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Medical aids reimburse doctors and specialists at between 100% to 300% of medical aid rates, but the reality is that many medical practitioners charge well in excess of these rates, which could result in a gap between the actual cost of the procedure and the amount that the medical aid will pay.
As a medical aid member you are then liable for the difference. Medical aids may also impose upfront co-payments for in- and out-of-hospital procedures such as scopes, scans and deductibles. Depending on your medical aid option, these co-payments are either payable from your Medical Savings Account, or as an out-of-pocket expense.