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More Unintended Consequences?

Laura du Preez wrote in Personal Finance on 12 September 2015:

Providers of primary healthcare plans that may soon be disallowed say that low cost benefit medical scheme options will not cater for people using these plans who earn more than the tax threshold but cannot afford scheme membership.

The Council for Medical Schemes has announced that from next year it will allow low cost benefit options that offer primary healthcare cover and no hospital cover.

But stakeholders say thousands of people earning between R6 000 and R13 000 a month could be left without basic healthcare cover when regulations under the Insurance Acts, which are expected to be issued this month, are promulgated.

The regulations, together with the implementation of a new definition of the business of a medical scheme under the Medical Schemes Act, are expected to ban primary healthcare plans that are not registered as a medical scheme.

Many people who use unregistered primary healthcare plans will be prevented from joining the new medical schemes options, because they earn more than the tax threshold – the maximum income level set for these options – and existing low cost options with hospital cover will be too expensive for them.

But medical scheme industry commentators are optimistic that the new low cost benefit options will grow medical scheme membership and reduce the burden on state healthcare facilities.

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