Medical aids use ignorance by members to avoid paying bills they are legally obliged to pay.Cape Town resident Angela Drescher, a consumer activist, gave her testimony at the Competition Commission market inquiry public hearings into private healthcare on Monday. The commission is tasked with finding out if a lack of competition is the reason for above average increases in medical inflation.Dresher called dealing with medical aids “traumatic”.Drescher’s experience in fighting for payment of her husband's and son's conditions made her realise that medical aids intentionally avoid paying for diseases known in law as Prescribed Minimum Benefits (PMBs). After 10 years as a medical aid member, Drescher discovered in December 2014 that PMBs existed thanks to Google.The law dictates that medical schemes have to pay in full for certain approved treatments of 270 diseases or 26 chronic conditions. But she claims they don’t. She has since worked with Discovery Health to improve its informati...
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