Medshield shares a guide on how to maximise your healthcare coverage when it runs out

But what if running out of cover didn't mean compromising on care? In a country where healthcare costs are rising and access to services can be uneven, knowing how to navigate challenges is crucial. At Medshield Medical Scheme, we offer a suite of innovative benefits designed to keep you covered, even when your funds run low. Enter the world of Virtual Care and Smart Care benefits, two of our game-changing solutions that can help you stretch your healthcare rands further without sacrificing quality.

Day-to-day and savings plans are designed to cover routine healthcare expenses, such as doctor visits, medication, and basic medical tests. These plans are a lifeline for many South Africans, helping to manage everyday health needs without paying out of pocket. However, these funds are finite; they can run out quickly depending on your healthcare needs.

When this happens, it can feel like you're suddenly on your own, with medical bills piling up. The good news is that strategies and resources are available to help you manage your healthcare effectively, even after your day-to-day or savings plan is depleted.

Steps to take when your funds run out

1. Review your medical aid plan

The first step is to review your medical aid plan thoroughly. Medshield regularly updates its members on new benefits, plan changes, and tips for maximising your coverage. Staying informed ensures you maximise your medical aid throughout the year.

Understand what is still covered under your hospital benefits or any additional benefits that may be available. Knowing what's still available can help you strategically plan your healthcare needs.

2. Prioritise essential healthcare needs

Once you clearly understand what's covered, prioritise your healthcare needs. Focus on essential treatments and consultations that cannot be postponed. Schedule routine check-ups, medication refills, and other non-urgent healthcare needs early in the year when your day-to-day funds are still available. It helps avoid a rush for care once your funds are depleted. By prioritising essential care, you can allocate your remaining resources more effectively. In addition, by registering your chronic medicine you ensure that it is covered from the Chronic Medicine Benefit and not your day-to-day or savings.

3. Explore virtual care options

Virtual care gained popularity in South Africa, particularly after the Covid-19 pandemic accelerated the use of telehealth services. It offers a convenient and accessible way to consult with healthcare professionals remotely, often cheaper than in-person visits. It can include video and phone consultations.

Medshield's Virtual Care options are designed to provide convenient access to healthcare professionals without needing a physical visit. Whether you need a prescription refill, advice on managing symptoms, or a consultation for a minor health issue, virtual care can save you time and money. For instance, instead of booking an in-person appointment with a GP for a recurring problem, you can consult with a doctor online, potentially at a lower cost and without the need to travel. Additionally, virtual care provides comprehensive services, including mental health support and chronic disease management, ensuring ongoing access to essential care even when funds are limited.

4. Leverage SmartCare benefits at Clicks and Dischem pharmacies

Medshield partners with over 600 Clicks and Dischem pharmacies countrywide under the SmartCare Network benefit and offers members access to affordable healthcare services through in-pharmacy clinics staffed by professional nurses. These clinics provide numerous services, including primary health checks, vaccinations, minor ailment treatments, and chronic disease management.

The collaboration includes telemedicine solutions that offers real-time virtual access to registered family practitioners. It allows the nurse to perform a thorough medical history and examination of the patient and advise the patient on over-the-counter medication available at the pharmacy. If the nurse determines the need for a general practitioner consultation, the nurse will virtually dial up the doctor and assist with the examination. The nurse will then print the doctor's written documentation, and the patient can fill their prescription at the pharmacy immediately.

All Medshield members have access to SmartCare benefits in addition to the general practitioner consultation benefits. These services are typically more cost-effective than an in-person GP visit, making them an ideal option when your GP consultation benefit, your day-to-day limit or savings plan has run out. For example, if you need a flu shot, blood pressure check, or advice on managing a chronic condition, the nurses at Clicks or Dischem (depending on your plan's pharmacy network requirements) can provide these services efficiently and at a reduced cost.

5. Use generic medications where possible

Generic medications are often significantly cheaper than their branded counterparts, yet they are just as effective. Ask your healthcare provider or pharmacist if a generic version of your prescribed medication is available. Clicks and Dischem also offer competitively priced medications along with SmartCare consultations. It is available across all Medshield benefit plans, making access to prescription medication convenient for members.

Making the most of your healthcare cover

In a healthcare landscape that can often feel overwhelming, it's reassuring to know that strategies and support systems are in place to help you manage your healthcare needs effectively. By being proactive and informed, you can take control of your healthcare journey, ensuring that your well-being is prioritised, even when your funds run low.

Medshield provides its members the tools and resources to navigate these challenges, ensuring you remain covered and cared for throughout the year. Whether through virtual consultations, nurse-led clinics, or affordable medication, options are always available to keep you healthy and well. Running out of day-to-day or savings plan funds doesn't have to mean compromising your health.