When it comes to using your medical aid, many people don’t realise that basic care services like blood tests, doctor visits, and routine health screenings can be covered by your medical aid’s hospital or chronic benefits, not your savings. If you’ve been paying for these services out of your pocket, you’re potentially missing out on a lot of savings!
Here’s How You Can Avoid Dipping into Your Savings:
1. Use Your Preventive Benefits
Most medical aid plans provide free or discounted preventative care like flu shots, blood pressure checks, and cholesterol screenings. These are part of your wellness benefits and do not need to be covered by your savings.
Tip: Make sure to take full advantage of these benefits every year. Not using them could cost you in the long run!
2. Check for PMB Coverage
Under South African law, medical aids are required to cover Prescribed Minimum Benefits (PMBs) for specific conditions like diabetes, asthma, and hypertension. This means that if you have one of these chronic conditions, your medical aid should cover the treatment, medications, and related tests in full, regardless of which plan you’re on.
Tip: Confirm that your condition qualifies for PMB coverage — and make sure you’re using Designated Service Providers (DSPs) to get the full benefit.
3. Maximise Your Chronic Illness Benefits
Once you’re registered for a chronic condition (like high blood pressure or diabetes), you unlock a “basket of benefits,” which could include regular tests, medication, and specialist visits — all covered by your medical aid.
Tip: Don’t pay for things like your annual blood test or GP visits related to your condition out-of-pocket. If you’re not registered, you’re leaving money on the table.
What to Do Next
• Check your benefits by calling your medical aid and asking what’s covered under PMBs and chronic benefits.
• Use the available tools like the Discovery Health ID or medical aid portal to find out exactly what’s included in your plan.
By following these steps, you can keep your savings intact and get the healthcare you need without extra costs. Save smarter and stay healthy!
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Written in collaboration with Practice Solutions — helping healthcare providers with practice management solutions so that they can focus on patient care. To learn more about their services, visit www.medpracsol.co.za
Quick Reference Table
| Benefit Type | Covers | Do You Need To Register? |
|---|---|---|
| Preventative Benefits | Check-ups, Screenings | X No registration needed |
| PMB | Emergencies & chronic conditions | ✅ Yes – must register and follow rules |
| Chronic Benefits | Ongoing tests, meds, specialist care | ✅ Yes – register & apply through your doctor |
Written in collaboration with Practice Solutions — helping healthcare providers with practice management solutions so that they can focus on patient care. To learn more about their services, visit www.medpracsol.co.za
