Guiding consumers since 2009

Primary healthcare to go, gap cover and hospital cash plans to stay

By Alina Hardcastle

The National Treasury has introduced two new medical scheme regulations which will set a limit on the amount of gap cover and hospital cash-back policies you can claim, as well as the termination of all primary healthcare policies.

Heidi Kruger, Justmoney’s medical expert, said: “The purpose of these reforms is to bring about better alignment between insurance policies and medical schemes by making insurance products complementary to medical scheme products.  They also seek to avoid the undermining of medical schemes e.g. by discouraging members of medical schemes from buying down to lower cost options.”

The regulations, which were demarcated in terms of the Long-Term and Short-term Insurance Acts, will come into effect on 1 April 2017 for the new policies and from 1 January 2018 for existing policies.

The new pay-out limits for gap cover and hospital cash plans

The new regulations stipulate that hospital cash-back plans are limited to paying clients a maximum of R3000 per day, or a total lump sum of R20, 000 per year; and the gap cover policies will be limited to a pay-out of R150, 000 per annum, per client.

Say goodbye to primary healthcare insurance policies

The regulations have also stated the Council for Medical Schemes (CMS) must come up with low cost medical scheme products within two years to replace the current primary healthcare insurance products.

Kruger said: “This is a very constructive move as it will allow lower income individuals to enter into the private healthcare environment, increasing the number of people on medical schemes and therefore increasing the risk pool.”

“The challenge will be for the National Department of Health, the CMS and the medical schemes industry to review the Prescribed Minimum Benefits (PMBs) and to amend the current Medical Schemes Act in such a way as to enable this to occur in a sustainable way.” 

Handy tip: Are you looking for a competitive quote on your medical insurance? If so, click here and fill out the form and a consultant will be in touch.

 

Recent Articles

Featured What impact does compound interest have on your savings and debt?

Interest plays a big role in your savings and debt. It determines how much you’ll receive for keeping your money in the bank and it also determines how much you’re going to pay your creditors. But what power does compound interest have on your finances?

Times are tough, but keep your debt under control

While the whole world is going through a rough patch, you may also be feeling the pinch. With the country in crisis, it may be difficult to keep up with your debt instalments. However, abandoning your debt obligations is not the solution.

Debt Series Part 2: Interest rates - unpacked

In the second part of our Debt-ucate series we explore interest rates –from how to get a better rate to what influences it, and how this affects the cost of your debt.

Debt counselling – the two sides of the coin

Being overindebted doesn’t just put a strain on your personal finances; it also puts a strain on your state of mind. The best solution is to start the process of debt counselling so that you can escape the debt cycle. But what are the ups and downs of joining this debt relief programme?

Deals

Chartered Finance Institute Free Course

Price: Available on request
When: Daily
Where: Online

Takealot Lockdown Specials

Price: Available on site
When: Daily
Where: Online

Woolies Winter Sale

Price: Available on request
When: Daily
Where: Online