Patients ripped off, inquiry told

17 February 2016 - 02:38 By Katharine Child

Medical aids are said to be exploiting their members' ignorance of prescribed minimum benefits to avoid paying for their treatment in full.Angela Drescher, a consumer activist, has spent a year trying to find out who is responsible for telling patients that they had been diagnosed with a disease the treatment of which is covered in full by a prescribed minimum benefit.She said that if patients did not know that their condition was covered in full, medical aids often broke the law and did not pay in full.This, Drescher said, had happened to a friend who died in December of bone cancer.There are 270 diseases and 26 chronic conditions that medical aids are obliged to cover in full.Drescher gave her testimony at the Competition Commission inquiry into private healthcare in Pretoria yesterday. The inquiry is trying to determine if lack of competition is a reason for above-inflation increases in private healthcare costs.Drescher said medical aids broke the law by not paying prescribed minimum benefit in full when patients were unaware that they were entitled to them. She said members were often "hounded" for illegal co-payments when they were "sick and at their most vulnerable".She said medical aids hoped such patients would "roll over and give up".Drescher said that for 14 months she had been asking medical aid administrators, the medical aid regulator, the Department of Health, and doctors and their representative organisations, whose responsibility it was to tell patients that they were entitled to a prescribed minimum benefit.She had not received an answer, she said...

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