Nearly half SA’s medical aid members are being ‘denied’ financial help - these schemes don't assist
- Medical aids could apply for exemptions that would allow them to give financially-stressed members a break during Covid-19.
- With such an exemption, schemes could allow members to use their medical savings to pay contributions, or defer their payments without losing coverage.
- But schemes that look after nearly half the medical aid members in SA never applied, their regulator says.
- For those people "their schemes seem not to be acting in their best interests" said the Council for Medical Schemes (CMS) on Thursday.
- Here is the list of schemes that have – and have not – applied for the power to help their members.
- For more stories go to www.BusinessInsider.co.za.
Medical schemes that provide around half of South Africans with medical cover "seem not to be acting in their best interests", regulator the Council for Medical Schemes (CMS) said in a strongly-worded circular on Thursday.
As the coronavirus disaster loomed, the CMS set up an exemption process that would allow tightly-regulated medical aids to waive some contributions and make other arrangements with members who had fallen on hard times.
It was critical to maintain medical cover wherever possible, the CMS said.
But many schemes simply did not apply for the exemptions offered.
In those schemes, "beneficiaries have been denied of this relief despite extreme Covid-19 conditions", said the CMS, with a promise to "monitor this inaction in the interest of protecting medical scheme members".
According to CMS records, just over four million South Africans are covered by the schemes that have not applied for special dispensation.
Schemes that have applied have options that include reducing the contributions stressed members are due to pay for three months, defering those contributions entirely for three months, or allowing for contributions to be paid by way of money held in medical savings accounts.
Only 19 schemes applied for those powers, although they include some of the biggest open schemes in the country, and so account for 4.9 million people.
These are the schemes that applied for exemptions, and can offer members financial relief, according to CMS records.
- Bestmed Medical Scheme
- Bonitas Medical Fund
- Compcare Wellness Medical Scheme
- Discovery Health Medical Scheme
- Fedhealth Medical Scheme
- Makoti Medical Scheme
- Medimed Medical Scheme
- Medshield Medical Scheme
- Momentum Health
- Spectramed (HEALTH SQUARED MEDICAL SCHEME)
- Motohealth Care
- Nedgroup Medical Aid Scheme
- PG Group Medical Scheme
- Quantum Medical Aid Society
- Remedi Medical Aid Scheme
- Tsogo Sun Group Medical Scheme
- Witbank Coalfields Medical Aid Scheme
These schemes have not yet applied for exemptions, and the CMS worries their members may suffer.
- Cape Medical Plan
- Genesis Medical Scheme
- Hosmed Medical Aid Scheme
- Resolution Health Medical Scheme
- Selfmed Medical Scheme
- Sizwe Medical Fund
- Suremed Health
- Topmed Medical Scheme
- AECI Medical Aid Society
- Alliance-Midmed Medical Scheme
- Anglo Medical Scheme
- Anglovaal Group Medical Scheme
- Barloworld Medical Scheme
- BMW Employees Medical Aid Society
- BP Medical Aid Society
- Building & Construction Industry Medical Aid Fund
- Chartered Accountants (SA) Medical Aid Fund (CAMAF)
- De Beers Benefit Society
- Engen Medical Benefit Fund
- Fishing Industry Medical Scheme (Fishmed)
- Food Workers Medical Benefit Fund
- Glencore Medical Scheme
- Golden Arrow Employees' Medical Benefit Fund
- Government Employees Medical Scheme (GEMS)
- Grintek Electronics Medical Aid Scheme
- Horizon Medical Scheme
- Impala Medical Plan
- Imperial Group Medical Scheme
- LA-Health Medical Scheme
- Libcare Medical Scheme
- Lonmin Medical Scheme
- Malcor Medical Scheme
- Massmart Health Plan
- MBMed Medical Aid Fund
- Medipos Medical Scheme
- Naspers Medical Fund
- Netcare Medical Scheme
- Old Mutual Staff Medical Aid Fund
- Parmed Medical Aid Scheme
- Pick n Pay Medical Scheme
- Platinum Health
- Rand Water Medical Scheme
- Retail Medical Scheme
- Rhodes University Medical Scheme
- South African Breweries Medical Aid Scheme (SABMAS)
- SABC Medical Aid Scheme
- Sisonke Health Medical Scheme
- South African Police Service Medical Scheme (POLMED)
- TFG Medical Aid Scheme
- Tiger Brands Medical Scheme
- Transmed Medical Fund
- Umvuzo Health Medical Scheme
- University of Kwa-Zulu Natal Medical Scheme
- University of the Witwatersrand, Johannesburg Staff
- Wooltru Healthcare Fund
(Compiled by Phillip de Wet)
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