Submitting a claim to medical aid is easy, as long as you have all your paperwork in order. In general, you’ll need to collate all itemised bills and invoices that relate to the health procedure you’re claiming for. This could mean invoices from hospitals, anaesthetists, general practitioners, specialists, or invoices for medication you’ve bought from a pharmacy.
Every medical aid has a different claims procedure, but generally you’ll need to submit your personal details, your medical aid number, and then the relevant documentation as outlined above. You can normally do this via email, fax or post.
There are generally two ways to claim for medical aid: either you can do it yourself, or your healthcare professional can do it on your behalf. Many healthcare providers ask that you settle with them first and then claim the money back afterwards. Others are willing to claim directly from your medical aid, so you don’t need to pay them first. Depending on which route you go, your medical aid will either refund the money directly into your bank account, or to the bank account of your health provider.
All medical aids have a limited time in which you can submit a medical claim. Specifically, all claims need to be submitted to your medical aid within four months from the date you received the service or treatment has been obtained. If you have a claim that falls out of that date, your medical aid will decline the payment of your claim, even if you have benefits available.
DISCLAIMER: The information on this website is for educational purposes only, and is not intended as medical advice, diagnosis or treatment. If you are experiencing symptoms or need health advice, please consult a healthcare professional.