National consumer commissioner Mamodupi Mahlala-Mulaudzi wants a clause in the Medical Schemes Act declared unconstitutional for discriminating against pregnant women, according to a report.
Sake24 reported that three medical schemes had received a notice that the commissioner had started legal steps to address a clause allowing medical schemes to insist on waiting periods for new members.
According to the Board of Healthcare Funders (BHF), it is unfair to existing members to allow new members onto the scheme who are about to undergo expensive procedures.
“Medical schemes are cooperatives where members’ monies are pooled to pay for health benefits when they have been incurred by the members or when they are needed by the existing members", according to a report released by the BHF.
It also stated that it would be against the principles on which medical schemes are based to allow new members to join, incur high medical costs, and then leave the scheme again.
The commissioner argued that this clause discriminated against new members who were pregnant, because these women would not be covered when they gave birth.
(Sapa, Health 24, July 2012)
20 claims medical schemes won't pay