Consider networks to manage medical costs

By Staff Writer

Consumers can help to keep their own as well as the medical scheme costs down if they make use of networks promoted by schemes. Peter Jordan, principal officer of Fedhealth believes that networks are all about achieving the best health outcome and consumers need to be more circumspect in what they are paying for and who they see.


"The reality is we do not have unlimited resources and many of the problems arise from over-servicing in the private sector and under-servicing in the public sector. There needs to be a drive towards encouraging members to utilize the networks which have been put in place more effectively," he says.


Jordan said that introducing networks has helped. In 2012, 82% of Fedhealth claiming beneficiaries accessed the Fedhealth GP network and 89% of the scheme’s claiming beneficiaries accessed the pharmacy network.


"We believe it is the scheme's responsibility to try and provide meaningful benefits to members which is why Fedhealth, on most options, provides unlimited access to GPs in the GP network. GPs are skilled at assessing the body as a whole and often pick up health issues that patients may not be aware of. This can lead to early prognosis and treatment without the need for a visit to a specialist. But in the event they do need a specialist, we have a growing specialist network base for them to access as well. "  


Fedhealth has 3 157 specialists contracted on its network, 4 333 doctors on its GP network and 1 679 pharmacies. “This is significant when you consider that hospital costs account for 45,3% of the claims submitted by its members, with another 19% going to specialists and 12% to general practitioners. Medicines account for 9.5% of claims," said Jordan.

Recent Articles

Featured Rating agencies may come knocking

It is only the middle of February, but the rand has already made two big moves. The first was the rand moving from R14.60 to R 13.20 at the beginning of the year, as emerging markets (EM) became fashionable again. The second was where the rand gave away nearly 90 cents in 2 weeks as the EM rally ran out of steam, and local events started to hit the headlines.

Read more

The cost of sending money home to neighbouring countries

Transferring money home within the Southern African Development Community (SADC) provides vital financial support for many households in neighbouring countries.

Read more

Student bank accounts: Which come out on top?

Being a student signals budgeting and not having a lot of money at your disposal. This means streamlining expenses such as your grocery costs and entertainment budget. But what if your bank account is in fact costing you more than you can afford?

Read more

Can you afford an ambulance in South Africa?

When a loved one is straddling the line between life and death, you won’t hesitate to call an ambulance. This week, Justmoney found out how much an ambulance ride costs in South Africa, whether you can refuse to get into an ambulance, and who pays the bill if you’re unconscious. 

Read more

Sign Up

To our weekly newsletter for advice you can bank on

Deals

President Hotel Easter Special

Price: From R1,500
When: 15 March to 30 April
Where: Cape Town

Kulula-Preskil Island Resort Special

Price: R16,999
When: 11 May -14 September
Where: Mauritius

A Touch Of Madness Tuck In Tuesday Special

Price: R70
When: Tuesdays
Where: Cape Town