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Save thousands by understanding your right to medical benefit

14 July 2010 | Healthcare | Medical Schemes | Gareth Stokes

The Council for Medical Schemes (CMS) 2008/9 Annual Report reveals there are 7 874 826 medical schemes beneficiaries in South Africa, spread among 119 medical schemes. Your editor – a principal member at the country’s largest open medical scheme – is one of these beneficiaries. Of course, things work perfectly with medical schemes until you need to claim from them. My doctor tried to explain why a textbook book length motivation wouldn’t be enough to get my medical scheme to pay for some essential dentistry: “You see – medical schemes are run like businesses,” began the familiar refrain.

The reluctance of medical aids to cover certain procedures led to the creation of a list of Prescribed Minimum Benefits (PMBs). The idea behind this list of minimum benefits is to ensure all medical scheme members have access to certain health services, regardless of the benefit option they have selected. One of the goals of the list is to provide people with continuous care to improve their health and well-being and to make healthcare more affordable.

What minimum benefits are prescribed?

Optivest Health Services recently distributed a press release asking whether a lack of knowledge regarding PMBs could result in medical schemes members paying for services the medical scheme should cover. Marcel du Toit, CEO of Optivest, says legislation is on your side; medical schemes need to pay for the diagnosis, treatment and care of the list of PMB conditions as compiled by the CMS. In 2008/9 the CMS announced penalties for schemes and administrators for non–compliance with PMB treatments and claim pay-outs!

As a minimum, medical schemes must cover the costs for the diagnosis, treatment and care of:

· Any emergency medical condition;

· A limited set of 271 medical conditions; and

· A set of 26 chronic conditions.

Know what you’re entitled to

The following example (provided courtesy of the CMS) illustrates how medical schemes might defer their PMB obligation:

Example - As simple as falling from a tree

When 11-year-old Johnny fell from a tree and fractured his left arm, his dad took him to their medical scheme’s DSP hospital.

The doctor on duty in the emergency room treated the fractured bone under local anaesthesia, applied a plaster cast and sent Johnny home with a prescription for pain tablets. The medical scheme informed Johnny’s dad that they were not going to pay the trauma facility accounts. In their opinion the member qualified for PMB services only if the person concerned was hospitalised.

Fortunately for Johnny’s dad, this is incorrect. PMB-related services are not restricted to a specific setting in which care should be provided. Therefore, PMB-related services can take place in the emergency room, at a clinic or in a GP’s rooms – in fact, wherever it is clinically appropriate.

“If you are worried about the cost of treatment, consult your medical aid broker or medical scheme, who will explain PMBs in detail,” says du Toit. “There are some rules the medical scheme can impose, like the service providers from whom you may obtain your medication – the Designated Service Providers (DSPs) – and chronic medication benefit programmes of which you should be part of.” It’s up to you to read the regulations and find out how your particular medical scheme applies them in practice.

A binding contract with your medical scheme

When you join a medical scheme you enter into a binding contract with the scheme. Optivest suggest you read all the fine print before signing, and that you read up as much as possible about PMBs, whether you choose the comprehensive or hospital plan option. Information is freely available from the CMS website (http://www.medicalschemes.com/).

The last word in the PMB debate hasn’t been had. Optivest notes that a task team has been established by the CMS and other stakeholders in the healthcare industry to establish a code of conduct – including how and why PMBs must be implemented. They add that the establishment of this team doesn’t mean the CMS will back down from its decision to penalise schemes and administrators for non-compliance.

Editor’s thoughts: There you have it. Your medical scheme is obliged to cover your treatment – subject to rules – for the emergency services, conditions and chronic ailments outlined in the PMB. Has your medical scheme forced payment for medical treatment of PMB conditions? Add your comment below, or send it to [email protected]

Comments

Added by Rob, 15 Jul 2010
As far as I am aware, PMB's are covered during the 90 day waiting period so I think Michelle is incorrect here. What does need to be highlighted is that although PMB's must be paid for by the medical scheme, they can dicate conditions to this such as: PMB's will onkly be covered in state hospital facilities, only generic drugs will be paid for etc etc. For instance, take Discovery/ Medihelp etc. they must cover hyper cholesterolemia as a PMB and provide medication therefore however, it can be the cheapest product available which may or may not be suitable for the patient. The drug may have side effects that are unacceptable to teh patient, but as the scheme is complying with the law regarding the supply of a drug for a chronic condition, there is nothing you can do about it except pay yourself. Medical schemes spend millions a year finding way NOT to pay for things!
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Added by Sam, 15 Jul 2010
As a healthcare broker, I keep a copy of the PMB's on my system - essential I think for my clients, and I ensure that the schemes that I sell pay the claims accordingly. I have found Discovery Health VERY accomodating regarding the payment for PMB's. It is essential that all consultants make themselves au fait with the legislation with regards to the algorithims and talk to CMS as well. The panel of Dr's there are very helpful. The most difficult PMB to understand is the hyperlipidaemia one (in my experience), and after many discussions with both Discovery and CMS, I finally understand it fully. If the broker is well informed, then all the knowledge can be passed on to the clients. It has certainly not been my experience that schemes will do everything they can NOT to pay!
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Added by Michelle, 14 Jul 2010
What needs to be pointed out is that not all members qualify for PMB's. If you have joined a scheme and have never been on a medical aid before or have had a break of more than 90 days from your previous medical aid, you do not qualify for PMB's and can have either a 12 month condition specific waiting period imposed or a general 3 months waiting period - in this time no PMB's will be covered.
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Added by Debby, 14 Jul 2010
HA - Try telling this to Discovery!! According to them, my husband has a less than 6% chance of having a heart-attack, so......despite his specialist physician insisting he carries on taking chol. lowering medication (which he has been on for about 10 years) and the fact that his family have a serious history of heart/chol related deaths, Discovery will not pay the +/- R120 per month for chronic medication. We have to self-fund as we are not prepared to take that "less than 6% chance!!"
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Added by GregS, 14 Jul 2010
As South Africans we are privileged to have the level of expertise available in the private health sector.Thank heavens as well for the Discovery's,Momentum's etc out there without which we would be stuck with State Healthcare.Amazingly I still come across people who purchase the equivalent of a Citi Golf in medical scheme benefits but then expect the benefits of the equivalent of a Golf GTI.You get what you pay for.....simple as that.
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