As “Origin Health and Wellness”, that is exactly what we do: Look after your Health and Wellness. Contributing to medical aid and GAP cover has become an integral part of personal risk management. Traditionally seen as a grudge expense, having private medical cover in this day and age is a necessity! Traditionally, medical aid covered all in-and out-of-hospital expenses. So, going to the doctor, dentist, pharmacy and having in-hospital procedures and treatment, were all covered by your medical aid. However, with the dawn of new legislation and new-age medical scheme options, the whole platform changed. Medical aid options now cater for the blue-collar worker, students and young families with children on an income-based scale. In-hospital only – cover and hospital plan options combined with savings facilities for day-to-day expenses became the norm. The more expensive and comprehensive options with wider scopes of cover, chronic medication, large savings facilities and threshold benefits are also available. Most conflict from members arises from outstanding account balances after an in-hospital episode. As medical aid plans mostly pay at 100% or 200% of medical scheme tariffs, members are mostly left with a balance in account from service providers as they are allowed to charge more than medical scheme tariffs. GAP cover then makes provision to cover the balance of pre-authorised in-hospital procedures up to 500% above plan tariffs with a maximum of R157,000 per member per annum. Only where the medical aid paid a portion of a procedure or account, will GAP cover the balance. If the medical aid does not pay for a procedure, GAP will not respond. GAP does not pay for hospital accounts, out-of-hospital expenses that the medical aid does not cover or where a savings account is depleted. Still this type of “back-up” cover for the price is one of the most value for money products in the financial market today.
Healthy Lifestyle or Wellness programmes have become a big drive for medical aids. A healthier member’s chances to have a medical episode is far less than an inactive, stressed member living an unhealthy lifestyle. Obviously, this has had a huge impact on costs for medical aids, thus most medical schemes reward healthy lifestyle activities involving contracted partners, for example going to the gym, buying healthy foods, going to the movies, cheap flights and car hire and buying electronic devices and sports goods. This has totally changed the medical scheme environment.
At Origin Health and Wellness, we are ready to offer you a wide variety of medical schemes, wellness programmes and GAP covers. Our aim is to assess each member profile and advise and assist members accordingly to make the right choice for 2020. There are options out there that can be tailor-made to your family’s needs and offer value for money. Our team of advisors are backed by a strong administrative office that cater to all your after-sales needs.
Time is running out to choose your plan for 2020 so contact us today. Origin Health and Wellness is there for you. The date by which you have to inform your medical aid of your plan choice for 2020 is as follows:
- Discovery Health: 14 December 2019 (please confirm with your adviser by 6 December)
- Momentum Health: 22 November 2019 (please confirm with your adviser by 18 November)
- Medi help: 13 December 2019 (please confirm with your adviser by 6 December)
- Profmed: 30 November 2019 (please confirm with your adviser by 21 November)
- Fedhealth: 30 November 2019 (please confirm with your adviser by 21 November)
- Bonitas: 30 November 2019 (please confirm with your adviser by 21 November)
Please contact your Origin Health & Wellness planner soon, should you wish to discuss the options and plans for 2020.
This article is a general information sheet and should not be used or relied on as professional advice. No liability can be accepted for any errors or omissions nor for any loss or damage arising from reliance upon any information herein. Always contact your financial adviser for specific and detailed advice. Errors and omissions excepted. (E&OE)