How to reduce co-payments

You can cut down on expected co-payments by using healthcare networks whenever possible. Find out how you can save by using these network tips.

Having a health plan with network restrictions impacts your day-to-day benefits and the medical aid cover you have at certain healthcare providers. Some medical schemes have arrangements in place that allow a lower contribution for members within a network. This is great for members, since the Society can offer full cover at these networks.

Not only would this keep your healthcare costs down, but usually, the Society will also pay healthcare professionals within their network directly, reducing your administrative load.

Some doctors charge more than the tariff specified by the Society. This is something they have a right to do, but it means that if your health plan only covers you for a specified tariff, you may be responsible to pay an amount yourself.

Patients are often embarrassed to discuss money with their healthcare provider, but when you make an appointment, you have a right to ask what rates your doctor charges and whether you'll be responsible for any amounts yourself. By doing this you can make informed decisions about how you're spending your funds. If you're set on using that specific provider and are happy to pay more, you'd know beforehand exactly how much.

Here are three ways you can save by being network-savvy:

At your GP

Our GP Network consists of preferred providers who have contracted with the Society to provide you with quality care at an affordable rate.

If you visit a medical practitioner who is part of our GP Network, they will not charge more than our contracted rate.

If you do not use a provider who is part of the GP Network, you will only be reimbursed 80% of the Society Rate. This means that you will have an amount greater than 20% to pay yourself if the provider charges more than the Society Rate.

At specialists

The Society has contracted with a group of providers to deliver quality healthcare services to you at a pre-negotiated rate. To avoid having to pay amounts yourself, we encourage you to use these networks for treatment both in-hospital and out of hospital. In partnering with these providers, the Society can manage claims costs which helps us to keep contribution increases as low as possible while still offering you great benefits.

To make it easier for you, the Society will pay Network Providers directly and in full, sparing you any up-front payments. Check your policy or contact the BEMAS call centre at 0860 002 107 to find out what your options are. Remember, you don't have to be shy to discuss and agree on rates with your specialist.

At pharmacies

Some medical schemes have pharmacy networks where you do not have to pay an amount towards medicines that are on the scheme's medicine list. More than 90% of pharmacies in South Africa are part of our network.

It's worth finding out whether your medical society offers you this service so you can save as much on your medicine spend as possible. Also, ask your pharmacist about generic.