for kids. Injections can also be given by these trained nurses.

Take the family for flu shots

Especially if you or any of your kids have any lung- or sinus-related issues, remember that prevention is always better than cure. Four people with serious flu in the same household can turn out to be an expensive exercise.

Phone your scheme before any of you undergoes treatment

Make sure what will be covered by your scheme option, and whether you have funds available. You might also need pre-authorisation for certain procedures. Failure to get necessary pre-authorisation could land you with a huge bill.

Start with your GP

Don’t go straight to a specialist – your GP might be able to help you at a much lower cost.

Use your scheme benefits

You are paying for them, so make use of them. You don’t have to go overboard, but many benefits, such as an over-the-counter medication benefit will be lost if you don’t use it. If you don’t know what your benefits are, make it your job to find out.

Negotiate with doctors

If they charge more than the fund rate, you can try to negotiate a lower rate with them. There is no harm in trying.

* Susan Erasmus is a freelance writer, and a member-elected trustee on the Nasmed Medical Scheme.

Disclaimer: Fin24 cannot be held liable for any decisions made based on the advice given. Under the ECT Act and to the fullest extent possible under the applicable law, Fin24 disclaims all responsibility or liability for any damages whatsoever resulting from the use of this site in any manner.

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