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The bill for laboratory tests is often unpaid by your medical aid – here’s potentially why.

by Dr David Green | Jun 22, 2020 | Medical Schemes, PMBs

Many medical aid members find that, although their doctor and other bills are paid (or at least part paid) by their medical aid, the pathology bills are not paid at all.  This is particularly puzzling in instances where the pathology tests were part of confirming...

Will your medical aid pay for your COVID-19 testing and treatment?

by Dr David Green | May 25, 2020 | Medical Schemes, PMBs

The answer to this question changed on Friday the 22nd of May 2020 when the Minister of Health published the required regulations to make COVID19 a Prescribed Minimum Benefit (PMB).  However, payment does still to some extent, depend on which medical aid you are...

Why do some doctors bump up their fees when the patient is insured?

by MedClaimAssist | May 19, 2020 | Healthcare News, Medical Schemes

There are as many views on whether doctors charge too much for their services as there are patients that visit doctors. Medical aids in South Africa set their rates for services by doctors and pay that as a benefit to contribute towards the cost of healthcare, no...

Frustrating non-payment of PMBs

by MedClaimAssist | May 19, 2020 | Healthcare News, Medical Schemes

Some years ago I travelled around South Africa and visited members of Medical Schemes who were weekly paid workers and members of a trade union. I came across a number of people who, as members of a Medical Scheme, had been hospitalised (or more commonly a family...

NHI seen by Moody’s in Same Light as Nuclear Build

by MedClaimAssist | May 19, 2020 | Healthcare News, Medical Schemes

Moody’s rating agency, in their statement “Moody’s places South Africa’s Baa2 ratings on review for downgrade” carried on their website they cite, amongst numerous other factors that they will look at to determine whether to downgrade South Africa’s rating...

Prescribed Minimum Benefits, Section 27, and the right to health.

by MedClaimAssist | May 19, 2020 | Medical Schemes

Efficiency Discount Options (EDOs) were introduced in 2008 to allow for differentiated contributions within an option of a Medical Scheme. EDOs are options where a discount can be offered to members who agree to limit their use of providers to a network designated by...
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Recent Posts

  • Does anyone choose their anaesthetist?
  • Cancer patients now have a better chance of getting their treatment fully funded by their medical aid
  • Will regulating prices control total costs in South African private healthcare?
  • The bill for laboratory tests is often unpaid by your medical aid – here’s potentially why.
  • Why do medical aids short pay?

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