Medical scheme regulator to decide what benefits can be offered under NHI

Medical scheme regulator to decide what benefits can be offered under NHI

Medical scheme regulator to decide what benefits can be offered under NHI

The deputy DG for NHI says medical schemes cannot cover the same benefits as those offered under NHI, to avoid people ‘paying again’.

24 JULY 2019 - TAMAR KAHN

The details of the benefits that medical schemes will be permitted to provide under National Health Insurance (NHI) will be determined by the sector’s regulator, the Council for Medical Schemes (CMS), a senior government official said on Wednesday.

The future role of medical schemes is one of the burning questions about the government’s plans for implementing universal health coverage, which it calls NHI.

“What we have done is propose that the registrar at the CMS make clear which services are covered by NHI and which are not, so there is a clear sense of what medical schemes will be able to cover. And they will revise it on a regular basis as the NHI benefits expand or change,” the health department’s deputy director-general for NHI, Anban Pillay, told delegates to the Board of Healthcare Funders of Southern Africa (BHF) annual conference, which took place in Cape Town this week.

The BHF represents medical schemes and their administrators, and its annual conference is a key industry gathering.

Medical schemes will remain voluntary and will be restricted to providing “complementary” cover, in line with the policy position set out in the NHI White Paper, said Pillay.

Read more:

https://www.businesslive.co.za/bd/national/health/2019-07-24-medical-scheme-regulator-to-decide-what-benefits-can-be-offered-under-nhi/