Illustrative image: When you go to your local pharmacy for medication, ask the pharmacist for the cheapest generic option. (Photos: Pixabay and Unsplash) 
We’re into the second half of the year and you may be one of thousands of medical scheme members now finding your medical savings accounts are depleted, leaving you to pay directly for day-to-day costs.
According to the Council for Medical Schemes 2022/23 annual report, South Africans paid close to R40-billion out of pocket for healthcare, with nearly half of this going towards outpatient services, not hospital stays. These costs include essential visits to specialists, radiologists and dentists, which are often not fully covered once medical savings accounts are exhausted.
Although there is no magic fix, there are ways to change the way you access healthcare to make it more affordable.
For example, Tania Joffe, founder of Unu Health, says that instead of spending R500 or more on a face-to-face GP visit, you could opt to speak to a doctor for a fraction of that cost through a telemedicine app.
“The old model of always visiting your GP or specialist in person for everything just isn’t sustainable any more,” says Joffe. “It’s time to embrace the hybrid model that includes telemedicine.”
See more: How medical schemes are using AI’s predictive power to revolutionise health risk management
One of the easiest ways to reduce medical costs is by taking advantage of low-cost or free screening tools offered by your medical scheme. For example, Discovery Health launched a Personal Health Pathways programme earlier this year.
Accessible via the Discovery Health app, the platform helps members and their healthcare practitioners to navigate the healthcare system with precise and personalised healthcare recommendations, improving both immediate and long-term health outcomes for each member.
Each pathway is tailored to the member’s specific health status, risk profile and engagement patterns, dynamically adjusting as new health data becomes available.
Dr Ron Whelan, chief executive of Discovery Health, says the AI-powered platform behind Personal Health Pathways processes more than 33 terabytes of data, and an additional 500 gigabytes are ingested daily. To illustrate the platform’s scale, there are more than 7 million possible pathways for completing 12 health actions. Examples of personalised pathway prompts include:
- A healthy 42-year-old woman may be encouraged to schedule a health check, complete a mental wellbeing assessment, go for a dental check-up, get a mammogram or Pap smear, nominate a primary care GP, complete a Vitality Age Assessment or receive a flu vaccine;
- A 45-year-old man with elevated cholesterol and blood pressure may be guided to visit his GP for a check-up, collect prescribed medicine, monitor blood pressure or cholesterol levels, or go for prostate or colon cancer screening; and
- A 65-year-old man who has diabetes may be prompted through the app to schedule an HbA1c test, collect medicine, undergo foot and retinal screenings, complete a prostate cancer test or have a mental wellbeing assessment.
When you go to your local pharmacy for medication, ask the pharmacist for the cheapest generic option. When you buy milk, you consider different brands and weigh up the costs before you buy – your medication deserves the same consideration.
Tax benefits
Continue submitting claims to your medical scheme even though your medical savings account is depleted. The scheme will not pay these claims, but it records the amounts as your out-of-pocket expenditure and this information is shared with the South African Revenue Service.
In the long run, this means less admin for you when you submit your tax return and a potential tax benefit – the additional medical expenses tax credit.
According to TaxTim, out-of-pocket expenditure that could fall under additional medical tax credits includes:
- A consultation and medicines supplied by a registered medical practitioner, dentist, optometrist, homeopath, naturopath, osteopath, herbalist, physiotherapist, chiropractor or orthopaedist to you or any of your dependants;
- The costs of a nursing home or hospital, or any duly registered or enrolled nurse, midwife or nursing assistant (or to any nursing agency in respect of the services of such a nurse, midwife or nursing assistant);
- Medicines prescribed by a registered medical practitioner and acquired from a pharmacist. Note – this will not include over-the-counter medication such as cough syrup and pain relievers; and
- Medical expenses incurred and paid outside South Africa. DM
This story first appeared in our weekly Daily Maverick 168 newspaper, which is available countrywide for R35.
