Overhaul planned for medical aid prescribed minimum benefits

The Council for Medical Schemes is reviewing the basic benefits that a consumer gets when joining a medical aid scheme. These are the costs medical aids schemes are obligated to cover no matter what the circumstances.

Dr Sipho Khabani, Senior Strategist at the Council for Medical Schemes, says the review is mandated by the National Medical Schemes Act, to be conducted every two years.

We are bringing this now to make sure that the benefit package that is offered to beneficiaries is in line with the prescribed technologies, is effective and in line with national health policies.

Dr Sipho Khabani, Senior Strategist at the Council for Medical Schemes

Currently there is a list of 270 conditions, 25 chronic conditions as well as the surgical procedures as part of the minimum prescribed benefits.

Khabani says the current minimum package has a lot of areas which are not covered.

He says this needs to be affordable and should cover the main essential conditions.

To hear more about the prescribed minimum benefits, listen below:


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