LETTER: Medical aid mugging
As a pensioner, I need to maintain medical aid membership in case of serious illness or injury. In the meanwhile, I remain a mugging victim
There have been numerous complaints regarding medical aid rule changes and practices that have hurt many. I was told by my medical aid about a year ago that medical inflation is so high — about double the official inflation rate — because many practitioners and hospitals charge excessively and there is a lot of fraud in the industry. Based on personal experience, that seems to be true. However, here are a few other facts: • Premiums have risen by about 10% annually for some years; • Rules are complicated in an obvious effort to confuse members — as are unnecessary limits placed on dentistry, medication, various forms of therapy and the like; • Reimbursements are terrible, with a regular consultation for GPs and specialists reimbursed at about R365. Most GPs charge significantly more than this, and you would be hard-pressed to find a specialist whose consultation fees are within 300% of this; and • There is the self-payment gap — an amount that a member has to pay personally once his...
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