12 Ways to make your medical savings work for you

A medical savings account can go a long way to helping you out with your day to day medical expenses. But all too often this valued account gets depleted too quickly particularly if you have a large family. Angelique Ruzicka asks the experts about how you can make the most out of your savings account without plundering the money within it:


1.       If your medical scheme has a network – use it


If your medical scheme has a network it will provide you with a list of doctors and specialists you can consult. Your choice of provider will be limited to this list. If you go outside of that you may have to make use of your savings account so make sure you take advantage of the service providers on the list.


2.       Try to preserve your savings

“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,” says executive principal officer of Liberty Medical Scheme, Andrew Edwards.  “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.”


3.       Work out the numbers

Edwards says you should 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.


4.       Submit all your claims

Some medical aid providers 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. With 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,” says Edwards.


5.       Pay for over-the-counter medicines yourself

For common illnesses, such as flu, your doctor may prescribe over the counter medicines as well as antibiotics to treat your symptoms. 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.


6.       Shop around for your pharmacy

“Although there is a set price on all medicines the professional fees which your pharmacist charges may be lower in some pharmacies. Chain store pharmacies and supermarkets can supply over-the-counter medicines such as headache tables and painkillers at a lower cost because they buy in bulk,” explains Heidi Kruger head of corporate communications at the Board of Healthcare Funders of Southern Africa.


7.       Find out if there are free services

Pharmacies and other health institutions may conduct free medical check-ups such as blood pressure, cholesterol levels and blood sugar level checks. If you know you need to have such a check-up make use of these and save your money in your medical savings account.


8.       Register for chronic medication benefits

If you’re on regular medication to treat a chronic illness like diabetes you could qualify for chronic medication benefits. This means that your medical scheme pays for it out of the risk pool and your savings account won’t be touched. You can get your doctor to motivate for this and by completing a simple form; you could save yourself hundreds of rand a month.


9.       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. “Consider paying cash for these and ask the service provider for a cash discount – usually between 5-10%,” says Edwards. “Then submit the bill to your medical scheme so that 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 aid to refund you for the payment you made in cash.


10.   Preventative care benefits

Some schemes offer preventative care benefits, these are paid from the risk portion of your medical aid and is 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.


11. 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,” explains Edwards.


12. Stick to generic medication

Generics are often just as good as non-generic medications and they are usually cheaper. So always ask your practitioner or the pharmacist if you can purchase