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Offline Worth-It

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Medical Aid Advice
« on: February 19, 2014, 03:20:06 pm »
Hello Fellow Wild dogs,

My husband Yami ST has introduced me to the WD Forum and I would like to offer my professional services to you. I am a trained and accredited Medical Fund broker that can assist you with advice on your current fund or provide you with quotes and comparisons on others.To understand your medical aid and how it works could be a daunting task and that's where I can shed some light.


I already assisted some of the Wild dogs and gathered that there is a need for more professional advice.

Please feel free to contact me on liesl.cmac@telkomsa.net or 082 924 0841
« Last Edit: February 19, 2014, 04:08:28 pm by Worth-It »
 

Offline Worth-It

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Medical Aid Advice
« Reply #1 on: March 05, 2014, 03:08:43 pm »
If you are uncertain as to what medical scheme to choose or do not understand what your scheme benefits are, please contact me for assistance.
« Last Edit: March 05, 2014, 03:36:23 pm by Worth-It »
 

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Medical Aid Advice - The importance of Gap and Co-Payment Cover
« Reply #2 on: March 10, 2014, 11:28:07 am »
GAP and co-payments cover

You are most certainly aware that most medical practitioners (specialists, anaesthetists, etc.) claim private rates for their services. Medical aids however, pay claims in accordance with the fundís tariffs. Resulting in a difference that needs to be bridged by the medical aid member. This difference can escalate to several thousand Rand. GAP coverage originated in order to overcome this difference and consequently to provide greater peace of mind.

A co-payment will occur when a member undergoes a certain procedure and the medical aid requires a further payment to cover the specific procedure.

Both GAP and co-payment cover has become particularly important. For only R145 for both, per month per family, this can save you a sufficient amount of money should a family member need to be hospitalised. Looking forward to the opportunity to discuss this with you further.
 

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Re: Medical Aid Advice
« Reply #3 on: March 13, 2014, 03:52:42 pm »
Does your medical scheme benefits match your healthcare requirements?

Let me assist you by doing a needs analysis and then considering a medical aid that provides you with options for basic care, chronic disease management and hospitalisation cover in addition to day-to-day costs for optometry, dentistry, medicine and doctor visits.

Please contact me for comparisons, quotations and advice at liesl.cmac@telkomsa.net
« Last Edit: March 12, 2015, 12:35:09 pm by Worth-It »
 

Offline Worth-It

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Re: Medical Aid Advice
« Reply #4 on: March 17, 2014, 03:14:02 pm »
Are you seeking affordable medical aid cover for your child that is studying? I can offer you a plan for just R395 for students enrolled at a registered institution in South Africa. Contact me on liesl.cmac@telkomsa.net for more information.
 

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Re: Medical Aid Advice
« Reply #5 on: March 25, 2014, 11:37:20 am »
Why are Schemes Penalising members when they apply for membership?

Even though one can argue that you havenít made use of the healthcare system and have not been a burden on the system, if you are over 35 and join a medical aid for the first time, you are considered a late joiner. You may be penalised according to the specific medical aidís policies simply because you have not accessed the medical industry before and may have underlying conditions you are not aware of. And in essence be a risk to the scheme.

Later joiner penalties are added to your premium monthly and are calculated on your age and the years without membership. It can range between 5-75% of your monthly premium. However, it is only calculated on your risk portion and not the savings portion of the premium.

In addition, late joiners have not previously added to the medical scheme pool fund and therefore a waiting period may apply or higher rates. Apart from that you will, however, still enjoy the benefits of belonging to a medical aid from then on. The best medical advice is then to become a member of reputable scheme sooner rather than later.

Contact me for quotes, comparisons and advice. Liesl.cmac@telkomsa.net
« Last Edit: March 02, 2015, 04:51:35 pm by Worth-It »
 

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Re: Medical Aid Advice
« Reply #6 on: March 27, 2014, 05:39:11 pm »
Did you know that Medical Aid Scheme's are all categorised into types of options? Do you understand the difference of a "new generation option" vs a "hybrid option' vs a "traditional option" vs a capitation option? Do you know what type of option your medical fund is and how it effect your benefits? Contact me for more information.
liesl.cmac@telkomsa.net
 

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Re: Medical Aid Advice
« Reply #7 on: April 07, 2014, 01:34:20 pm »
Why is having a needs analysis so important? Every family has different requirements when it comes to medical aid. Draw up an list of expenses between doctor consultations, dentistry, medicine, optometry, etc., to see what you have spent most money on in the last 12 months.

That way you can find a few affordable medical aid quotes that reflect exactly what it is you need. There is no point in getting quotes from schemes that don't cover these aspects.

Finding out that what you need is not included in your cover is both frustrating and financially straining. It is, however, something that can easily be avoided. So make sure you find a few affordable medical aid quotes that reflect exactly what it is you need.

Please contact me to assist you in finding a scheme that would cover your family's requirements. liesl.cmac@telkomsa.net
« Last Edit: March 12, 2015, 12:34:03 pm by Worth-It »
 

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Re: Medical Aid Advice
« Reply #8 on: June 06, 2014, 10:07:20 am »
The Tax Season will be opening soon. Some Medical Schemes have issued the member's tax certificates already. If you have not received your as yet, you can either download it from the Scheme's website, or request it from their call centre.
 

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Re: Medical Aid Advice
« Reply #9 on: June 18, 2014, 02:11:36 pm »


DID YOU KNOW: WHAT IS A DESIGNATED SERVICE PROVIDER OR DSP.

Several funds are already, or starting to make use of Network of Suppliers or Designated Service Provider (DSP). 

Ensure you know which providers, e.g. hospitals, doctors, specialists, etc., form part of your fund's network. Should you make use of suppliers outside of this network the cost implications to yourself could be significant. Most of the times, this cost would also not be covered by your GAP Cover of Co-Payment cover, as you were suppose to use only certain providers.

It remains the memberís responsibility to know which suppliers are specified as part of the fundís network. Should you require  more information regarding the above, please do not hesitate to contact me.
 

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Re: Medical Aid Advice
« Reply #10 on: June 23, 2014, 08:47:34 pm »
What is a medical emergency?
You rush to the hospitalís emergency rooms with a medical issue you believe needs immediate attention. Treatment is given and you are sent home. However, not before you are presented with the account and told this is for you to settle.

How does this then work? You had a medical emergency! Emergency rooms are however nothing else than a doctorís practice attached to the hospital and offering a 24-hour service. Therefore, if you are not admitted to hospital from the emergency rooms and did not stay overnight, the account will be treated as a doctorís consultation. The account will be claimed from your available day-to-day expenses. Or if you medical savings plan is depleted for the year, this is for your own expense.

The Medical Council describes an emergency medical condition as follows: An emergency medical condition means any sudden and unexpected onset of a health condition that requires immediate medical or surgical treatment, where failure to provide such treatment would result in serious impairment to bodily functions or serious dysfunction of a bodily organ or part, or would place a person's life in serious jeopardy. An emergency medical condition must be certified as such by a medical practitioner. Emergencies qualify for PMB and must therefore also be registered for PMB treatment. Contact me for any more information on the above.
 

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Medical Aid Advice
« Reply #11 on: July 01, 2014, 12:58:57 pm »
Medihelp
 

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Re: Medical Aid Advice
« Reply #12 on: August 13, 2014, 11:54:55 am »
The tax season is currently in full pursuit and medical fund certificates can be requested directly from your aid. By registering on your medical aidís website with your membership number you will have access to your tax certificate as well as plenty of other important information pertaining your benefits and claims.
 

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Medical Aid Advice
« Reply #13 on: August 27, 2014, 06:38:26 pm »
Waiting periods and underwriting understood

Ever felt confused by the underwriting process of any Medical Scheme? Here is a more understandable summary.

Each and every member applying to a Scheme will fall into category A,B or C. Each category will in turn have an impact of what waiting period might be applied after the underwriting is completed.

Step1: Calculate the period that the member has been without cover from his previous scheme to the date of enrolment of the new scheme.

Is there a break in cover of 90 days and more (>90days)? If Yes, member will fall intoCategory A
Is there a break of less than 90 days (0-89 days)? If yes, calculate if the previous scheme coverage is up to 24 months or more than 24 months. If it is less than 24 months, the member will fall into Category B.

If more than 24 months, the member will fall into Category C.

Waiting periods for Category A:
General waiting period of 3 months - have to pay premiums but will not be able to claim. Emergencies and Chronic conditions will not be covered.
Condition-specific waiting period of 12 months - any current condition being treated or diagnosed will be excluded for 12 months.

Waiting periods for Category B:
Condition-specific waiting period that was unexpired from the previous scheme may be continued at new scheme.
Emergencies and Chronic conditions will be covered.

Waiting period for Category C:
General 3 month waiting period
Emergencies and Chronic conditions will be covered

Please do not hesitate in contacting me should you require quotes, comparisons or Advice on Medical Aid or GAP Cover
 

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Medical Aid Advice -Announcing Products for 2015
« Reply #14 on: September 17, 2014, 07:51:00 pm »
It is that time of the year where most of the Schemes will announce their 2015 product offerings during the course of September and October. And soon after that, you will be notified of the new products and premiums for 2015.

As medical aid member, you should again reconsider your medical aid options. You need to reflect on the last yearís medical events and decide whether it is best to remain on your current plan, upgrade, downgrade, or if necessary even consider a different Scheme in totality.

This could be a daunting task, but you are not alone in this decision process. As a trained and accredited medical aid broker, I am here to assist with advice on your current plan or to provide you with quotes on new schemes you would like to evaluate.

Should you not currently have GAP and Co- payment cover, now would be a fitting opportunity to reassess these products. These products are of cardinal importance and could literally save you and your family thousands of Rands.

Please contact me on liesl.cmac@telkomsa.net

 

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Medical Aid Advice-student plans for 2015
« Reply #15 on: September 25, 2014, 11:51:26 am »
Do you have an 18 year old child that will be studying in 2015? I can offer you a student plan from as little as R330.00 per month with Hospital and Day-to-Day cover through a network of Service Providers. Please contact me for a free quote. Contact me on liesl.cmac@telkomsa.net
 

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Re: Medical Aid Advice
« Reply #16 on: October 08, 2014, 09:11:07 pm »
What to Consider When Changing Your Medical Aid Scheme
Posted on September 18, 2014 by admin in Medical News.

If you are thinking about changing your medical aid scheme, consider the quality of care you are currently receiving, the benefits that go with your medical scheme and the price you are paying for services. One thing to consider is that you should never choose a plan based on extra offers concentrating on services that are unrelated to medical care and benefits. For instance, do not change your plan simply because you can get a special discount when you travel. Instead, choose a scheme that fits your personal budget and features benefits designed to maintain healthy lifestyles for yourself and your family.

You Need to Make Sure You Only Belong to One Scheme

South African law dictates that you cannot legally belong to more than one medical aid scheme at the same time. So, you need to do research to ensure that the plan you choose provides you, your spouse and your children with the care you expect at a cost you can afford to pay. One medical scheme may include special benefits you need or a list of preferred doctors and hospitals that your current plan does not include. Before changing your health plan, consider all your options carefully.

Please contact me should you have any queries or want to compare your current scheme with other schemes. I also have most scheme's 2015 premiums and plan offerings! Liesl.cmac@telkomsa.net
 

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Medical Aid Advice
« Reply #17 on: January 27, 2015, 05:09:58 pm »
MEDICAL AID ADVERT
« Last Edit: January 27, 2015, 05:10:45 pm by Worth-It »
 

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Re: Medical Aid Advice
« Reply #18 on: February 24, 2015, 06:57:44 am »
Morning

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Re: Medical Aid Advice
« Reply #19 on: May 20, 2015, 09:47:11 pm »
Questions To Ask Yourself Before Choosing A Hospital Plan. (Posted on May 15, 2015 by Kirstie Ricketts in Medical Services)

Hospital Plan - When it comes to choosing a medical scheme such as a hospital plan, there is no quick way to deciding which option is the perfect choice for you. You need to remember that what works for some people might not work for you. Make sure you do not make a hasty decision and rather take time to weigh your options and see who has the best solution for you.

Ask yourself the following questions before choosing a hospital plan:

Am I currently healthy?
What amount am I willing to spend on a medical scheme?
Will I be able to cover my other non-hospitalisation expenses?
Will I be adding dependants onto my medical scheme? If yes, how much will this cost?
What hospital procedures will my medical scheme cover?
Which hospitals will I be able to go to?
What fund tariff will the hospital plan pay?

It is also important to keep the following issues in mind:

Even if your hospital plan covers 100% of your hospital bill, if the bill if higher you will have to pay anything over the agreed tariff.

There are minimum benefits that all medical scheme members are entitled to no matter what scheme you are a part of.

Medical schemes are vitally important as an accident can happen at any time and none of us are immune to all diseases.

« Last Edit: May 20, 2015, 09:55:13 pm by Worth-It »