Posts tagged with 'Prescribed Minimum Benefits'

 

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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Health Market Inquiry:- calls for medical aid schemes to be transparent

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A report by the Health Market Inquiry (HMI) looking into the private healthcare industry has recommended that there be increased transparency and improved competition.

The HMI released its provisional report on Thursday after hearing evidence from a number of stakeholders in the past three years.

The inquiry, which is chaired by the ex-Chief Justice, Sandile Ngcobo, was set up to look into the costs of healthcare and the operations of medical schemes.

“Overall we recommend changes to the way scheme options are structured to increase comparability between schemes and increase competition in that market.

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

“A system to increase transparency on health outcomes to allow for value purch
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Medical Schemes amendments could threaten schemes’ sustainability

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While the proposed amendments to the Medical Schemes Act seek to lower the cost of private healthcare, they may have the unintended consequence of threatening the sustainability of medical schemes.

The amendments look at abolishing the practice of copayments on certain benefits, removing waiting periods and prescribed minimum benefits and tapping into the reserves medical schemes are required to hold.

These provisions in isolation could affect the financial stability of medical aids, says Lerato Mosiah, CEO: Health Funders Association (HFA). “Whilst we welcome the dialogue in the sector, it is critical that this takes into consideration the broader picture and context. It is thus important to understand that medical schemes utilise risk management measures in order to ensure that they remain viable.

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The Health Department might be sued over proposed NHI changes

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‘I can’t mention who are the parties I am expecting litigation from but I can assure I know who they are. Health Minister Aaron Motsoaledi is preparing to be taken to court as he continues to propose changes in the healthcare system that could cost medical aid schemes millions.

Motsoaledi introduced the draft Medical Schemes Amendment Bill and National Health Insurance (NHI) Bill in Pretoria this week. The new legislation proposes significant changes to the way healthcare is funded and managed, including abolishing co-payments, prescribed minimum benefits and waiting periods for medical aid cover.

Medical aid schemes currently hold about R 60-billion in reserve — an amount almost 10% higher than what is statutorily required, said Motsoaledi speaking at a Pretoria press conference.

“These huge reserves were accumulated partly through high premiums but also by introducing the co-payments such that medical schemes avoid having to pay or even dip into the
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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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New Act could redress medical scheme sustainability issues

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Health Minister Aaron Motsoaledi has hinted at a number of reforms that directly address challenges of sustainability that the medical schemes industry is currently facing.

“We know that rising costs in healthcare are outstripping inflation, and legislated steps to address this are overdue. The proposals will usher in a new set of rules for how medical schemes operate,” says Mark Arnold, principal officer of Resolution Health Medical Scheme.

“While the details of how uniform tariffs for healthcare providers will be arrived at are not expected to be addressed in the Medical Schemes Amendment Bill, but rather will be informed by the outcome of the Competition Commission’s Health Market Inquiry, this is an important step towards protecting healthcare consumers.”

Looking for a affordable Medical Aid or Hospital Plan, just click here Medical Aid or just
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Medical aid waiting periods and late-joiner penalties: What. How. Why?

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The world of medical schemes in South Africa is a very different one to 25 years ago. There are strict rules and regulations governing the industry, there to protect both the members and the financial sustainability of the scheme. Now is the time of year when medical schemes announce their annual increases and benefit changes…
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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..
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