Information
• SPG (Self Payment Gap) and Thresholds Just writing these words gives me a chill down my spine. How can one define something that cannot be quantified or described? It is like a black hole…. When you choose an option with a SPG, the exact amount is disclosed, but somehow the amount never stays the same, it is never less but the gap has a bad way of “growing”. Words like: “Your savings have been depleted…” or “you have reached your gap…” is the last thing you want to hear when standing in a queue at a pharmacy. The following will increase your SPG: o o o Schedule 0 to 2 medicines; rather pay for these medicines separately. Homeopathic medicines and vitamins. Practitioner accounts that are charged over and above your elected medical aid’s benefit. All benefits that reduce your SPG accumulate to your threshold. The threshold is the limit. amount of claims submitted and approved, that you have to reach before you can benefit from your medical aid again. Once you have reached the threshold, certain sublimits might apply, for example optometry.
VISIT:
www.medicalschemes.com
TIPS!!!!
• • • • • • • • • Familiarise yourself with any co-payments. Try to use generic medication. It is not dangerous or less effective. Make sure your chronic medication is on the formulary or obtain approval.
www.doh.gov.za
Start re-evaluating your medical aid options as early as October each year for the following year.
Understand your SPG and threshold limits as well as any sub limits such as prosthesis, oncology, etc. Investigate the option of insurance to cover any shortfalls, usually referred to as GAP cover, such as Trulogic, Dennis, etc. Make provision for additional savings to cover unforeseen expenses, such as Momentum’s Health Saver. Do not be afraid to negotiate rates, after all, you are paying! Constantly read articles etc. to familiarise yourself with changes in the industry
– Knowledge is power!
Charissa Jacobs
Certified Financial Planner* Please contact me for a life-changing discussion. Cell: 082 870 3557 Tel: 012 368 7800 Fax: 086 631 9626 I also specialize in: • • •
Dr Jaco van Niekerk
(General practitioner)
Botox injections Injectable fillers Weight management
Take care of your body and skin the responsible way. Contact me @ 012 567 1538 (421, Braam Pretorius Rd, Montana)
Email: [email protected]
Email: [email protected]