What you need to know about network doctors

Product info • by Ryno Ellis

Having medical insurance is vital to ensure easy access to primary healthcare for you and your family.

With GetSavvi Health’s medical plans, your whole family can get doctors’ visits, providing they make use of a selected network of more than 7 500 service providers.

 A frequently asked question is: “What is a network doctor and how does it differ from a non-network doctor?’

A network doctor is a medical doctor (and in this case also refers to a healthcare facility) that has accepted and signed an agreement to the terms and conditions of a medical service provider.

Through the agreement, network options also offer a lower fee to a provider of health services in return for more patients being channelled to their offices.

A non-network provider that doesn’t have an agreement with a primary healthcare provider will charge a patient or member full price for a consultation.

When a GetSavvi Health member consults a doctor for treatment, that doctor must be a member of our network so that there won’t be any shortfall in payment that the member will need to self-fund.

Should the member, however, consult with a medical doctor outside of the GetSavvi Health network, they will be liable for the full cost of the consultation.

Tips when using GetSavvi Health’s network option:

  • To avoid unforeseen out-of-pocket expenses, ensure that you regularly check the network list to find a doctor. You can find this on our website’s Client Zone.
  • Find out if the GP on the network is dispensing (has a licence to issue medication) or non-dispensing (unable to issue medication and would instead issue a prescription) to avoid unforeseen out-of-pocket expenses.
  • Ensure that you familiarise yourself with the terms and conditions of the network option.
  • Always have your membership card ready.

What to do when a network doctor is out of your area:

When a network doctor is not accessible within a 10km radius of where a member resides, the member will be able to consult a non-network doctor for treatment, pay cash for the visit and send in a claims form.

GetSavvi Health will then refund the member at the standard scheme rate.

Should any claim exceed our rates, the member will be liable for the shortfall.

Other than this, any visit to a provider of health services outside of the network won’t be covered.