Discovery ordered to stop selling cheap health cover (Discovery Primary Care)
76 days ago
An industry association (Board of Healthcare Funders) has effectively revoked the permission given to Discovery to provide more affordable healthcare products.
The BHF took the matter to the medical schemes regulator, which had provided the applicable exemption in the first place.
The decision affects the Discovery Primary Care range.
This is the description of the product on the company website:
"Discovery Primary Care is an employer funded healthcare-related benefit for employees. It is not a medical scheme."
It covers things like consultations with general practitioners, basic medicines, dentistry, radiology and pathology.
The products have been on the market for about five years and meet an essential need says Hylton Kallner, CEO of Discovery SA.
At the core of the matter is that medical schemes themselves want to be able to offer these products, he says.
Up until now only insurance companies have been offered this exemption, or been able to take advantage of this exemption process. More medical schemes want access to it.Hylton Kallner, CEO - Discovery SA
He explains the technicalities:
Medical schemes have to provide what's called prescribed minimum benefits... and that effectively sets almost a minimum premium for the medical scheme, because you have to provide those benefits... Health insurance products don't have to.Hylton Kallner, CEO - Discovery SA
The case is one between the Board of Healthcare Funders [BHF] and accountable medical schemes in terms of the license that's been given to Discovery Life to sell low-cost life insurance and the process we went through in order to get that exemption...Hylton Kallner, CEO - Discovery SA
Kallner emphasizes that clients who are already on the plan are not affected by the decision.
These are very important products for South Africans, particularly at this point in time... We have about 100,000 members on this product...Hylton Kallner, CEO - Discovery SA
Essentially the ruling of the appeal board that adjudicated on this has said that the exemption wasn't exceptional at the time (which is one of the requirements) and therefore the council and ourselves have got to go back to the drawing board.Hylton Kallner, CEO - Discovery SA
Kallner says most employers want to cover their staff within the scope of primary healthcare needs.
He believes these products will move into the regulated, medical scheme environment in time.
For more detail, listen below:
This article first appeared on 702 : Discovery ordered to stop selling cheap health cover (Discovery Primary Care)