Medical aid options

[kavesh]

Hi everyone

My family and I currently are on Discovery Coastal Saver. I do not require the savings account but chose the option because there are other added benefits to saver members besides the savings account. Over the years I have accumulated a large positive balance in my savings account.

This costs me around R6 600 for a family of 4. (2 adults and 2 children)

A friend recently told me that he was on Profmed and was very happy with it and it comes in at around R4 400 without the savings account. Like with Discovery you will have to use their service providers.. I also have GAP cover with Zestlife so any shortfalls for major claims should be covered by GAP.

I would like to know whether anyone here are members of Profmed and what has there experience been when claiming.

Furthermore is it normal for medical aids to impose a general waiting period of 3 months when one moves from one medical aid to another?

I am self employed so not part of any group scheme.

I would really appreciate any input.

Thanks in advance.
Kavesh

[AmithS]

Cannot comment on Profmed.

However in general if you are moving from medical aid to another without any claims in the pipeline that you aware off no waiting period.

Although if you ask the medical aid - they will tell you to complete the application and apply - then only they will be in a position to provide you with an absolute answer on waiting periods that may apply.

[kavesh]

Cannot comment on Profmed.

However in general if you are moving from medical aid to another without any claims in the pipeline that you aware off no waiting period.

Although if you ask the medical aid - they will tell you to complete the application and apply - then only they will be in a position to provide you with an absolute answer on waiting periods that may apply.

Medical aids are rather strange beasts. It is an insurance after all.
If I was employed and changed jobs then no waiting period would apply. Now because I am self employed and on a medical aid for many years, they just decide to make the rule such that a waiting period must apply. How ridiculous is that?

[Blurock]

Is a savings account not just an additional premium that you pay for the convenience of paying the doctor with your own money and not out of the medical aid?
Keeping the "savings" premium money on a call account earns you interest and you end up paying the doctor only when you use him.

[adrianh]

I wouldn't touch Discovery with a barge pole. Be careful though, most medical aids are run by Discovery anyway and only exist in brand name.

[kavesh]

Is a savings account not just an additional premium that you pay for the convenience of paying the doctor with your own money and not out of the medical aid?
Keeping the "savings" premium money on a call account earns you interest and you end up paying the doctor only when you use him.

Quite right, teh savings is really for those that prefers the medical aid to manage their day to day medical costs. So if you can manage your own costs then you would not need a savings account. However, if you compare Discovery coastal saver to Discovery Coast Core, you will see that over and above the savings account there are other benefits which are not available to Core members.
I guess its there to encourage more people to go onto the savings plan. That way the medical aid has more cash to control, bloody clever if you ask me!

[AmithS]

The problem with savings is that the savings are still subject to the schemes rules.....

Meaning they may still not pay for certain treatments and medicines even from the savings.... (some medical aids you will have to make a special application for payment)

So rather save the savings (no pun intended) and use it on the treatments & medicine you want too....

Just my 2 cents....

[Blurock]

The problem with savings is that the savings are still subject to the schemes rules.....

Meaning they may still not pay for certain treatments and medicines even from the savings.... (some medical aids you will have to make a special application for payment) So rather save the savings (no pun intended) and use it on the treatments & medicine you want too....
Just my 2 cents....

Exactly why I keep my savings in my own account! They still have the audacity to say what they will and will not pay from your own savings! Then they expect you to pay an additional amount to cover what they are not paying! The medical aids are run by bean counters and their only objective is to coin it as much as they can.