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SPECIAL REPORT: MEDICAL COVER OPTIONS
NHI turmoil makes private health schemes' role uncertain
Me d i c a l ai ds gra p p l e wi th c han ge
Reports by Lynette Dicey SA’s two-tier health care system continues to be challenged by a high disease burden and limited resources in the public sector, leading to significant inequalities in care. About 16% of the population contribute to medical aid schemes, providing them with access to private sector health care. The high cost of medical aid membership is one of the biggest challenges facing schemes. Many South Africans in formal employment are not members of medical schemes though they do use private primary healthcare services. To better meet the needs of this sector of the market, a number of companies including retailers, insurers and even hospital groups have introduced alternative insurance solutions that provide more affordable access to private health care. These insurance products are different from the plans offered by medical aid schemes.
Thursday July 20 2023 Sowetan
Public queues at Covid-19 vaccination facilities. / S A N D I L E N D L O V U Their greater affordability is because they don’t need to cover the prescribed minimum benefits (PMBs) that medical schemes are required to pay for. It is estimated that healthcare insurance products pro-
vide cover to about 1-million South Africans. The health insurance market has experienced good growth in recent years, showing the strong demand for these types of products.
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WINNER 2023 MEDICAL SCHEME OF THE YEAR AT THE NEWS24 BUSINESS AWARDS Sowetan Page 14,Thursday July 20 2023
The Council for Medical Schemes (CMS) has been working on a framework which would exempt schemes from offering PMBs and allow them to offer more affordable plans, something which medi-
cal schemes argue would alleviate pressure on the already over-burdened public health sector. The big question now, how■ Continued on Page 15