Tag Archives: medical aid

Medical Aid Gap Cover: Pretty Useful After All My Life 08 APR 2014

stratum benefits logoA couple of years ago, just after Chantelle and I had gotten married and were in the process of amalgamating all of our accounts, etc, Chantelle on the advice from her family had us sign up with Stratum Benefits through a broker.

Now essentially, Stratum provides medical aid gap cover, but because it sounds nicer and more important when they say it:

Dear medical aid member, it is important to understand that should you be admitted to hospital for any reason, there might be a difference between what the medical provider charges and what is actually paid by your medical aid. You will personally be liable for these shortfalls that could amount to THOUSANDS OF RANDS, as illustrated below.

Our products are designed to protect medical scheme members from the shortfalls which they may encounter when incurring medical expenses. The reality is that the portion of medical bills not covered by medical schemes have increased significantly in recent years. Inadequate cover could spell financial ruin for a family in the event of a long period of hospitalisation or other medical crisis. […]

Yes, it is a little sensationalized, what with all those unnecessary CAPSLOCK instances, but it turns out that they really do provide a useful service, if you are at all inclined to end up in the hospital on more than just a few occasions.

Obviously our big hospital encounter was the recent(ish) birth of Emily at the Vergelegen MediClinic, and although everything went super smooth and we were thrilled with the level of service received from both Dr. La Grange and Dr. Blaine, the reality is that when the invoices arrived, both far exceeded the Discovery Health’s Medical Rate, pretty much by double.

Of course these were grudgingly paid, and of course, that left a rather large hole in our finances, which therefore makes it super pleasingly that, after a brief review period, Stratum has just gotten back to us with the following news:

Patient: Chantelle Louise Lotter         
Procedure: C-Section
Admission date:  2014-01-13
Doctor La Grange: R 6 788.00
Doctor Blaine: R 2 567.40
ClaimStatus: Assessed
Claim amount:   R‎ 9 355,40
Claim payment date: 2014-04-15

…which is of course a welcome sigh of relief for my rather stressed bank account.

So yay for medical aid gap cover then in other words.

Related Link: http://www.stratumbenefits.co.za/

Getting Serviced Jessica | My Life 23 MAR 2011

Two things getting serviced today actually, the first being Gina G. Getz who goes into the Hyundai Helderberg Service Centre for her big 30,000 km service (a couple of days before her 1st birthday actually) and the second being little Jessica who is going in for one or other big injection which costs around R8,000 a shot and which gets repeated for the next four months or so (i.e. it costs a truckload to get this one done!).

In terms of Gina G., it is a simple matter of parking her in the parking lot, handing over your keys and double checking that everything is still under warranty and a service plan, which it should be considering that the car isn’t even a year old yet.

Seriously, the kilometres are piling on rather too quickly for my liking – the 15,000 km service was done a mere 5 or so months ago!

The second service, Jessica’s injection, is obviously a far more complicated affair.

One needs to first wake, prepare and get her to the hospital, then hold back the tears as they painfully inject her and then deal with the aftermath as we have been told that this one will hurt – a lot. Needless to say, my sympathies to C who is handling this one! :)

And it cropped up as a bit of a mystery actually. We received a phone call out of the blue telling us that Jessica has been authorised for it, but we didn’t know what, who or why, never mind what the actual injection contents is or does!

Turns out it was a mistake on the part of Dr. Edson as he forgot to inform us about it, but thankfully the hospital didn’t and with Discovery Health’s blessing, everything is sorted out now, so much relief in other words and an even better protected baby as the end result.

Anyway, now to the actual reason behind this slightly inane post. While you can’t really call Gina G. Getz cute, there shouldn’t be any problem applying the cute tag to a rather fluffy eared Jessica:

See what I mean? :)

Jessica’s Lengthy Bills Jessica | My Life 15 MAR 2011

I’m not sure if I ever got around to mentioning just how much money Jessica’s arrival into this world cost you, the medical aid contributor.

The various bills and statements from all the parties involved have all more or less stopped flowing in now, and bar a few hundred Rand here and there, I can thankfully say that Discovery Health were absolute stars and picked up 99% of the costs, costs which would have made any mere mortal man weep.

The lengthy bill/statement I am holding up in the photo above is that from Netcare Kuilsriver Hospital. They were the big ones, with a total bill weighing in at a staggeringR248,000 (Remember, Jessica was in the Neonatal Intensive Care Unit for just short of two months)! The paediatrician responsible for ensuring Jessica’s survival, Doctor Edson, sent me a paper bill just as long in terms of lenght, though his costs came in at roughly R32,000, and then there was still the odd couple of thousand that came in from the various support services, like the radiologists for example.

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