Council to review medical aid benefits

MEDICAL aid consumers are facing premium increases of 10% or more next year, but the medical aid regulator may be finally doing something about rising costs.

The Council for Medical Schemes said it is doing a review of prescribed minimum benefits – the basic package of care all consumers have when buying a medical aid.

These benefits have to be covered no matter the cost, according to the law, and many medical aids have said this law pushes up premiums.

The benefits mean medical aids have to cover 26 chronic conditions and 270 diseases, ensuring consumers have a basic level of care in exchange for their premium.

But many schemes have provided evidence to the Competition Commission’s independent inquiry into health costs showing the benefits are increasing costs and repelling new members.

The council said its review needed to ensure the basic benefits were financially sustainable and viable.

It costs an average of about R600 for a medical aid member to pay for these benefits, meaning all medical aids have to cost more than this.

Older people who use these benefits cost medical aids more than R1 000 a member per month, according to the council’s latest annual report.

The review will also look at what diseases are covered as a basic package of care by medical aids.