FAQ on Health Squared Medical Scheme
The Council for Medical Schemes (CMS) has developed these frequently asked questions (FAQ) in an effort to answer the questions you may have as members of the health Squared Medical Scheme. Members will also be kept informed of the development of the seven schemes as often as possible.
1. Contributions are payable in advance – will members be liable to Health Squared on the new scheme on 1 September?
According to the letter issued by Health Squared to members, members will be covered for their claims arising from health events up until 31 August 2022, provided that their contributions have been duly paid. In relation to those members who pay their contributions in advance, their contributions will be up to date to cover claims incurred until 31 August 2022. The CMS is on the tail end of discussions with seven medical schemes to consider options for Health Squared Medical Scheme members while ensuring their existing membership is not unduly disadvantaged.
2. Can I still get pre-authorisation for a health event?
According to the letter issued by Health Squared to members, members will be covered for their claims arising from health events up until 31 August 2022, provided that their contributions have been duly paid. In relation to those members who pay their contributions in advance, their contributions will be up to date to cover claims incurred until 31 August 2022. It is expected that these should include authorisations.
3. Will members on ongoing oncology treatment still be covered going forward?
Yes, as oncology is one of the conditions covered under the Prescribed Minimum Benefit (PMB) level of care for which all medical schemes must provide a basic level of cover. This basic level of cover includes the diagnosis, treatment and costs of the ongoing care of these conditions.
4. What happens on 1 Sept?
These discussions continue with due consideration to the urgency of the situation and that Health Squared members need to be onboarded by 1 September 2022.
5. Will contributions be matched by new schemes?
The CMS is on the tail end of discussions with seven medical schemes to consider options for Health Squared Medical Scheme members while ensuring their existing membership is not unduly disadvantaged.
6. Must I look for an alternative medical scheme?
Members who want to look for alternative medical schemes are welcome to do so; however, The CMS is negotiating with sevens schemes to consider options for Health Squared Medical Scheme members while ensuring their members are not unduly disadvantaged.
The CMS aims to conclude a concession that will allow Health Squared Medical Scheme members to join these schemes without the conditions of reinsurance and waiting periods to guarantee members’ financial protection.
7. Whether the risk of condition-specific waiting periods and late joiner penalties can be overridden?
The CMS is on the tail end of discussions with seven medical schemes to consider options for Health Squared Medical Scheme members; those members who join other schemes may not qualify to be part of the dispensation should the migration concession be successful. If a member leaves Health Squared and once the dispensation is finalised, they will not be part of the dispensation.
8. Do I need to engage a broker to get a new medical scheme?
Medical schemes cannot reject a membership application directly from a member.
