Medical aid members will have to seriously bargain with health providers if gap cover is banned in South Africa. Thousands of people want answers. Why exactly has the SA government considered banning gap cover?
It seems as if there are corrupt officials who want to syphon funds into their own pockets.
The government has identified the medical aid industry as being a cash-cow. As a result, they are trying to control schemes. Further, the government has named this scheme the National Health Insurance (NHI). And it will be compulsory for everybody who earns a salary.
In March 2012, it was the government’s intention to ban gap cover, meaning that clients must pro-actively manage their own health costs in the future. They would also have to arrange with their healthcare providers for better costs for treatment.
For people relying on gap cover to help them with their health costs, banning gap cover is a total blow. Government healthcare mostly helps out the poor and the lower income people with the South African taxpayers footing the bill.
In late December 2016, the finance minister, Pravin Gordhan, along with the health minister, Aaron Motsoaledi, published the final regulations around gap cover.
According to the final regulations, gap cover will continue to exist. But our government will strictly enforce regulations from 1 April 2017 with regards to payouts. Any current policies will have to comply with the new laws in effect from January 2018 and the new policies of 1 April 2017.
Members have options if Gap Cover is Banned.
There are always measures that members can consider if gap cover is banned. Anyone who is a medical aid member should still discuss the costs involved with their surgeon to find out whether their medical aid will cover them in full.
If this is not the case, members need to discuss discounts or ask for other quotes to ensure that they end up with the best rates possible. The bottom line is that patients bargain with healthcare providers. So as to agree on costs of treatment.
Indeed, medical costs are not standard across the industry. Different surgeons charge different prices. So be sensible about the cover you take out. Plan wisely. It is of crucial that you make use of gap cover.
Health insurance is top priority
Belonging to a medical scheme and having gap cover go hand in hand.
Also, it is possible to reduce the risk of your contracting many diseases just by simply changing your lifestyle. When the Government brings out unexpected policies and regulations, at least with gap cover, you won’t get sick of hearing about the huge bills you have to pay.
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All info was correct at time of publishing