Click here to read more on Medical Aid enhancements
Please contact Namhla or Tammy in our Health and Wellness Department, email [email protected], if you have any queries about Discovery Health Source: Discovery
0 Comments
![]() It’s now time to review your medical aid scheme cover for 2020. This means you have a window within which you can switch to a different plan for the new year. This window usually closes at the end of November (depending on your current provider), so don’t delay collecting the necessary information. This is not a decision to be rushed. Why do I have to decide now? Medical aid providers allow you to switch to a higher plans once a year (at the end of the year) without penalties or consequences. If you want to save on premiums or you need to increase benefits, now is the time to do it. What if I want to change providers altogether? If you are unhappy with your medical aid provider, you can switch to another at any time of the year. But before you do, consider the following: Waiting Periods Medical Aids by law must accept anyone who applies to join their scheme. To protect themselves from older or sickly members that join without having contributed to the risk pool, they usually impose a waiting period of between 3 and 12 months. Waiting periods will apply if 1) you have not been a member of another South African medical aid for the past three months or more, 2) if you change medical schemes before 2 years of being covered with your previous medical aid provider and 3) if you have a pre-existing medical condition. Finding out about any waiting periods is extremely important before deciding to change providers. Late joiner penalty As an additional means to manage the risk of older or sickly members joining without having contributed to the risk pool, medical schemes (according to the Medical Schemes Act) are entitles to add a late joiner penalty to your premium if you were not part of a medical scheme before 01 April 2001. The late joiner penalty is calculated (using a prescribed formula) based on the number of years that you were not on a registered South African medical scheme. The late joiner fee can range between 5% and 75% of the total contribution, depending on the number of years that you were not covered by a medical scheme. Please contact Namhla or Tammy in our Health Department, email [email protected], to find out about different Medical aid options Source: Medicalaid.co.za ![]() What happens when my benefits start and what do I need to know?
The following benefits needs pre-authorisation
The following benefits do not need pre-authorisation
How to get pre-authorization • Please call 0860102 493 to get an authorisation number • Please ensure that you have the information regarding the treatment required- E.g. Policy Number/ date of treatment/ Dr or Hospital practice number/ ICD10 Code, and Procedure Code Day-to- Day Benefits These are the benefits that are only available from your chosen Ingwe Active Primary Care network doctor. Chronic benefits to a list of medicine, referred to as s Network-entry-level formulary Day-to-day benefits are subjected to the network’s protocols, which are the rules and provisions set by the Network. Benefits are also subjected to the Network’s list of applicable tariff codes. What to do when wanting to see a doctor? You may visit any Doctor on the Ingwe Active primary care network. To check which doctors are in the area, you can call 0860 102 493 or visit Momentum website at Ingwehealth.co.za Momentum allows members to use any doctor on the Ingwe Active Primary Care network doctor. If you visit a non-Network doctor, you will have to use the emergency / casualty visit and pay R100 co-pay, this visit is covered at 100% of the Momentum health rate. There is no limit to the number of times that may visits the Ingwe Active Primary Care network doctor, however all the visits for the 11th onwards must be pre-authorised by contacting the call centre on 086 0102 493 How and where to find Doctor near your area To check which doctors, you can call 0860 102 493 or visit the website ingwehealth.co.za To apply for the Ingwe option for your chid please contact Nmahla or Tammy in our Health Department, email [email protected] , Many people may have failed to get insurance premiums paid because of changes to their bank accounts or problems with their bank accounts, resulting in temporary suspension of medical insurance. Beginning in 2019, Discovery has changed its online information to online instead of submitting changes in writing. The advantage of changing bank information online is no waiting time! The system will be updated immediately after the change. After the change is made, you can apply for a new charge directly online. Note: You can change only the primary guarantor bank information systems. The following are the detailed steps on how to change bank details online. 1. Go to Discovery website www.discovery.co.za and login into profile. 2. Once you are logged in you will see below red box, indicating arrears, "click fix it now to make payment". 3. Click "select to pay", if you have Vitality as well click "select to pay" on Vitality. 4. Then click "continue" to get OTP. 4. Confirm whether OTP they should be sent to the mobile phone or the mailbox. Fill in and submit the order. If the "please note that your OTP details have been sent to" is blank, please go to "Verification Code Settings". For more please go to here to see steps. 5. Select the newly added bank account 6. You will see confirmation of payment
Many people may have failed to get insurance premiums because of changes to their bank accounts or problems with their bank accounts, resulting in temporary suspension of medical insurance. Beginning in 2019, Discovery has changed its online information to online instead of submitting changes in writing. The advantage of changing bank information online is: no waiting time! The system of the insurance company will be updated immediately after the change. Note: Bank information can be changed only on the system of the principal. Here are the steps to update online: Step 1: After logging in to the website, click on "manage your health plan" under Medical Insurance. Step 2: Update your profile Step 3: Click to change bank information Step 4: At this time, the insurance company will send a verification code to your mobile phone or email address, fill in the verification code, and click Send. Step 5: At this time, you will enter the page for changing the bank account. The insurance company may send a confirmation request to your mobile phone. Please select the account to change the bank account on the mobile phone. The first one is the banking account. ), the second is the banking details for debit order, please make sure to change the part that needs to be changed, and finally click to send it. Step 6: After the change is successful, the following screen will appear For any queries please contact Namhla or Tammy in our health and wellness department email :[email protected] tel no: (011) 658 - 1333
![]() Medical aid is a form of insurance where you pay a monthly amount, called contribution or premium, in return for financial cover for medical treatment you may need, as well as any related medical expenses. Medical aid and health insurance are two different products. Medical aid, or medical scheme, is regulated by the Medical Schemes Act, provides in-hospital cover and chronic illness benefits, and pays for treatment according to specific medical scheme tariffs. Some medical aids also provide for day-to-day medical expenses. Health insurance, on the other hand, is regulated by the Short-term Insurance Act. It provides a more limited set of health benefits, up to a monetary limit. Health insurance is a cheaper alternative for people who cannot afford medical aid. Why medical aid is important Having a good medical aid plan with a reputable medical scheme can help you protect both your health and your wallet. The reality is that your health, and that of your family holds immeasurable value to you. There are many advantages of belonging to a medical aid. It financially protects you if you suddenly have to pay large, unexpected medical costs. Being a member of a scheme also means you have access to private medical care, instead of having to rely on public health services. If you are looking for advice on healthcare needs for you, your family or your company, you can contact us on the following channels: - WeChat: daberistic - Email: [email protected] - Phone: working hours 011 658 1333 ![]() What is Gap Cover? Gap Cover is the invaluable safety net that covers the shortfall between what medical schemes pay and what specialist doctors charge. Without a gap cover policy, a member would be required to pay this unexpected cost from their own pocket. In addition, a comprehensive gap cover policy also covers co-payments, penalty fees and cancer benefits. At Daberistic, our preferred provider is Sirago. Why Choose Sirago? • Personalised customer service • Gap Cover Solutions • Cover for in and out of hospital • Shortfall cover for day-to-day specialists, GP consultations, dentists and Alternative Therapy • Standard waiting period • Emergency Room Cover for accident, trauma and Illness • No maximum entry age. Benefits do not cease at the age of 65. • Cover for you and your family either on single medical scheme membership or on multiple memberships. • Sirago provides effective turnaround time so as not to compromise policyholders. • A stated benefit is paid straight into the policyholder's bank account or arrangements can be made to settle directly with providers • Claims run weekly • You can claim online, an industry first and for our clients: https://www.daberistic.com/gap-claim-ch.html |
AuthorKevin Yeh Archives
January 2025
Categories
All
|