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No more unfair penalty co-payments will be allowed for medical schemes after the Council for Medical Schemes (CMS) declared this practice irregular and undesirable in terms of the Medical Schemes Act in a notice published in the Government Gazette.
The declaration comes after the Registrar of Medical Schemes received information that some medical schemes:
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The Registrar of Medical Schemes decided to, subject to written representations by interested people and with the concurrence of the CMS and the minister of health, declares these co-payments that exceed the difference between the amounts charged by the designated or non-designated service provider as undesirable. This also includes any other co-payments which are unfair to members or beneficiaries or cannot otherwise be numerically justified.
The CMS will publish guidelines on co-payments within 180 days.
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