Make your medical aid work for you

Sarah Nicholson, Justmoney’s commercial manager, offers ten tips to help ensure you enjoy the medical aid scheme benefits to which you’re entitled.

Extremely high medical costs mean that many South Africans prudently subscribe to a medical aid scheme. But how do you make the most of your selected package, which needs to meet your medical needs for the year ahead?

Read the fine print

You may have stayed with the same plan for many years. Take time to understand the rules and benefits, which may have changed since you first signed up.

Maximise your money

Take up preventative health screenings and tests, free vaccinations, and baby programmes. You may also decide to register for a programme to better handle a chronic condition.

Explore loyalty programmes

Benefits could vary from product discounts to travel and retail promotions, and subsidised gym memberships.

Spread out claims

Rather than blow your allocation early in the year on over-the-counter purchases, speak to your pharmacist and health practitioners about how to best allocate medical, optical, and dental purchases.

Keep your benefits for essential medicines and services to be used as the need arises. This is especially important if you have small children or sickly dependants.

Choose wisely

Build up a good relationship with your pharmacist, who can advise you on general health topics from seasonal allergies to stress management.

Ask your doctor to prescribe generics which cost less. Whether you are looking at over-the-counter medication, or prescription drugs, generics can cut your bill considerably. You can also shop around and compare prices.

On the record

Be meticulous about filing claims and saving correspondence.

Plan for a procedure

If you require an operation or specialist treatment, obtain pre-authorisation. Do your homework, get a quote from the hospital and medical practitioners before you are admitted. Determine if there will be a shortfall and plan how to fund this. Check if you can use designated healthcare providers on your medical aid’s network for cheaper negotiated rates.

Back a buddy

Oncology and other treatments can make one feel under par for a lengthy period. Ask a family member or friend to help you keep track of medical claims and submissions, or offer to do the same for them.

Conflict resolution

If you’re having difficulties resolving a problem with a call centre agent, find out if your medical aid has a walk-in service. Dealing with someone face to face can help resolve a problem quicker.

Saving grace

Should you have problems keeping up with payments,speak to your medical aid about alternative, cheaper plans. Don’t drop your medical aid completely as medical bills can be enormous.

If you don’t yet have a medical aid, do comparisons online or ask for advice from a qualified broker. This will help you to choose the scheme and plan that offers the best possible cover for your age and personal circumstances.


Sarah Nicholson is the commercial manager for Justmoney. Justmoney is a personal finance website that provides busy and digitally savvy South Africans with easy access to financial products, services and information, including medical aid.

LIKE THIS? ------------------------------------------------

SUBSCRIBE to our FREE Diabetes Focus Newsletter.