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Question

03 Feb 2004

Medical aid vs. Private patient
We are a family of 4 on a medical aid with a savings plan for general doctor's consultations and medicine. Every year our savings plan runs out earlier and earlier even though we are a relatively healthy family. So in an effort to curb costs we have offered to pay for consultations and medicines ourselves in exchange for 'cash' discounts. This, however, is seldom met with any enthusiasm. In the past I have noticed different prices quoted for medical aid members and private patients and when asking for private patient prices which are obviously cheaper we are told we may not avail of this. I have recently been enquiring about the costs for eye tests and spectacles as a cash paying, private patient and am very disappointed at the contempt shown.
Do we have to disclose that we are members of a medical aid?
How negotiable are the fees?
What discounts can we demand?
Answer 599 views
Expert
medical money

01 Jan 0001

Hi,

There is no legal requirement to disclose that you are a member of a medical aid. This is generally done so as to avoid having to pay the bill then and there. However in your case you are quite happy to do that and I see no reason why they should not give you the benefit of a cash paying client.

Discounts are at the discretion of each and every practise, in negotiating these you should be aware that practioners have huge bad debts so any up front money is welcome and you should therefore be in a stronger negotiating position. You could of course change your provider if you are not getting any joy. Technically because you pay for these costs out of savings you are not enjoying these benefits from the medical aid but your own money.

Even if you pay for these benefits yourself, I would still submit the claims to your medical aid so that you can be refunded from your savings. They are legitimate expenses and you are entitled to use your savings for them.

Regards
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