Claims

 

Need to know information:- What to look out for when choosing a medical scheme

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Are your health insurance costs too high? Try decoding your medical aid terms and conditions and associated costs to make sure that it works for you.

“While health insurance is important, it comes at a cost that is rapidly rising. Unfortunately for the consumer, this affects medical scheme membership contribution rates, and the increases of which are sometimes significantly higher than general inflation.

As schemes try to contain their costs in the face of increasing claims, they make changes to their plans and benefits, which can come as a surprise to the consumer,” says Mark Payne, CEO of the Independent Community Pharmacy Association (ICPA).

Annual review of your plan

He recommends that an annual review of your plan is absolutely vital, and will affirm that it is serving your needs rather than the other way around.

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The Showdown at the UN: SA takes on the US for cheaper drugs

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When the US went to bat for Big Pharma in the fight against this killer disease, South Africa wasn’t having any of it. Here’s what happened next.

Graveyard cough, white plague, consumption. A killer by any name, TB has stalked the human race for aeons, lurking in crowded tenements or following miners deep underground, hanging in the air of our hospitals.

Always there, yet rarely spoken.

Today, it kills more people than HIV and malaria combined, the World Health Organisation (WHO) reports. In South Africa, Statistics South Africa’s latest data shows TB remains the leading cause of non-violent deaths.

Yet it took the United Nations 73 years to call a meeting on TB — and only because a very excitable South African health minister agitated enough for it.

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Bonitas:- Price hike and big changes for medical aid plans in 2019

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Medical aid scheme Bonitas is to increase prices across its various plans by a weighted average of 8.9% in 2019 – while also launching two new lower-cost plans.

The group said that the weighted average is on par with the industry corridor of 3% to 4% above CPI, and comes amid a tough economic climate, which included a hike in VAT to 15% in April 2018.

“The past 12 months have been extremely trying, with a number of uncertainties and changes anticipated,” said Bonitas principal officer, Gerhard Van Emmenis.

Looking for a affordable Medical Aid or Hospital Plan, just click here Medical Aid or just send your Name, surname, age, area in which you live and email address to 082 738 5586

“In addition, consumers have been heavily impacted by the increase in VAT and escalating prices which resulted from this.”

In July Bonitas reporte
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The biggest medical aid schemes in South Africa – and how much they’re charging in 2018

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The majority of South Africa’s biggest medical aid schemes have released their prices for 2018, showing below 10% increases across all plans.

According to the latest statistics released by the Council for Medical Schemes (CMS), there are currently 82 medical aid schemes operating in South Africa with a total subscription of just under 8.9 million members as at December 2016.

Discovery remains the largest medical aid scheme in the country, with over 2.7 million members.

This is followed by the Government Employees Medical Scheme (GEMS) with 1.8 million members, and the Bonitas Medical Fund, with just under 680,000 members.

Due to the nature of medical aids, and how each scheme is structured to cater for different hospital networks and cover different medical needs, it’s incredibly difficult to compare like for like, especially on price.

However, with all medical aids now releasing their contribution structures for 2018, the tables below outline the pr
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ATM pharmacy launches in Bloemfontein (Free State)

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Twin City Mall in Bloemfontein is the newest site for the innovative ATM pharmacy that gives patients with chronic illnesses repeat medication in under five minutes.

The Pharmacy Dispensing Unit (PDU) was unveiled on 25 September, during Pharmacy Month, at the central community shopping centre, which is on main transport routes and is open for extended hours including weekends and public holidays. The first such dispensing unit was launched in Alexandra in Gauteng in March this year.

The Pharmacy Dispensing Unit works like an ATM for medication, with Skype-like audio-visual interaction between patient and a remotely located tele-pharmacy contact centre. Patients are able to talk to pharmacists in a call centre 400km away in Centurion, Gauteng – showcasing the benefits of tele-pharmacy to patients in rural and outlying areas. This allows patients to access accurate medicine information and counselling from qualified pharmacy staff.

The dispensing data is hosted
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Famous local farmer in Tzaneen wins battle against governments expropriation plan

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Famous local farmer in Tzaneen wins battle against governments expropriation plan

A well-known Tzaneen farmer gave the government a big blow after the state attempted to expropriate the first farms in South Africa without fair compensation. Shortly before the Easter weekend, notice of expropriation was served to the owners of Akkerland Boerdery that include the farms behind the Soutpansberg Lukin and Salaita. The owners of Akkerland..
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Health Professions Council of SA pursues bogus health practitioners

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A rise in bogus health practitioners has forced the Health Professions Council of SA (HPCSA) and medical schemes to strengthen their forensics units to curb fraud. A team at the HPCSA is conducting about 400 investigations into bogus practitioners. To date, just more than 40 arrests have been made, but prosecutions are slow.

Data from this special investigation unit suggests that about 7% of all medical aid claims in SA are fraudulent and stem from both bogus practitioners and unscrupulous ones.

Estimates are that this type of fraud costs the private sector R22bn a year.

Bogus practitioners include those who had previously been registered with the HPCSA, but were struck off for various infractions, while others had no medical qualifications or experience and used practice numbers belonging to registered healthcare practitioners.

Eric Mphaphuli, a senior inspector at the council, said on Monday that, initially, his team had issues getting the police on board
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Medical negligence claims in public health sector rise by 25%

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The sorry state of the public health sector is reflected in the sharp rise in medical negligence claims against provincial health departments, increasing by around 25% per year between 2011 and 2016.
Medical negligence claims rise by 25%.

This is according to Kirstie Haslam, partner at DSC Attorneys who says that the Gauteng Department of Health receives a particularly staggering number of negligence claims each year. Since January 2015, it has been forced to pay out more than R1.017bn to settle 185 medical negligence claims.

“Deteriorating conditions in state hospitals, as well as incompetence and gross negligence on the part of staff members, are at the root of these claims – the majority of which were ruled in favour of the plaintiffs,” Haslam explains.

She points out that several shocking cases of gross medical negligence have received media attention over the past few years.

Birth injuries

Haslam says that medical negligence claims involving
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How to save on your medical aid

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JOHANNESBURG – Medical aid schemes. The essential but expensive line item in a monthly budget for the less than 20 percent of South Africans who can afford medical aid cover.

John October, Chief Executive of online insurance and financial comparison website, Hippo.co.za, says in many cases people are forced into medical aid schemes.
“Many have to take compulsory schemes through their employers or have the need for specific medical care or treatment that they cannot afford as an out-of-pocket expense.”

There are ways to minimise the cost of medical cover. How? Ask yourself the following questions:

Have you compared the costs and benefits you are currently receiving with other service providers? Maybe you are paying too much for the same cover.
What are your health requirements for the next year? Are you covered if you know you are planning to start a family? If not you could be charged extra at a later stage.

Are your dependents old enough to pay for
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Motsoaledi has ‘zero authority’ to help ailing hospitals

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Cape Town – Health Minister Aaron Motsoaledi says he has “zero authority” to improve the functioning of troubled state hospitals, which are all managed by provincial governments.

Motsoaledi told the portfolio committee on health on Thursday that a two-year ministerial task team report highlighted 19 key problems at hospitals in six provinces around the country.

The task team spent two years visiting the 25 hospitals, most of which were struggling with staffing issues, budget problems, high-level vacancies and poor service conditions.

The minister said all 19 findings fell broadly into four categories, none of which were in his control.

“My conclusion is that a minister in health has a huge responsibility, but zero authority where it matters the most,” he lamented.

“Such authority is with the MECs of both finance and health, their premiers and executive councils.”

The areas in which these hospitals are falling short include human resources, procurement
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Noord-Kaapse departement van gesondheid staar Miljoene rande se eise in gesig vir nalatigheid by 3 geboortes

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Die Noord-Kaapse departement van gesondheid kan hom regmaak vir eise van R60 miljoen vir skadevergoeding nadat hy mediese nalatigheid by die geboorte van drie babas erken het.

Die bedrae wat geëis word, moet nog in verdere verhore bewys word.

Dit volg op drie siviele gedinge wat die afgelope drie weke in die hooggeregshof in Kimberley teen die LUR van gesondheid ingedien is.

Die babas wat weens nalatigheid gestremd is, benodig heeltydse versorging en terapie. Geld moet ook vir hul toekomstige mediese behoeftes opsy gesit word.

Hul ouers moet onder meer ook sielkundige berading kry.

Die eise vir die babas beloop elk tussen R18 miljoen en R20 miljoen, en vir die ouers sowat R1,1 miljoen elk.

Die eis van ’n vrou wat heeltydse gesondheidsprobleme weens die bevalling ontwikkel het, beloop R1,8 miljoen.

Die mediese personeel in die drie gevalle word daarvan beskuldig dat hulle nie deurentyd die pasiënte en hul ongebore babas gemonitor en betyds regst
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To eat or not to eat at Wimpy? – Wimpy investigates claims of food tampering after customer alleged that her husband’s meal was spiked with feces

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Wimpy in i’langa Mall recently came under fire after a customer alleged on social media that her husband’s food was spiked with a “substance similar to feces” this past weekend. The customer, Mildri Parker Potgieter, was adamant to prove that it was intentionally placed there and took to social media. Even though it seems like..
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Faking an Illness:- This is how doctors can spot it!

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It’s one thing to cough and sniff in front of your parents or boss, but you need to realise that it’s a completely different matter to fake an illness to an actual doctor.

Most of us have faked a cough and sniffle to get out of going to school or work for a day. However, it usually does not involve lying to a doctor and faking symptoms to legitimize your sick leave.

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Transnet mediese fonds bankrot?

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Volgens vertroulike inligting wat ontvang is, blyk dit dat Transnet se mediese fonds in finansiële moeilikheid is.

Lede van die fonds gaan klaarblyklik oorgeplaas word na ‘n ander mediese fonds, maar lede sal baie meer moet betaal vir mediese dekking.

Oud Spoorweg werkers word veral geraak aangesien dit vir hul bykans onbekostigbaar gaan wees om die nuwe premies te bekostig.

Die Transnet pensioenfonds was in die verlede gereeld die hoof onderwerp in die media en moes oud spoorweg werkers hulle uiteindelik tot die hof wend om beter behandeling te kry.

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Free Medical-Aid, Hospital and Funeral Plan and Insurance Quotes at www.MedSure.co.za
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Noord-Kaapse LUR van gesondheid moet opdok vir bejaarde se onderbeen

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Die Noord-Kaapse LUR van gesondheid is Woensdag in die hooggeregshof in Kimberley beveel om die mediese en regskoste te betaal van ’n bejaarde man wat sy onderbeen weens mediese nalatigheid verloor het.

Regter Mpho Mamosebo het in haar uitspraak gesê dit ontstem haar dat ’n kundige soos dr. Qebelo Maseme, wat vir die LUR getuig het, partydig is. Sy het sy getuienis verwerp.

Patrick Erasmus (nou 76) se linkerbeen is in 2013 bokant die knie afgesit nadat hy aanvanklik vir ’n groottoon met infeksie behandel is.

Sy probleme het begin toe hy op 13 November 2012 vir ’n opvolgbesoek by ’n private dokter was.

Die dokter, wat intussen ’n skikking met Erasmus buite die hof bereik het, het ’n rekkie om die toon gebind om die toonnael te verwyder. Die toon is toegebind.

Twee besoeke later het die dokter Erasmus ingelig dat hy gangreen in die toon het en hom na die staatshospitaal in Kimberley verwys.

’n Senior dokter daar het op 20 November verde
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