Doctor Doctor

Before I moved here I wondered, what would going to the doctor in South Africa be like? What if I became seriously ill? Could doctors in Joburg successfully treat me? What if they couldn't properly diagnose me until it was too late? 

I know some expats who have their annual physicals when they make visits back home. But live away from home long enough and eventually you will need to see a doctor. And, if like me, you actually look forward to getting your teeth cleaned every six months then you will certainly need to see a dentist or a hygienist while you are living away. 

Fortunately throughout our stay in South Africa, Mr. Deep and I have remained healthy. However, I counted the number of receipts that we have for doctor visits and combined Mr. Deep and I (although mostly Mr. Deep) have visited doctors and dentists 35 times in less than 22 months! I know what you're thinking, that it's amazing that we were able to squeeze in any travel or safaris given the significant amount of time we are spending receiving medical attention. Mr. Deep asked that I clarify and tell you that most of these visits are for physical therapy or as it's called here biokinetics.

The first time I visited a doctor in Joburg I completely over complicated the situation. It was April of 2015, two months after we arrived. I had been feeling sick with a stomach bug and despite my best efforts to treat the illness with ginger ale and tums, I wasn't getting any better. 

Upon arrival I checked in with the receptionist. She told me the name of the doctor I'd be seeing and said I could "go through." Coming through or going through is South African terminology for "go on in." What I wasn't sure of was did she mean go and wait in the waiting room or go right in and see the doctor? Maybe I was delirious from sickness but I decided that she must mean that I should go directly in to see the doctor. 

I walked down the corridor and found the door with the doctor's name on it. It was slightly ajar so I entered the office. The doctor seemed a little surprised to see me. I explained that I wasn't sure if the receptionist meant that I should go right to his office or not (although it was becoming clear not.) He said that usually, and by usually I think he meant always, patients wait in the waiting room until they are called. I am sure he was wondering where in the world I was from where it's normal for patients to barge in to see the doctor. He was really nice about it though and proceeded with my appointment rather than sending me back to the waiting room. 

Overall I have found the medical system here to be quite good. While I don't know if the care I am getting is any better or worse than what I would be receiving back in the U.S., there are certain aspects here that are definitely better.

First, the wait times are very short. In South Africa I don't think I've waited to see a doctor for longer than 15 minutes. In the past I have waited over two hours even with a scheduled appointment.

Second, it's easy to get an appointment. If I were to call my doctor's office right now, they would ask me if I wanted an appointment today. I would not have to beg or cough dramatically into the phone in order to be seen. In the U.S. if I were to call a doctor today and ask for an appointment, I would be given the earliest available appointment which would be in March, 2017.  

Third, the doctors here are not afraid to prescribe drugs. Some people think this is a bad thing, but if I am feeling poorly enough to visit the doctor then I am looking for fast relief in the form of tablets. 

Fourth, results are given quickly. When I had annual blood work, I was called with the results the next day. When I needed a chest x-ray for my visa I got the films right away. When I had a mammogram the results were provided to me before I left the hospital.

For a year Mr. Deep and I paid for all of our medical expenses in cash. While visiting private doctors is sadly cost prohibitive for a majority of people in this country, to us the visits often cost less than our co-pay would back home. Although we were aware that we had some type of insurance for expats neither of us researched the matter. I am sure that this task was supposed to be handled by the Ops team, but it wasn't and eventually Mr. Deep got tired of seeing money fly out the window and requested that I submit the paid invoices to insurance to see if we might be reimbursed for any of our expenses.  

He handed me a stack of invoices and gave me the Cigna Global Health Benefits log in information. Of course I procrastinated the project for a while as I was busy with other things. Finally, I sat down to complete my assignment. The whole process was quite simple and straightforward. In fact, the only challenge I had was that in order to successfully submit photos of the paid invoices I had to install a "photo shrinker" app on my phone. Once that was done, I was able to quickly submit each claim.

The process for submitting claims via Cigna Global Health Benefits is as follows. First, register on the website (have your Cigna ID card handy for this.) Next, enter banking details for what is called ePayment Plus to allow reimbursement to be deposited directly into your bank account. After selecting which family member you are filing on behalf of, type a few sentences explaining the diagnosis/symptoms. For example, "visit to doctor for stomach illness" or "biokinetics for knee pain." Next, from a drop down menu choose the country where the expense was incurred. Upload a photo of the invoice you paid (remember you may need to shrink the size of the photo first as it must be less than 6mb.) Finally, agree to the terms and submit the claim. The whole process takes about 15 seconds.

As I submit claims Mr. Deep receives three emails from Cigna. The first, when a claim is submitted, the second when we are reimbursed for an expense, and the third when a new explanation of benefits has been posted to the website for our viewing. There is also an app called the Cigna Envoy App that can be downloaded to track claims but I have yet to try it.

A few days after I completed my claim submissions a miraculous thing happened and we started receiving payments from Cigna into our bank account. Nothing (not even birds) makes Mr. Deep happier than money appearing into his bank account.  

This post was sponsored by Cigna Global Health Benefits. All opinions expressed and experiences shared are my own.

Putting up a Hotel on Baltic Avenue

Mr. Deep asked me a really good question the other day. He asked, "are you thinking in rand yet?" Keep in mind the man is an accountant so this type of question is equivalent to him asking me the meaning of life. 

What he meant was, when I see prices in South African rand do I still convert the price to U.S. dollars in my head? And, do I have a sense of how much is reasonable to pay for something in rand? Because what I would be willing to pay for that same item in dollars isn't relevant.

I think most of us can relate to being on vacation in another country, not bothering to really think about the currency, because it looks fake to us, handing a cashier a wad of money and hoping for the best. Or the worst example, going to some place like Disney World and getting that God awful bracelet that you can wave around and pay for anything and everything with. "Giant turkey legs for everyone on me!" Really fun until you get the bill. This strategy may work when you are on vacation (or not) but it's not a good way to live your life for three years.

When you have lived in one country your whole life, you just know things. If you're from the U.S. You know how long a foot is, what 70 degrees feels like and how much is reasonable to pay for a loaf of bread. It's really just a feeling, a sense that you have for these things based on your experience. That sense is something I am trying to develop here because I don't think it's in my best interest to spend three years and be converting things to a dollars the entire time.  Better to try to get comfortable with these scales and measurements. 

Here's how I first knew I was starting to think in rand. I went to a fancy - well more fancy than the supermarket where I usually shop - wine store. I told the woman working there I wanted a Pinotage which is a great South African red wine that you should run right out and try today. She immediately directed me to a really expensive bottle. I think it was like 280 rand or something. And I just knew the answer was no. I didn't convert it I just told her, no that's too expensive.  But I knew I was starting to think in rand in my head, starting to know what was reasonable and what was not and starting to also know whether or not I wanted to pay that price for it. Progress!

Some South African Currency. All the new bills have Mandela on the front and one of the big five game animals on the back. The coin is 5 Rand. 10 rand is the smallest bill available.

Now, onto working on my knowledge of Celsius because reciting this rhyme (while cute) is not going to cut it for three years.
zero is freezing
ten is not
twenty is warm
thirty is hot