How do we pay for day-to-day medical care?
As a closed medical scheme, we can design our benefits to meet your specific needs. The University of KwaZulu-Natal Medical Scheme uses two benefits to pay for day-to-day medical expenses, namely the General Benefit Pool and your Medical Savings Account. We pay for certain healthcare services at the Scheme Rate from the General Benefit Pool until you reach your yearly limit. Once you reach your limit, we pay for claims using the funds in your Medical Savings Account. If you use up all the funds in your Medical Savings Account, you have to pay for medical expenses yourself.
General Benefit Pool
We pay claims for certain healthcare services at the Scheme Rate from the General Benefit Pool until you reach your yearly limit. We use the funds in the General Benefit Pool to pay for things such as:
Medical Savings Account and General Benefit Pool
At the beginning of the year, we set an amount aside and put it in your Medical Savings Account and the General Benefit Pool. We use the funds in your Medical Savings Account to pay for certain day-to-day benefits. Day-to-day benefits may also be payable from the General Benefit Pool first and upon depletion of the General Benefit Pool from funds available in your Medical Savings Account. You are kindly referred to the Scheme's annual Benefit Brochure for details in this regard. If you do not use all the funds in your Medical Savings Account during the year, you earn interest on the amount, and the balance at the end of the year is carried over to the next year.