Covid-19 Pandemic and its Impact on the Medical Aid Schemes
The Council for Medical Schemes (CMS) has called the Schemes to assist its members during this difficult time. It is believed that the CMS has requested the schemes to afford its members a 3 months holiday premium in certain circumstances. This, according to the CMS, must be assessed on a case by case of those members facing financial difficulties due to the national lockdown.
The CMS has also requested the schemes to cover its members for the screening, diagnosis, treatment and proper medical care for the Covid-19 patients. The medical aid schemes have their own set of Rules governing their entire operations and among others is the Prescribed Minimum Benefits (PMB). Most schemes if not all, under their PMB, do not cover for Covid-19 tests when a member and/or a dependent has tested negative. They only cover when a member and/or a dependent has tested positive and for the treatment thereof. The CMS Chief Executive Officer, Dr Kabane has now sent a draft amendment of the PMB to the Minister of Health for the inclusion of the above-mentioned benefits.
The CMS has also requested the schemes to cover its members for the screening, diagnosis, treatment and proper medical care for the Covid-19 patients.
It is clear that the lockdown will also affect the schemes in that they are likely to receive less premiums during this heavy time. However, if the proposed amendment is effected, members will feel encouraged to go for screening and this will also reduce the number of infections.
