Consumers of insurance need to be aware of the legislation that protects them from the abuse by some medical professionals. The new Demarcation Regulations for Healthcare have seen a change in the choice of products available. The regulations conduct the affairs of these insurance companies in terms of product offerings. And one of these is medical gap cover. Others are hospital cash plans and primary health insurance policies. So is the gap cover controversy over?
- Yes, gap cover is no longer a dishonest industry
- It is no longer just a cheap alternative to medical aid
- Many medical aid members feel that gap cover is another unnecessary expense because of the inadequacies of medical schemes.
- Some people have mistakenly invested in cheap medical aid believing gap cover would simply make up the shortfall.
- Gap cover is still vitally important today because of unregulated specialists who charge so much.
Low-Cost Way to Good Healthcare – Is the Gap Cover Controversy Over
Health insurance companies are important because they offer these lower cost alternatives that enhance medical scheme benefits and also benefit lower- and middle-income people. Without these affordable options. Many South Africans would have to give up their medical coverage and turn very reluctantly toward public health.
Somebody facing cancer treatment, for instance, may well be looking at a medical bill of R1 million, with medical scheme covering half of the total cost. This will leave the person with a shortfall of R500‚000. Without gap cover, they would have to pay out of their own pocket.
The devastating thing now is that gap cover benefits were once unlimited. But now under these new regulations, the payout is capped at R150 000 a year for each beneficiary.
Medical aids have plenty of bucks in reserve but they aren’t going to use this to pay for the full cost of the treatment. Even though there is this gap cover cap, without it, some people would be bankrupt trying to find the money to pay for treatments the medical aids won’t cover.
New Regulations Hinder Good Healthcare
Many people, however, are bitter about the new legislation with gap cover as they feel it is actually denying them the right to healthcare. They question the motives of government and whether the government actually wants them to have access to healthcare.
Instead of encouraging low-income earners’ access to quality healthcare‚ these regulations are stopping insurers from providing low-cost health insurance products.
Medical insurance such as hospital cash plans, gap cover and primary health care policies were once regulated by the long- and short-term insurance Acts, but now the demarcation regulations are making it that health insurance products be regulated like a medical aid by the Council for Medical Schemes.
Now they’ll have to comply with the same rules as medical schemes‚ which includes providing for prescribed minimum benefits.
What’s the good of these regulations. As all they’re doing is driving healthcare up and out of the reach of low-cost earners.
For Now, Hold onto your Medical Aid and Gap Cover – Is the Gap Cover Controversy Over
Nobody can really trust the government with their medical plans for the future, but if at all possible, in 2018, hold onto your medical aid and supplement it with good medical gap cover.
It seems that whatever gap cover’s future is, for now, it is still a vital link to good healthcare.
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