Stop your medical aid from getting nasty

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I recently got an email from a very angry guy…and I can’t really blame him.

“Joining them was not by choice, it was part of what was required by my employer, leaving them was not by choice either. I maintain I will not pay a cent. I have forwarded our conversation to….She will be in touch with you. I don’t owe anyone anything!”

Let me explain what happened:

This poor guy belongs to one of my group schemes. When he joined he liked the idea of the medical savings account.

Now for those of you who don’t know what this is – a medical savings account is credit which your medical aid gives you upfront in January every year for the year ahead. This credit is then used to pay for doctor and dentist visits, over-the-counter medication, spectacles, that type of thing.

Unless you’re on one of the top plans, once this runs out, that’s it. You have to pay for any further doctor visits from your own pocket. But here’s the thing…if you use up all the medical savings account by May like this guy did, and you then resign or get retrenched, you have to pay back the amount credited to you.

In this guy’s case, he was given say, R6, 000 in January which he had used up by April. He then terminated his membership at the end of May, and now the medical aid wants a portion of the R6, 000 back (for the months of June till December).

Problem is, if he doesn’t cough up, it’s going to get ugly, blacklisting, all that good stuff we have in the sunny republic of South Africa.

So to prevent this from happening to you, we’ve included a calculator to help you identify if you have a problem.

Here’s how the calculator works:

Click on the image to enlarge:



  • First get hold of the contribution rates for your medical aid scheme. In my example I’m using Discovery Health rates for 2015.
  • You will see that the medical savings amount for the main member is R543 per month. You’re going to insert this rate into your spreadsheet

Let’s now look at the calculator:

Click on the image to enlarge:


  • Click on the block marked “Jan” and select from the drop down menu the month you joined the scheme
  • Click on the block marked “Dec” and select the month you were last on the scheme
  • Below that indicate the monthly amount you’re paying towards the savings account per member. This information you get from the contribution table.
  • To the right of this enter the number of adult dependants and the number of child dependants, but be careful…some medical aid schemes only charge for a maximum of 3 children. So don’t enter 5 kids if they only take into account the first 3. And don’t include yourself with the adult dependants!
  • Below that you will see the amount your medical aid has advanced to you for the year – R14, 244 in the example.
  • Below that is the amount which legitimately belongs to you – R14, 244 in the example.
  • Finally we get to the amount you owe the scheme – in this case nothing.

I hope this helps you.

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Until next time.

The InsuranceFundi Team

If you would like further information, submit your details below & we will contact you.