Top tips to stretch your benefits further​

As healthcare costs continue to rise, it has become increasingly important to take charge of your medical expenses. Knowing how to get the best cover from your medical aid is crucial. By making the most of what your medical aid has to offer, you help yourself in determining how you can get the best out of your cover and preserve your benefits. Using your medical aid well, means you won’t have to pay many medical expenses out of your own pocket. We’ve made up a list of tips you can use to make sure you stretch your medical benefits even further and have sufficient cover at all times.​

Be Doctor Wise

Always go to your General Practitioner (G.P) to get an initial diagnosis. You have limited benefits for consultation, so make sure the time is well spent so that you don’t have to keep going back to the doctor. Be clear and honest with your GP about your symptoms & concerns. Your doctor can only diagnose you properly if you thoroughly explain your symptoms. Let your GP be your first point of reference before approaching a specialist. ​

Watch for billing errors

Human error is a factor everywhere – even when it comes to medical bills. It’s always worth double checking your bills to make sure no accidental charges have crept in. Ask for itemised bills, check for accidental double bills, and if you pick up a mistake, ask. ​

Discussing  pricing

Don’t be embarrassed to discuss cost with your doctor, pharmacist or healthcare provider. When you make an appointment, ask what rate your doctor charges. When your doctor is writing you a prescription, don’t be afraid to ask for the generic version of the medicine that is being prescribed. Ask your pharmacist about their administration fees (if they have any). Make informed decisions about how you’re using your benefits. ​

Know your plan

Get to know your medical aid scheme. Read through all the information you receive from your medical aid scheme, from their quarterly newsletters to all their emailers, SMS notifications and online communication. Use their website and social media pages to speak to their consultants on what you are covered for. Ask your medical aid for your particular plans’ medical details, and/or ask for help in understanding your plan. When you know what you are covered for, you can start using your medical aid efficiently to minimise your out-of-pocket expenses.​

Don’t wait

If you’re starting to feel ill enough to call in sick, go to the doctor. If you notice a chronic pain, a strange mole or any health change that is causing worry, go to the doctor. Catching illness early – from the flu to cancer – makes it quicker, easier and cheaper to heal. ​

Take care of yourself

Take steps to remain healthy to avoid costs that are associated with chronic diseases. Preventable diseases such as diabetes, heart disease, lung cancer and hypertension can be avoided by maintaining a healthy lifestyle. If you already have a chronic condition, work with your doctor to manage it effectively. This can help prevent complications and reduce the need for expensive medical care. When you Invest in your own health you minimise your doctor’s visits ensuring you save your benefits for when you absolutely need it.

Generic Medication

Medical aids are more likely to pay in full for a generic medicine. This is because generic medication costs up to 80% less than the original brand and has little to no co-payment levies. Generics medicines are the exact copies of original brand medicines. They have the same medical benefits and use the same active ingredient, strength and dosage as the original. Always ask your pharmacist if there is a generic option for your medicine as substituting with generics is a very effective way of reducing costs.​


Some procedures cost more than the tariff covered by medical aids. Members may have co-payments from their own pocket to cover the above tariff rate that  a medical aid does not cover. Ask your medical provider about their NAMAF tariff rate, and negotiate. Or investigate gap cover that will be there when you need the boost. ​

We hope these tips help you unlock additional value from your medical aid so that you can make the most of your medical cover.​


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