The BHF believes offering LCBO is vital for the industry’s sustainability and prevents the insurance industry from offering inferior products that do not cover the prescribed minimum benefits.

 

The Board of Healthcare Funders’ fight for permission to provide Low-Cost Benefit Option (LCBO) received a confidence-booster this week when judgement was handed down in its favour. This follows BHF’s court application, which sought to compel the Council for Medical Schemes (CMS) to give a complete record, providing light on the LCBO’s decision-making process thus far.

The Court ordered the Minister of Health and the CMS to provide all of the papers listed in Rule 30A within 10 days of receiving the applicant’s notice of motion.

This is critical for the main application that challenges CMS’s refusal to provide medical schemes with an exemption to offer Low-Cost Benefit Options (LCBOs), as outlined in Section 8(h) of the Medical Schemes Act (MSA), and the imposed moratorium on medical schemes, preventing them from providing LCBOs until the LCBO Guidelines were finalised.

BHF remains determined that the CMS must allow medical schemes to offer low-cost LCBO because it is critical to the industry’s sustainability. The BHF filed a court application seeking an exemption to offer LCBO because the insurance industry is cannibalising medical schemes and in most instances offering policy holders inferior products.

Medical aids are compelled by law to cover in full the 270 prescribed minimum benefits, but this is not the case for products doing the business of medical schemes.