nottheaverageactuary

Actuarial news and views from Cape Town and beyond

The list medical schemes won’t give their members

2 Comments

Today’s article on MoneyWeb sheds some light in a potential dark corner in Medical schemes.

In essence, Medical Schemes are required by law to cover a list of 26 Chronic illness, medical emergencies, plus an additional 270 conditions, however it seems near impossible to get this 270-long list from medical schemes, and thus difficult if not impossible to confirm that you are not paying for services that should be provided free of charge..

This is very interesting and makes one wonder about fair treatment, or perhaps it is just a lack of understanding (and communication?), either way it will benefit members if addressed.

Even more relevant given our upcoming debate!

See more here:

http://www.moneyweb.co.za/news/industry/the-list-medical-schemes-wont-give-its-members/

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2 thoughts on “The list medical schemes won’t give their members

  1. Hi Landi, what do you mean by services that should be provided free of charge ? My understanding is that some of your contribution should still go towards funding PMBs and cover for those 270 conditions ?

  2. Hi Darryn, with free of charge I meant that there seems to be some treatments, knowledge of which does not seem to be easily accessible, that might currently be paid for from a member’s MSA (Medical Savings Account) for example, that should have been included as a minimum as part of the cover (paid for by the medical scheme). Thus “free-of-additional-charge” I suppose 🙂

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