Minister of Health, Dr Aaron Motsoaledi, is planning a major shake-up for the medical aid scheme industry that will give consumers a better deal.
Motsoaledi said that he had presented the proposals to a cabinet committee on Tuesday. The most crucial aspect of the Medical Schemes Amendment Bill was a proposal to introduce uniform tariffs for services and to prohibit co-payments.
A co-payment is the amount the medical scheme owner must pay out of their own pocket for a particular treatment or procedure. The treatments and procedures differ from medical scheme to medical scheme.
Services such as immunisation and contraception for women are co-payments, and Motsoaledi believes that these should fall under primary health care. “We want to replace Prescribed Minimum Benefits with something called Basic Minimum benefits or BMB, in other words, the minimum medical schemes must start paying for primary health care,” the Minister said. “So they must pay for things like immunisation, they must pay women for contraception and they must pay for prevention of diseases.”
He also adds that R90 is paid to a broker that the medical scheme account holder did not select. Instead, this broker is selected by the medical aid scheme.
“We would like to introduce a regulating body to medical aid schemes,” Motsoaledi said. “Currently, medical aid schemes can basically do as they please with their customers.”
But our medical aid ya cheat(a) baby girl… we pay close to R30k and only have access to R3k for GP visits. They know very well there’s a very slim chance of us of using the hospital plan that we also pay for
— Gosiame Malepe (@GoldenSuprise) May 17, 2018
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