The Council for Medical Aid Schemes says any changes made to benefits that members are entitled to needs to be communicated at least 30 days prior to implementation.
This is in response to Discovery Health and its new schedule of approved facilities for medical procedures.
With the new changes, a member will be required to make a R5000 co-payment if they get a procedure done in facilities that are not approved by the scheme.
Paresh Prema, the Council for Medical Aid Schemes GM for Benefits Management, says Discovery should have implemented the campaign to communicate those changes more effectively to members before implementing.
And if some members received authorisation for their procedures, Discovery should honour those authorisations, says Prema.
If Discovery has made authorisations when we talk about booking, they should honour those in terms of those authorisations. If they change it they need to communicate back to that member and accommodate them according to that authorisation.— Paresh Prema, Council for Medical Aid Schemes GM Benefits Management
Dr Ryan Noach, Discovery Health deputy chief executive, confirmed on CapeTalk that it would be honouring those arrangements.
To hear the rest of the conversation with Paresh Prema, listen below:
This article first appeared on CapeTalk : Medical Aid Schemes Council responds to Discovery Health's 2019 changes