Medical aid cover, especially if you are young and healthy, seems like an unnecessary monthly expense. However, if some mishap should befall you like a road traffic accident, you will quickly appreciate the quality of health care that medical aid cover will afford you.
Nobody wants to think of the worst case scenario. But living in a country with one of the highest rates of road accident deaths mean that it is a reality for every one of us. Even a low impact collision has medical consequences. Whiplash, which is the most common injury sustained in an accident, can arise from even a small fender bender and you will need medical care to manage the pain and stiffness.
And in a serious accident, the cost of hospitalisation, x-rays and specialist care can break anybody”s budget. Worst of all, most private hospitals will only stabilize you and send you off to a government facility unless you have medical aid.
Road Accident Fund or Medical Aid
Up until a few years ago, many private hospitals accepted any road accident victim whether they had medical aid cover or not. The Road Accident Fund ensured that all road users, citizens and foreigners, were fully covered for medical care should they be involved in an accident. Unfortunately most hospitals will no longer deal with the Road Accident Fund and in turn the RAF’s amendments mean that you will only be compensated in certain circumstances.
Medical Costs from an Accident
Even the smallest accident can be costly in terms of medical expenses. Chest x-rays to assess any rib fractures are considered as a necessary diagnostic investigation after an accident, even if you are not experiencing any pain. This will cost you at least R1,200. Add in the cost of the doctor’s consultation fee at the emergency room and other investigations like a CAT scan or an MRI should your doctor suspect a concussion and you can expect the bill to exceed R6,000. This excludes hospitalisation costs.
Should you be severely injured and require hospitalization or even surgery, you can expect your bill to run into the tens if not hundreds of thousands. You may have a hospital cash back plan or a medical benefit as part of your car insurance cover but most private hospitals will not recognize this as surety for your medical expenses. Your only option is a large cash deposit upfront or a government hospital.
Expenses After an Accident
An accident, no matter how minor, will mean that you will incur expenses at some point. You may need to hire a car, pay for your repairs should you not have insurance or even miss a couple days of work to overcome the shock. You may be able to squeeze out the cash from somewhere or just do without. Medical care however, may not be manageable for most of us on an already tight budget these days and you can definitely not do without it. Private health care is expensive and few of us want to undergo treatment at a government hospital. This will mean borrowing at a time when it is difficult to get credit.
Without medical aid, you can expect to be out of pocket well beyond the costs of fixing your car or missing a couple days of work. If you are in pain, even if you are not hospitalized or have sustained any serious injuries, you want top quality care , which means consulting with a doctor, buying expensive painkillers and seeing a physiotherapist or chiropractor for many treatment sessions afterwards. These expenses are unlikely to be covered by the Road Accident Fund and most private medical practitioners expect payment upfront these days.
What will medical aid pay for in a road traffic accident?
All medical aids will cover the emergency expenses associated with an accident. If you only have a medical aid hospital plan, then your scheme will only pay for costs incurred when hospitalised. But with a comprehensive benefit, the costs of seeing a doctor on an outpatient basis, x-rays, painkillers and other medication as well as follow up consultations will be fully covered.
Your medical aid will also pay for the emergency medical services at the scene of the accident as well as for the ambulance to take you to the hospital. This may seem like a minor expense but it can quickly add up to a R1,000 or more when you count in the cost of materials necessary to treat your wounds at the scene. Depending on the extent of your injuries, cosmetic surgery and certain types of reconstructive surgery will not be paid for by most medical aids so you will have to pay for this on your own or through a medical loan.
You will always appreciate quality health care when you are the most vulnerable and need immediate medical attention. A high impact road accident is one of those situations and even if you are not seriously injured, nobody wants to have see loved ones refused care simply because they did not have medical aid cover.