Medical Aid

 

Best and worst medical aids in South Africa.

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The latest GTC Medical Aid Survey for 2016 has been released, which compares local medical aid schemes on price across various levels of cover.

According to the latest General Household Survey from Stats SA, only 17.5% of South Africans are covered by medical aid.

Between 2002 and 2015, individuals who were covered by a medical aid scheme increased from 7.3 million to 9.5 million persons.

According to the Council for Medical Schemes’ Annual Report, released in July 2015, 37.55% of all medical aid costs were in-hospital, followed by 23.51% from specialists of which less than 10% was attributable to out-of-hospital services.

This reflects a total of almost 61% of healthcare costs paid for by medical aids were for in-hospital procedures. Expenditure on all health benefits by medical schemes rose by 11.1% in 2014 to reach R124.1 billion.

The GTC makes an admission that trying to compare medical aid schemes in a comprehensive way is virtually impossible due
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‘No money for medicines’ shock – What is going to happen to the patients ???

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Patients’ anti-depressant, anti-anxiety drugs cut – but department denies shortage

State patients needing anti-anxiety drugs or anti-depressants are being turned away from Provincial Hospital’s outpatient clinic and told by the nurses to buy their own drugs or that they do not need pills to stop an anxiety attack.

“I have lost so much weight that I now fit in a size 30 dress,” Cilla Uys, 67, said.

She developed an anxiety disorder after her husband was murdered. “I need my pills.”

Petro Wessels said: “They told me to drink less coffee and exercise more.”

Shelly Strimling, 50, was given a prescription for her anti-depressants on Thursday and told to go and buy the pills herself at the pharmacy. They cost R485.

“There are many others like me,” she said. “I am collecting letters of complaint to take to the Department of Health.”

Strimling has been a state patient for eight months.

When she went to collect her pills at the
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Groote Schuur Hospital and UCT break ground on neuroscience centre

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Work has begun on a state-of-the-art Neuroscience Centre at Groote Schuur Hospital (GSH), which will be the hub for neuro-clinical disciplines at the hospital and University of Cape Town’s neuroscience research programme.

The centre will be home to the newly-established UCT Neuroscience Institute together with the GSH Clinical Neuroscience Centre, where researchers and clinicians will work together to treat the brain and nervous system disorders that burden the South African population.

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

“UCT has invested in new interdisciplinary research institutes to address important problems facing our society,” says Dr Max Price, vice-chancellor of UCT. “The Neuroscience Institute is one of these
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Is your GP contracted in to a medical scheme network?

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If GPs are contracted in to a medical scheme network, they might be pressurised to recommend cheaper treatment options and medications, say SA health bodies.

The Board of Healthcare Funders (BHF) and the IPA Foundation (IPAF) is extremely concerned at the comments made recently by the Health Professions Council of South Africa concerning Designated Service Providers (DSPs).

The HPCSA recently released a statement to the effect that healthcare practitioners should be cautious when concluding designated service provider (DSP) agreements with medical schemes as the medical schemes attempted to reduce costs by applying pressure on practitioners within a DSP network to prescribe medication or recommend treatment options, when other more appropriate, albeit more expensive, options were medically indicated and readily available.

Pushing healthcare costs down

In the current environment where there are no regulated tariffs for healthcare procedures,
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Malaria still kills so many due to fake drugs

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Malaria, a mosquito-borne parasitic infection that affects about 3.2 billion people in 95 countries, has become largely a disease of the young and poor.

Due to effective medications like chloroquine and artemisinins, malaria deaths dropped an estimated 60 percent worldwide between 2000 and 2015. The Americas and Africa saw the greatest improvements.

Still, 216 million new cases of malaria were reported in 2016, the latest data available. Most of them occurred in Nigeria, the Democratic Republic of the Congo, Uganda, Ivory Coast and Mozambique. And of the 445,000 people who died from the infection, about 70 percent were children under the age of 5.

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

If malaria is a curable disease with ef
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Most affordable medical aid schemes and hospital plans in South-Africa for 2017

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The medical aid industry saw a massive shake-up in April as National Treasury introduced new regulations which will see a limit on the amount of gap cover and hospital cash-back policies you can claim, as well as the discontinuation of all primary healthcare policies.

This is was done in an effort to differentiate between “medical scheme products” and “health insurance”, both of which are regulated by separate Acts causing confusion in the medical arena.

The new regulations will now outlaw all primary healthcare policies from 1 April. According to legislation these are not seen as full medical schemes, instead providing limited medical service benefits, such as GP visits, basic dentistry and optometry, and some acute and chronic medication.

The new laws also stipulate that hospital cash-back plans are limited to paying their clients a maximum of R3,000 per day, or a total lump sum of R20,000 per year. Currently there are no limits in place for these pa
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Why opting out for a cheaper medical cover can cost you in the long run

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Medical cover is expensive, and getting more so every year. Unfortunately this could mean we opt for lower monthly premiums that could mean you aren’t covered in the event of an expensive procedure.

The South African Society of Anaesthesiologists (SASA) is advising South Africans to consider the multiple factors affecting cover when choosing access to medical care.

The SASA understands that healthcare is often hard to comprehend and expensive to access. As a result, the Society believes, many consumers choose their medical plans – including how much cover it offers and whether care is provided at public or private institutions – based on the principle of “what can I afford monthly”.

“The truth is, most people look at cutting their medical costs in an effort to reduce their household spend when they feel an economic pinch. This is a difficult decision, since we’d all like to have access to the best facilities and treatment with the least out of pock
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Public comment open soon for The National Health Insurance Bill of 2018

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The National Health Insurance (NHI) Bill of 2018 will be published in the Government Gazette shortly for public comment.

A key provision of the bill will be the establishment of an NHI fund to pay for health services so that all South Africans have access to quality care.

“The bill seeks to establish the NHI Fund of South Africa, as a public entity, so as to provide for a sustained universal health access that is affordable and of high quality. It also sets out its functions, powers and duties,” Cabinet said in a statement following its regular fortnightly meeting.

The bill provides a framework for the active purchasing of health care services by the fund on behalf of users and creates mechanisms for the equitable, effective and efficient use of the resources of the fund to meet the health needs of users.

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With winter around the corner, you need to know what flu really feels like !!!

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You’re sneezy, stuffed up, and feel bad all over. Is it a cold, or do you have the flu?

The symptoms can be a lot alike. But if you know the warning signs of the flu, you can get treatment quickly and work on feeling better, sooner.

What You Need to Know

Unlike a cold, flu symptoms usually come on suddenly. Another key difference is a fever, which might not happen with a cold. You might also have:

– Severe aches in muscles and joints
– Pain and tiredness around your eyes
– Weakness or extreme fatigue
– Warm, flushed skin and red, watery eyes
– A headache
– A dry cough
– A sore throat and runny nose

Adults with seasonal flu don’t usually vomit or have diarrhea, but children might.

Some symptoms can mean your illness is severe. Get immediate medical help if you have any of the following:
– Trouble breathing or shortness of breath
– Pain or pressure in your chest or belly
– Sudden
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Is Dr Aaron Motsoaledi fiddling while healthcare is burning?

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Despite the Life Esidimeni tragedy, non-existent oncology services in some provinces, striking healthcare workers and a damning quality standards report before parliament, Health Minister, Dr Aaron Motsoaledi seems to be labouring under the delusion that the South African public healthcare system is not collapsing.

Speaking at a media briefing, the minister said he was not aware of any scientific methods used to measure the veracity of the claims made about the breakdown of the health system.

“I am not here to challenge that because I do not know the yardstick that was used to arrive at a conclusion of collapse. Surely healthcare systems are measured on some form of scientific yardstick to arrive at any conclusion.”

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Have you factored in medical expenses into your retirement savings?

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People often believe that if you gather significant assets during your lifetime and put enough into your retirement or pension fund during your career, you don’t have to worry about living comfortably in your later years. But in an environment where medical costs are rising and markets are constantly fluctuating, is that really true?

Here’s a figure that might be surprising if you are planning to retire soon and haven’t considered your health care costs. If you are 65 and retiring this year, you will need about R990 000 during retirement to keep up the same cover you currently enjoy. For a couple, that total is about R1 990 000. (assuming you are on the Discovery Health Medical Scheme, on the Classic Delta Comprehensive Plan, a contribution of R4059 to your plan, and that your retirement grows in line with medical inflation- currently CPI +4%)

These numbers are based on the assumption that a man will live to be 85 and a woman 87, however with publications lik
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The case for a restricted medical scheme

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With the sustainability of medical schemes coming under increasing scrutiny, many companies may be left wondering whether offering restricted medical scheme membership to their employees is still a viable benefit.

Restricted membership medical schemes – those not open to the public and where membership eligibility is dependent on working in a certain industry sector, company, professional association or trade union – are gradually giving way to the larger open membership schemes that anyone can join.

That being said, restricted medical schemes have again achieved the highest scores in the Alexander Forbes Health Medical Schemes Sustainability Index released in January. SAMWUMED and Polmed (the top scorer for the third consecutive year), were once again top performers in the index.

It is evident that by pooling together certain individuals, restricted medical aids are able to better manage their risk exposures in some instances, collect premiums more easily f
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Manage your medical expenses during winter season to obtain optimal value

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To obtain optimal value from your medical scheme plan, it’s critical to fully understand the scope of benefits it offers and to manage those prudently.

To obtain optimal value from your medical scheme plan, it’s critical to fully understand the scope of benefits it offers and to manage those prudently. It’s an especially important consideration during the winter months. This is according to Dr James Arens, clinical operations executive at Pro Sano medical scheme.

Minor ailments like a recurrent common cold, for example, may not necessarily require repeated doctor visits that could potentially use up benefits that might be more appropriately used elsewhere.

Dr Arens points out that the economic climate in recent years has seen many South Africans downscaling on their lifestyles.

“This often means ‘buying down’ when it comes to medical scheme cover. It’s understandable that when money is scarce, people wish to pay as little as possible while sti
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Desperately seeking: A viable healthcare payment system

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South Africa’s private healthcare sector is under severe pressure, particularly with rampant inflation tracking at rates higher than CPI, creating a system that will eventually, in the not too distant future, become unsustainable.
In fact, at the end of last year, most of the country’s medical aids announced double-digit premium increases for 2017.

“Issues that are blamed for the high cost increases include; advancement in medical technology, cost of importing medical technology, administrator fees, broker fees, supplier induced demand, member over use, aging profile of medical scheme and therefore higher claims ratios, increased rate of illness in populations, legislative changes, incentives in the system.
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What to consider when deciding on 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.

The ICPA advises on several important things you should look at when considering a new medical scheme or reviewi
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