Tag: medical scheme

Healthcare in South Africa is in a state of flux due to a shifting regulatory landscape compounded by the current economic challenges the country is facing. This environment can be complex and challenging to navigate for most people, even if they have already purchased health cover products.

The South African government started discussing the National Health Insurance (NHI) in 2003. After several poor attempts at starting, most people thought that a fully funded first-world healthcare system could never become a reality.

Benefits are an important part of attracting and retaining talent for corporates, and these offerings can often be a point of differentiation. As such, many businesses have started to offer Employee Assistance Programmes (EAP) to cater to physical, financial and mental health, along with the more common medical aid, pension and provident funds.

The South African government started discussing the NHI (National Health Insurance) in 2003. After several poor attempts at starting, most people thought that a fully funded first-world healthcare system could never become a reality. Furthermore, the role of medical schemes was not clear since no policy direction exists in this regard from the Department of Health. Many medical schemes have since come out supporting the NHI, realising there is room for collaboration and more fundamental co-existence of the two healthcare systems.

Access to quality primary health care will address around 90% of our population’s health needs throughout their lives, largely through early detection and prevention of disease, preventative care and health screenings including vaccinations, cancer screenings, pre-natal and antenatal care, as well as ongoing management of chronic conditions, building a more resilient, healthier, productive population.

During the worst of the COVID-19 pandemic, medical claims looked very different to the usual patterns. Now, however, the COVID-19-bubble has burst, and we are beginning to get back to greater levels of normalcy. One thing that COVID-19 highlighted was the need to have adequate healthcare in place.

Many South African’s feel the economic impact of the pandemic, which has ultimately affected their pocket. People are forced to make difficult decisions in order to rearrange their finances to suit their current financial constraints. 

As the number of confirmed Coronavirus COVID-19 cases rise every day in South Africa, many people are wondering whether they’ll get adequate medical attention should they be diagnosed with the virus.

The circular released on the 10th April 2020 by the Council for Medical Schemes (CMS) entitled 'COVID-19 Medical Schemes Industry Guidelines' outlines the relief measures which schemes may offer their members – individuals and employer groups – detailing what they can and can’t do to alleviate the economic suffering during this pandemic and lockdown period.

Medical aids have released their rates for 2020, and there are increases ahead of inflation. While it may not seem that way to the end customer, medical aids are locked in a delicate balancing act to maintain a tolerable level of increase and keep private healthcare affordable.