Could you be the first medical scheme consumer champion?

By Staff Writer

The Council for Medical Schemes (CMS) is on the hunt for a medical scheme consumer champion and has embarked on a campaign entitled ‘it starts with you’ to find the right candidate by the 31 August 2013.

Empower yourself with knowledge
Dr Monwabisi Gantsho, chief executive of Council and Registrar of medical schemes said it was time for South African consumers to stop being armchair critics and slacktivists and become actively involved with the running of their medical schemes.

“Medical scheme members must take ownership of their schemes. They can start by reading their medical schemes’ specially produced booklets, brochures and rules and by attending the annual general meeting (AGM) of their medical scheme.

Members must make an effort to understand the rules and to follow them. By all means make your scheme work for you but make sure that you are doing your share. Ask questions when necessary and be pro-active,” adds Dr Gantsho.

How do you become the CMS’ champion?
The CMS is looking for someone who is active, engaging and passionate about finding out everything there is to know about their medical scheme. To demonstrate this, you have to share news of what you have done to become more proactive on the CMS' website or through its Facebook or Twitter page, which is accessible from the CMS website.

If you are crowned South Africa’s first medical aid champion (MAC) you will have the equivalent of your medical scheme contribution paid for by the CMS for the remaining three months of 2013. You will also be awarded with a super hero T-shirt worn by medical aid champions on CMS’s billboard ads. Winners will be notified by 17 September 2013.

It starts with you
Dr Elsabé Conradie, head: stakeholder relations at CMS, said the campaign provides South Africans with the opportunity to find their voices and become empowered. She added that there are lots of ways in which MACs can empower themselves including:

• Doing their research before selecting a medical scheme to make sure the scheme meets their needs.

• Finding out what medical scheme offerings there are and comparing them. This can be done through active research and by comparing medical scheme benefits and rates.

• Understanding what prescribed minimum benefits is and under what circumstances their scheme provides cover to members.

• Finding out what their medical schemes reserves (solvency ratio), non-healthcare expenditure, such as administration costs are, to ensure the right medical scheme is selected for their needs and that they are in good health.

• Having a closer look at the various options their own medical scheme provides. By doing so they could substantially reduce their monthly contributions.

• Reporting suspected fraud committed by a medical scheme broker, broker organisation, managed care organisation, administrator, doctor, healthcare practitioner, medical scheme or employee to their own medical scheme’s tip-off line or the CMS’s tip-off anonymous hotline. Call the CMS toll free number on 0800 867 423 or email them cms@tip-offs.com. This could substantially reduce the cost of fraud and potentially result in their medical scheme fees being lowered. Each member of a medical scheme in South Africa is estimated to be paying about R2 500 and R2 800 a year to cover fraudulent and irregular expenditure.

• Not using their medical savings to buy sunglasses and other non-medical items.

• Attend their scheme’s AGM to meet their Board of Trustees and nominate new Trustees to serve on the Board.

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