Weekly Thoughts 21 September 2018

A week ago – Thursday, Friday and over last weekend – I was down and out with very bad flu or whatever it was.  So I put in for some sick leave and spent some time feeling sorry for myself, working from my bed or the TV coach over the weekend.  I didn’t even go off to the annual Hilton College Arts festival – the girls went every day without me.

In times like this one often gets bored and begins to watch or read things you might not usually read.  And so it was that I got stuck into reading some emails that my medical aid – Genesis – has recently been sending out to members.  Articles they have called ordinary explanations of important stuff.  The one I read this particular day was on Scheme Exclusions.  Now I am someone who buys something and never reads the instruction manual.  It must just work.  So with medical aid I would read the upfront info on the benefits you get, but I’ve never spent time finding what they might exclude me on.  The results were quite thought provoking, and maybe very important to know.  The article told me to go and read further in the Scheme Rules, annexure C, which I found frustrating to find.  This resulted in a grumpy email from me to Genesis which further resulted in a personal phone call back with a very helpful lady guiding me through the website.  Here are the exclusions that stood out to me.  There are more – anyone thinking of cosmetic surgery, for example, you need to go read that bit.  But this is not on my agenda, so I skipped over it.  The following things I found interesting for one reason or another.

In short, if I have injuries arising from or out of the use of the following, I might get no medical aid care, even in hospital:

  • quad bikes  (always told my son we don’t ride these)
  • motorized speed contests  (does this include me racing my mate down the streets in the middle of the night…?  Maybe rather just don’t do it)
  • alcohol or drug abuse  (includes an injury from driving under the influence)
  • breach of the law
  • willful self-inflicted injuries
  • attempted suicide
  • injuries sustained from hazardous hobbies where normal safety procedures were not followed
  • participation in civil commotion  (so this potentially could have included the inconsiderate people who blocked highways in my province last month to protest the fuel price.  Then they get injured…?)

I might be thinking that if I need to go to hospital, all is covered.  I then find out when the R300 000 bill comes, that they won’t pay because I broke the law.  Does this include me having an accident while driving and talking on a cell phone?  Afterall, I breached the law.