Updated 26 February 2014

21 ways to cut your medical costs

Money's tight for everyone - whether you have a medical scheme, a hospital plan, or nothing. Here's how to get the necessary treatment without breaking the bank.


Money's tight for most people at the moment. Everyone's cutting corners and cutting down on things that are thought not to be essential.

And what's more medical schemes in SA are said to be five times more expensive than elsewhere in the world, when purchasing power is taken into consideration.


"Your medical needs should be considered first and foremost," says Johan van Tonder, independent medical scheme researcher. "If you're healthy and don't suffer from any chronic diseases, a hospital plan might be enough. However, if you're older, you might be more prone to chronic conditions, which might bankrupt you if you have no cover for out-of-hospital expenses."

In the case of those who have no cover, the cost of injury or emergency surgery could be crippling. While some state hospitals offer excellent services and facilities, many don't. And paying for a private hospital out of your own pocket could set you back the price of a good second-hand car. That is, if it's not a big operation. Then we're looking at a new one at least.


What you can do
Here are some ideas:

Stick with the company medical scheme. This is often cheaper than going for an open-market medical scheme, where you as an individual may have little bargaining power. Also, closed schemes often charge you according to your income, but everyone gets the same benefits. So it's good for lower and middle income earners. Open schemes charge a set fee for a particular option, regardless of your income. If there's a clinic at work, use it. It's probably free.

Stick together. If you have two children and a spouse, it will be cheaper to all be on the same medical scheme than if you or your spouse join different schemes as principal members. Even if your company insists on your joining their scheme, you can usually get out of it if you're on your partner's scheme as an adult dependant. There are some options where you only pay for one or two children and the rest are free. Just check that you won't get a better deal if you move everyone onto your in-house scheme.


Chronic medication costs. The list of chronic conditions or PMBs (Prescribed Minimum Benefits) indicates which conditions medical schemes have to continue treating - even if an individual member's benefits have run out. If you suffer from one of these conditions, ask your GP whether there is a suitable generic for the medication he/she is prescribing for you. In this way you can keep the costs down.

Use your benefits. If you have an over-the-counter facility on your medical scheme, use it. The R100 you save on vitamins by not paying for them out of your own pocket could be spent on petrol in those last three desperate days before payday. Also don't go over your limits if you can help it - if the medical scheme covers up to R800 for frames for your new glasses, take the best you can find in that price range.

Get a hospital plan. If you have no medical scheme, because you think it's too expensive, try a two-week stay in a private hospital after an accident. A hospital plan is a lot cheaper than a full a medical scheme, but go for one that covers you from day one, otherwise there's little point. Many schemes have very reasonable hospital plan options if you are prepared to go to a particular hospital chain for elective procedures (not for emergencies). This allows the scheme to negotiate bulk discounts. Make use of this.

Read: Hospital plan vs. medical scheme

Get your facts straight. Unless there's a medical emergency, don't be shy to ask exactly what your hospital plan or medical scheme will cover before you're admitted to a private hospital. This isn't the time to be modest. What some people do, if they have no cover, is to have the operation done in a state hospital, and to go to a private hospital to recover from it. Post-operative care is often a problem area in state hospitals, usually not the operations themselves.


Read: How to find the right pharmacy

Phone your doctor. You might have to leave a message for him/her to call you back, but it might be an idea to speak to the doctor first to find out whether a visit is really necessary. You might just have the stomach bug that's doing the rounds, and for which you could pick up something at the chemist. Don't make a habit of phoning the doctor all the time, though. They are busy and don't much like interruptions. But once or twice a year is fine.



Look at generics. Generic medication have the same active ingredients as the original brand, but without the brand name. They can cost a fraction of the price. This will increase the time you may take to reach your claim limits in certain categories, leaving you covered for longer. Many schemes already insist that you use these, unless there's a medical reason not to do so. If you are unsure, do ask your doctor or pharmacists.

Take your own supplies to the hospital. Find out in advance what you'll need – tablets, cotton wool, bandages, antiseptic – and take them with you. Hospitals are notorious for charging you for a whole packet of earbuds if you used only three of them.




Ask your pharmacist. Pharmacists can often give good medical advice about things such as skin rashes, flu, or minor infections. Ask your pharmacist about over-the-counter medication or self-treatment for minor ailments. Pharmacists are also often open after hours. Most big cities have all-night chemists with a pharmacist on duty. Clinic sisters can often also give you injections, or take your blood pressure, or do simple tests – you might only have to pay for the medication, not a full doctor's consultation.

Deal now with medical issues. Ignoring a medical problem, because you don't want to pay the GP, often means that you end up paying for three consultations, because the condition has gone from mild to serious as a result of being neglected. If something's wrong, it's simply cheaper to deal with it right at the beginning. But learn to distinguish when it's serious, and when it's not.

Avoid after-hours consultations. Obviously, if there's a crisis, you'll have no choice. But going to the GP at the 24-hour clinic on a Sunday morning, because you have a sore throat, is going to cost you a lot more than it would on Monday morning.


Medical savings account. If you have depleted your medical savings account, continue sending receipts of bills you have paid to the medical scheme. In that way they will know when you have gone through your self-payment gap, and the benefits could kick in again.

- (Susan Erasmus, Health24, updated February 2014)


Read Health24’s Comments Policy

Comment on this story
Comments have been closed for this article.

Live healthier

Up for grabs! »


Win one of the 3 new devices from Twisp!


Love your heart »


How old is your heart? Take this test
