By THANDI SKADE
Medical aid costs have gone up, benefits have been reduced and families are now faced with the choice of either going without some medical services or paying for them out of their own pockets.
Advanced dentistry and access to allied healthcare are among the major benefits either scrapped or diminished by SA’s two largest medical aid schemes this year.
This comes on top of annual increases in monthly subscriptions of more than 8 percent.
With over 2.1 million beneficiaries, Discovery Health is the biggest medical aid scheme. It increased premiums for 2012 by 8.9 percent. Its decision to introduce the single allied and therapeutic benefit, which now places a limit on providers like psychologists, occupational therapists and physiotherapists, has caused outrage.
Bonitas, the second-largest scheme with more than 600 000 beneficiaries, scrapped its advanced dentistry plan for Bonsave members, with members now having to pay for dental work like crowns and implants from their savings. Bonitas premiums were hiked by 8.4 percent.
So, as monthly contributions rise and the amount of cover a beneficiary receives goes down, is it worthwhile having medical aid cover?
The answer is yes, according to Professor Alex van den Heever, Old Mutual chairman of social security at Wits University. When something major or unexpected happens, you can’t afford not to have it, he said, but the government needed to do more to bring down the escalating cost of private healthcare, which was primarily driven by lack of regulation.
“The cost that people are experiencing are specialists charging over and above what medical aid schemes will pay. There has been no attempt to reasonably regulate private healthcare costs despite recommendations to do so. The failure to provide a reference price list has left the market open to abuse.”
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