We entered 2017 reeling from a series of double-digit medical insurance premium hikes. It was becoming clear that schemes are in trouble; undercut by unregulated, selective insurance products and forced into tighter and tighter modes of managing care delivered. We were facing an affordability crisis then – that, without serious systematic change, schemes will be..
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Private healthcare in SA – continued decline and a solution
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So kies jy die regte mediese plan vir jou
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Hospitaalplanne, omvattende dekking, netwerkopsies . . . Besluit watter opsie vir jou die beste is. As jy lid is van ’n mediese fonds, het jy tot 15 Desember kans om jou voordeleopsie vir 2018 te verander. Oorweeg jou gesin se omstandighede: Hoeveel is julle; hoe is jul gesondheid; wat kan jy bekostig? Besluit dan watter..
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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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Mediese selfbetalings styg met skokkende 13,4%
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Die brood het gekrimp, maar ons betaal nou meer daarvoor. Só het ’n ekonoom die verhoging van meer as 13% in selfbetalings deur mediesefondslede die afgelope jaar beskryf. Verbruikers wat elke jaar swaar trek aan die premies vir hul mediese fondse het boonop nog verlede jaar R29,7 miljard uit hul eie sak opgedok. Dit is..
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Syndicates and devious health professionals may target National Health Insurance
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Criminal networks are targeting your medical aid rands but could you be part of the problem too? Criminal syndicates and unscrupulous doctors may be defrauding the private health sector of millions as experts warn that medical schemes may reach a breaking point. “The health care sector is being targeted by criminal syndicates and even devious..
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Genesis wins case on accounting for use of medical savings funds
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On Tuesday, the Constitutional Court ruled that all funds paid by members to their schemes should be considered as assets, regardless of their intended use. Genesis medical scheme has won its legal battle with the Council of Medical Schemes over how to account for the funds in members’ medical savings accounts (MSAs), a development that..
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Making Sense of Medical Aid Rates and Tariffs
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The medical aid industry is known for confounding consumers with all sorts of complex terms. Among the most confusing of all are references to medical aid, or medical scheme, rates. Schemes and plans are quoted as covering the costs of in-hospital procedures up to 100%, 200% or 300% of the scheme rate or tariff. You..
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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..
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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..
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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..
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