New medical Aid bursts onto the market
Keikantse Lesemela | Monday April 28, 2014 13:04
CEO, Rose Tatedi told media last week that after an assessment of the eight operating medical aid companies, Symphony had decided to distinguish itself by offering new generation products.
“The traditional medical aid scheme offers a member benefits up to the limits of the health plan,” said Tatedi.
“We are totally different and we are offering new generation services.” The new generation services, the CEO revealed, include a medical aid scheme consisting of two components, being a risk pool and a medical savings account.
“The risk pool, which is 75 percent of the monthly premium, covers uncontrollable expenses such as surgery or hospitalisation while the 25 percent of the medical savings account is a percentage of one’s monthly premium that goes towards payment of controllable expenses such as hospital visits and chronic medication,” Tatedi said.
She explained that any balance on the medical savings account not used by the member in any given financial year would be carried over to the next financial year.
The CEO said that scheme membership was open to corporates and individuals with no age restrictions. Individuals can cover their dependents, parents, in-laws and children above 21-years of age who are neither schooling nor working.
According to available figures, 83 percent of people using medical aid in Botswana are covered by the government healthcare system while only 17 percent are covered by private sector medical aid funds.
The Non-Banking Financial Institutions Regulatory Authority (NBFIRA) has engaged a consultant to conduct research and recommend whether new regulations are needed for Medical Aid Funds or whether to simply transform the MAFs to underwriters of health insurance. Insurers are currently covered by the Insurance Industry Act and are regulated by NBFIRA.