PREVENT OUT OF POCKET PAYMENTS ON MEDICAL SCHEME BENEFITS
An Optivest consultant can assist you to determine the reason behind out of pocket payments on medication and consultations – Request Assistance
USE DESIGNATED SERVICE PROVIDERS
Maybe you have noticed the word Designated Service Provider (DSP) on your medical scheme brochures.
What does it mean and is it even important to know? Knowing who the designated service providers are that your medical scheme contracted will help you save paying out of your pocket.
Contrary to what medical scheme members might think or believe, schemes do try their utmost to try and manage down the cost of healthcare service and medication. One of the ways is to contract with service providers and negotiate lower fees. These translate in direct benefits for the members of the scheme, in the form of lower premium increases. Yes, I know the premiums are high and the annual increases are way more than the normal inflation rate.
So, let me share some information that can help you keep the money you pay out of your pocket a minimum to zero.
Your medical scheme will have agreements with general practitioners, specialists, pharmacies and certain hospitals. The question is how can you benefit from using the designated service providers?
Using the doctors and pharmacies your medical scheme have contracted will result in you not having to pay a fee out of your pocket for consultations in addition to what your scheme covers.
Medical schemes also have network options, meaning if you are prepared to go to specific private hospitals, which could be the hospital in your neighbourhood, you will pay a lower premium than on an option catering for all private hospitals. It is important to understand that you only have to use the hospital on the network for planned procedures…in other words a procedure that your specialist got pre-authorisation for and that is booked for a specific date. In the case of an emergency you will be taken to the nearest private hospital – the network arrangement does not apply to emergencies.
You will be able to save money unnecessarily spent on medical bills, make sure you have a thorough understanding of your medical scheme benefits and know who the designated service provider are.
Karin Andrea
Chief Executive: Optivest Corporate Solutions
Optivest Health Services
Saving you money……supporting you for life
