{"id":150685,"date":"2017-01-16T11:58:17","date_gmt":"2017-01-16T09:58:17","guid":{"rendered":"https:\/\/businesstech.co.za\/news\/?p=150685"},"modified":"2017-01-16T11:58:17","modified_gmt":"2017-01-16T09:58:17","slug":"big-medical-aid-changes-are-coming-sooner-than-you-think","status":"publish","type":"post","link":"https:\/\/businesstech.co.za\/news\/finance\/150685\/big-medical-aid-changes-are-coming-sooner-than-you-think\/","title":{"rendered":"Big medical aid changes are coming sooner than you think"},"content":{"rendered":"<p>The Council for Medical Schemes has <strong><a href=\"http:\/\/www.medicalschemes.com\/files\/Circulars\/Circular1Of2017.pdf\">announced plans<\/a><\/strong> to review the prescribed minimum benefits\u00a0(PMBs) offered to policy holders, in order to bring it in line with the upcoming National Health Insurance (NHI) legislation.<\/p>\n<p>The Medical Schemes Act currently states\u00a0that\u00a0270 Prescribed Minimum Benefits must be provided to all members at cost, establishing a basic standard of care to all policy holders.<\/p>\n<p>One of the\u00a0concerns surrounding this prescription is that it\u00a0prohibits low-income persons from accessing medical aids due to its affordability.<\/p>\n<p>National Treasury recently introduced two controversial\u00a0regulations aimed as easing in NHI policies,\u00a0including a limit on the amount of gap cover and hospital cash-back policies members\u00a0can claim, as well as discontinuing\u00a0all primary healthcare policies.<\/p>\n<p>The move has been met with mixed reactions: in theory, healthcare will become increasingly affordable in South Africa\u00a0&#8211; but at the cost of the overall level of care, which will see a legislated decrease.<\/p>\n<p>The Council for Medical Schemes announced that two technical committees have been established to oversee the\u00a0process of reviewing PMBs.<\/p>\n<p>The<strong> Clinical Advisory Committee<\/strong>\u00a0will define what will constitute the new PMB service package, while a <strong>Costing Committee<\/strong> will introduce new tariffs for this prescribed benefits package.<\/p>\n<p>In full, the review process will:<\/p>\n<ul>\n<li>Consider,\u00a0from all relevant stakeholders, the conceptual, regulatory and operational challenges related to the current PMBs.<\/li>\n<li>Consider the basket of primary healthcare and hospital-level services.<\/li>\n<li>Specify a comprehensive set of out-of-hospital an in-hospital essential healthcare benefits.<\/li>\n<li>Identify specific interventions so that the specified healthcare benefits can be provided on a sustainable basis.<\/li>\n<li>Identify measures to ensure\u00a0that the specified healthcare benefits are affordable.<\/li>\n<\/ul>\n<p>The process is expected to be completed by the end of February 2017 with the first changes being introduced as early as\u00a031 March 2017.<\/p>\n<hr \/>\n<p><strong>Read:\u00a0<a title=\"Permalink to Two massive medical aid changes coming in 2017 that you need to know about\" href=\"https:\/\/businesstech.co.za\/news\/business\/149569\/two-massive-medical-aid-changes-coming-in-2017-that-you-need-to-know-about\/\" rel=\"bookmark\">Two massive medical aid changes coming in 2017 that you need to know about<\/a><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The Council for Medical Schemes has announced plans to review the prescribed minimum benefits offered to policy holders, in order to bring it in line with the upcoming National Health Insurance legislation.<\/p>\n","protected":false},"author":10,"featured_media":149477,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11121],"tags":[26],"class_list":["post-150685","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-finance","tag-headline"],"_links":{"self":[{"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/posts\/150685","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/users\/10"}],"replies":[{"embeddable":true,"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/comments?post=150685"}],"version-history":[{"count":16,"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/posts\/150685\/revisions"}],"predecessor-version":[{"id":150747,"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/posts\/150685\/revisions\/150747"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/media\/149477"}],"wp:attachment":[{"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/media?parent=150685"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/categories?post=150685"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/tags?post=150685"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}