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S.Africa Medical Insurers Ask Court for Price Clarity, Star Says

South Africa’s Board of Healthcare Funders will today ask a court to clarify a law that requires medical insurance operators to pay so-called prescribed minimum benefits “in full,” the Star said.

The board said “in full” means paying for 270 medical conditions and 28 chronic illnesses at medical insurance rates and not at private tariffs charged by some healthcare providers, the Johannesburg-based newspaper reported, citing BHF spokeswoman Heidi Kruger. Since reference prices, there haven’t been tariff guidelines for the industry, the newspaper cited Kruger as saying.

The Council for Medical Schemes’ interpretation of the Medical Schemes Act doesn’t provide a cap on charges and would result in higher premiums for consumers, Kruger told the Star.

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