Spiralling healthcare costs have resulted in medical schemes introducing measures to contain what is spent on treating members to what is necessary and appropriate.
Some of South Africa’s biggest medical schemes have announced significant contribution hikes for 2017. Even more worrying is that, on some schemes, the increases were accompanied by a reduction in benefits, which means that members will be paying more for less.
Choosing a medical scheme that requires you to use networks of general practitioners (GPs), specialists, optometrists, pathologists or pharmacists doesn’t mean you will receive poor-quality treatment.
Many members blame their medical schemes for not paying their bills, or complain that schemes make big profits, but these false accusations have their roots in myths about how schemes operate. When you join a medical scheme, you belong to a community where the members rely on each other for support. A scheme operates like a mutual society or stokvel, rather than an insurance company.