Maybe a great benefit came through for you in times of need, or perhaps you really liked the friendly and warm service you received. Whatever it is, please submit your reason or reasons to housecall@ thecheesehasmoved.com so we can share them with all our members.

This month we look at the fact that medical aid benefits are sometimes complex to understand and demonstrate the value of our unique benefits in practical rands and cents terms.

We received an overwhelming response to our invitation for members to provide us with their reasons for staying with Fedhealth. Unfortunately, while we are unable to publish all responses in full, we can quote a few excerpts from them:

"I want a medical aid that pays my medical bills in a fair and expedient manner, not one that gives me arbitrary unnecessary benefits that I do not require. Fedhealth fits the bill entirely."

"I was advised to join the largest medical scheme in SA-what a shambles! Claims not paid... claims paid twice... helpline staff who were ill-informed! Scared, alone, bombarded with advice l saw an ad 4 Fedhealth, phoned, felt at home and have never looked back. Why? Because they CARE!"

"I have compared my benefits with that offered by Gems and whatever I may save in monthly fees I am sure to spend on co-payments with Gems."

Thank you for writing in and telling us why you stay part of the Fedhealth family. Please e-mail us on housecall@thecheesehamsoved.com.

We've had a fascinating response to our question to our members about why they are Fedhealth members. While some members have used the column to voice dissatisfaction with the level of benefits or the service levels in some cases, most of the contributions have been able to demonstrate the powerful importance of having adequate cover during a medical crisis.

The real reason for a medical scheme is to assist members with significant medical expenditure. We're talking here about prem babies, a frightening car crash or a dread disease like cancer. The treatments by the hospitals and the various specialists can run into many hundreds of thousands of rands and it can financially cripple a family. This really highlights the role of medical aids, but it is also fortunate that most families are not confronted with this sort of trauma.

No one plans to have major medical expenses - and few people even contemplate the possibility of it happening. Which is why medical aid contributions are often begrudged as a high and unnecessary expense when your family are healthy. And it is also why most medical schemes have, to varying degrees, some cover for day-to-day expenditure. As much as the calamitous events are infrequent, just about everyone has regular dental, GP and physiotherapy interactions. These events should probably be viewed as part of your day-to-day running costs like petrol, electricity and the plumber. Over time they have been incorporated into most medical scheme benefits in order to add value to the cover provided by the medical aid.

The problem is, these sorts of day-to-day expenses are not really insurable as they are elective and predictable. So when we work out what these expenses cost the scheme - in terms of your contributions - it's a simple case of what you pay is what you get. Because we can't know every member's likely requirement every year, and because the regulator denies us permission to give the member the choice of how much they'd like to pay into their day-to-day benefit, we know that there are anomalies. Some members get more benefits than they need and others would like more. And then they can feel aggrieved by the perceived lack of value: "I pay and pay and then when I claim there's nothing there!"

The point I'm trying to make is that day-to-day benefits are there as a convenience, but they are not the be all and end all of the scheme. Be grateful if you have not had to access the real value of the scheme. It means that your family is healthy or has not had a major trauma. And in which case, your medical aid spend is nothing more than being responsible. But more importantly, if you have the misfortune to really need your medical aid, be grateful that it is Fedhealth.

What will happen if my doctor charges more than the NHRPL price?
Subject to the OHEB benefit being available, the scheme will refund up to the NHRPL price and automatically refund the difference from your available savings.

Will the full cost of this procedure accumulate to my Safety Net Benefit?
No, only the NHRPL rate will accumulate to the Safety Net.

How much OHEB do I have available for the year?
The limit depends on the number of dependants a member has. Please see the table below.

What happens when I have used up my OHEB?
Once the Out-of-Hospital-Expenses Benefit has been exhausted, further out-of-hospital claims will be paid from the member's savings or self-funded by the member until the Safety Net Level is reached. Thereafter claims will be paid from the Safety Net Benefit.

EXAMPLE:
Your GP charges R290 for a consultation and the tariff amount is R190.80.

Option 1: OHEB and savings available: The scheme will refund you the full R290 (R190.80 from OHEB and R99.20 from Savings). R190.80 will accumulate to your annual Safety Net Level.

Option 2: OHEB depleted but savings available: The scheme will refund the full R290 from your savings. R190.80 will accumulate to your annual Safety Net Level.

Option 3: OHEB and savings depleted: You will not be refunded anything. However, R190.80 will accumulate to your annual Safety Net Level.

In the April issue of HouseCall! we will feature the savings account.

When it comes to global warming, hamburgers are the Hummers of food, scientists say. Scientists studying the environmental costs of food from field to plate look at everything, from how much grain a cow eats before it is ready for slaughter to the emissions released by manure.

A single kilogram of beef produces 16kg of carbon dioxide equivalent emissions: four times higher than pork and more than ten times as much as a kilogram of poultry.

Another part of the problem is people are eating far more meat than they need to. "Meat once was a luxury in our diet," say scientists. "We used to eat it once a week. Now we eat it every day."

So there you have it, not only is regular and excessive red meat consumption linked to cardiovascular diseases and increased risk of cancers of the colon, rectum, stomach, breast and prostate, but producing it in such large quantities is said to be slowly killing our environment too.

The recent outbreak of polio in Namibia has got local disease experts worried because this country, like South Africa, was considered to be one of those countries in which the virus was on its way to being eradicated.

Doctors here agree yet again that authorities can never afford to be complacent about the re-emergence of infectious disease.

The risk is low - but serious
The chances of getting the most serious form of polio, which causes paralysis, are very slim - especially for those of us lucky enough to be living in good socio-economic conditions and following sound hygiene practices, say the experts.

If you are planning a trip to Namibia take note of the following:

Life is demanding, we know that. And exercise and good eating eventually and usually does fall low on the list. But if you really had to sit down and think about it, you'd see that you can't have all the things you do if you don't take care of the very thing that gives you life.

But since we know that life is quite full and change is overwhelming, we are offering you easy diet and exercise tips in a step-by-step approach so that hopefully, healthy living choices will eventually become second nature.

Step #01 - Water! Water! Water!
Why is water so important - and how can I actually get myself to drink more?

Water is vital in a climate like South Africa's where we love being outdoors or playing sports, etc. and this is what makes staying well hydrated even more essential.

Also, as working people, we often find ourselves in air-conditioned offices, cars and planes - all very dehydrating environments.

OTHER FACTORS CAUSING DEHYDRATION:

Drinking around 1.5 to 2 litres of water a day increases metabolism by as much as 15%. It also creates a feeling of fullness and can help to reduce the amount of actual kilojoules consumed. Some signs that you aren't getting enough water:

HOW TO DRINK MORE:

∗ 3 cups of green tea daily has been proven to accelerate weight loss because of the thermogenic effect (it's also alledged to be a great cancer fighter)

Step # 02 Move a Little!
Exercise is vital as it not only helps with weight loss, but it forces us to breathe more effectively. More oxygen in the blood means improved memory, concentration & improved energy levels. But if you are struggling to make set times for exercise, here are a few great ideas on how to incorporate exercise into everyday life:

In our continued strive to improve on service delivery we have implemented a new IVR (Interactive Voice Response) system which we hope will help us reduce the amount of time spent on the phone for hospital pre-authorisation. It also means that you will be able to call after-hours and on weekends and have access to service.

Speech recognition is a user interface which allows the caller to speak to the system naturally as if speaking to a consultant.

Benefits
The speech recognition system will make it easier and more accurate to use when entering information as you can now say it as if you are speaking to a reviewer. It also enables us to capture diagnostic (ICD10) codes, which was not possible using the touchtone system. This will further enhance our levels of service by streamlining the authorisation process and improving the availability of reviewers to complete the authorisation process.

General tips

Power tips

As with everything we do, this new system has been introduced to make your life easier and provide you with a better and more efficient service. However, if you do experience any problems, do speak to a consultant or e-mail us.