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Is your medical aid ripping you off? MediCheck can help you resolve claims

27 January 2021 8:25 AM

R35 billion spent by members out of their savings, which is their own money, or out of pocket this past year, says Mark Hyman.

Have you had a medical claim declined by your medical aid even though you were told it would be covered?

Sometimes these are due to certain conditions that need to be met and other times it is due to an admin error.

MediCheck's Mark Hyman talks to Refilwe Moloto about how they will help you get to the root of the issue and check if the decision is valid.

MediCheck is a consumer activist organisation.

It handles for the first time in the country, the member's problems that he has with his medical aid.

Mark Hyman, Joint Chief Executive Officer and Marketing and Operations - MediCheck

MediCheck covers all 75 medial aids whether they are open or restricted schemes, he explains.

It is our function and duty to assist members in the resolution of claims with their medical aid.

Mark Hyman, Joint Chief Executive Officer and Marketing and Operations - MediCheck

Hyman says there has been rising out of pocket expenditure for South Africans who are on medical aid schemes.

Consumers may not realise that when they walk into a pharmacy or visit the doctor, while they are not seeing an account, the bottom line is they are still paying.

In the last year, R35 billion has been expended by members out of their savings, which is their own money not the medical aids' money, or out of their own pockets.

Mark Hyman, Joint Chief Executive Officer and Marketing and Operations - MediCheck

Many of these payments occur in terms of co-payments and levies if the member has visited a doctor not designated by the service provider, or where the medical practitioner has incorrectly coded a diagnosis, he explains.

South Africans pay 55% more out of pocket in the past 5 years.

Mark Hyman, Joint Chief Executive Officer and Marketing and Operations - MediCheck

Listen to the interview below:




27 January 2021 8:25 AM

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