Bestmed Medical Scheme offers personal medical savings accounts (PMSAs), otherwise referred to as ‘medical savings’, ‘annual savings’ or just ‘savings’, on certain benefit options. As a medical aid member, it can get a bit confusing when trying to wrap your head around how your savings work. This is why we have compiled the below questions and answers to address frequently asked questions as comprehensively as possible, allowing you and your dependants to make the most of your annual savings.
- What is a personal medical savings account (PMSA)?
A PMSA, is a benefit account established in the name of the relevant member. The savings amount available for use for healthcare services and/or products from the PMSA is calculated using a fixed percentage of a member’s total contribution during the financial year. The amount may not exceed 25% of the member’s total gross contribution.
- How is the PMSA calculated?
The PMSA is calculated using a fixed percentage of the total contribution. In 2021:
- Beat2 and Beat2 Network saving are calculated at 16%,
- Beat3 and Beat3 Network savings are calculated at 16%
- Beat4 and Beat4 Network savings are calculated at 14%
- Pace1 savings are calculated at 19%
- Pace2 savings are calculated at 14%
- Pace3 savings are calculated at 14%
- Pace4 savings are calculated at 3%
Beat1, Beat1 Network, Pulse1 and Pulse2 benefit options do not have any savings.
- When do these funds become available?
The savings portion of your contributions for the year is made available in arrears and up front on 1 January every year.
- Do all Bestmed plan options have a PMSA?
No, not all plan options have a PMSA. The Pulse and Beat1 options do not include a PMSA.
- What happens when my PMSA runs out?
On Beat4, Pace1, Pace2 and Pace3 your day-to-day benefits will become available. On Beat2 and Beat3, however, members pay out of pocket after their savings have become depleted.
- What is paid for from a PMSA?
Medical expenses for out-of-hospital services are paid from savings if your chosen option includes a PMSA.
On Bestmed’s Beat4, Pace1, Pace2 and Pace3 options, day-to-day benefits become available once the PMSA is depleted.
Prescribed minimum benefits (PMBs) and co-payments are not funded from the PMSA. Member will also not be able to use available funds to offset contributions. However, the Scheme may use funds in the PMSA to offset debt that the member owes the Scheme, following the member’s termination of their Scheme membership.
- Do members lose their personal medical savings if there is an amount that is not used?
Any remaining personal medical savings amount remains the property of the member. If a member or their dependants do not use the funds in their PMSA by the end of the year, the available funds are transferred to the principal member’s vested savings account, depending on their benefit option.
- What are vested savings?
Vested savings are remaining savings accumulated from previous years.
- What is paid for from vested savings?
Beneficiaries may request payment of services such as co-payments to be paid from their vested savings, depending on their benefit option. Day-to-day benefits can also be paid from the vested savings account.
Beneficiaries may also apply to the Scheme to use their vested savings to pay for additional benefits, such as tinted glasses and certain excluded medicine items. However, costs relating to PMB services, or the self-payment gap, cannot be paid from vested savings.
- Do I lose the money if I don’t use it?
No, you don’t lose it. It becomes a part of the following year’s savings or will be added to your vested savings, depending on your benefit option.
Do PMSA and vested savings accounts earn interest?
Yes, members with positive balances (whether active or resigned) earn interest on the net positive balance of the annual personal medical savings and vested savings accounts. Funds are invested within seven days of receipt thereof in a savings trust account according to specifications of the Medical Schemes Act. Bestmed’s trust accounts are current and money market accounts.
The Scheme then allocates the interest on the combined net positive balance of the annual personal medical savings and vested savings, and not on each account separately. Therefore, interest received on invested funds, minus bank charges on the trust accounts, is allocated to the principal member’s month-end savings balance on a pro rata basis at month-end.
What happens if a member terminates their scheme membership?
If a member resigns from Bestmed and decides not to join another scheme, the member will receive the balance of funds, including interest earned. The same applies if a member decides to join another scheme or benefit option without a PMSA option.
However, the funds are transferred into the new scheme’s PMSA if a member joins another scheme with a PMSA option.
- How do I access vested savings?
Members can give permission to pay for claims from the vested savings account. Some claims are automatically paid from vested savings.