Medical Aids Sue Cms To Offer Cheaper Cover - But There's A R149 Plan

In January, the Pretoria high court heard an application by the Board of Healthcare Funders BHF to compel the Council for Medical Schemes CMS to allow medical aids to offer cheap versions of their products.

CMS opposed the application. It argued that it had rejected the low-cost benefit products proposed by medical aids because they did not offer members adequate financial risk protection and did not address South Africa's disease burden. The court has reserved judgement in the matter.

Reacting to BHFs application, Dr Reinder Nauta, the Managing Director of healthcare administrator and managed care organisation National HealthCare Group , says reliable and affordable low-cost medical cover for employees is already available.

However, corporate South Africa has been slow to embrace these products, he said this week in a statement shared with Current Affairs ZA .

Nauta said National HealthCare has proved that it is possible to offer comprehensive primary care for as little as R149 a month.

"Medical aid premiums have just risen by an average of 10.7, more than twice the rate of inflation. Employers and individuals are struggling under the burden of more expensive monthly premiums and medical aids are losing members who can no longer afford their products," he said.

National HealthCare was launched in 2018 and is backed by Patrice Motsepe's African Rainbow Capital and Remgros Invenfin. It has a network of over 12,000 doctors, pharmacies and other service providers.

The group has three products with different levels of cover provided to tens of thousands of people through their employers. Fast food chain Hungry Lion was one of the first companies to sign up and provides medical aid cover to 4,000 staff through the scheme.

"Each member has unlimited, instant access to telemedicine via a WhatsApp chat with qualified nurses or doctors," Nauta said.

"Where needed, members will be referred to a network of more than 3,400 private doctors for an in-person consultation. In addition, employees can also access more than 8,000 other healthcare providers, including 3,500 pharmacies throughout South Africa."