Thousands of former Gen-Health medical aid members in the Eastern Cape will have to cough up massive sums of money for medical services and medication after
the national health scheme went into liquidation.
Of the Johannesburg-based scheme's estimated 14000 members, about 3000 are believed to live in the Eastern Cape.
And amid concerns that many of the province's former members may not yet be aware of the company's closure, scores of others are finding themselves deep in
the red after the scheme reportedly failed to pay accounts for medication and treatments incurred between four and seven weeks ago.
In addition, according to a Port Elizabeth-based medical aid services broker, many former members currently receiving treatment in private hospitals may be
asked to leave and seek treatment in state hospitals, while pensioners are believed to be among those be most severely affected by the liquidation.
The scheme's clients were unexpectedly left in the lurch on Thursday after a curatorship failed to turn the embattled health care scheme around and resulted
in a Council for Medical Schemes (CMS) announcement that the company would be liquidated.
CMS spokesman Aleksandra Serwa said the curatorship of Gen-Health had unfortunately failed to bring about the turnaround of the scheme and that Kobus
van der Westhuizen of Tutor Trust CC had been appointed its liquidator.
Gen-Health members are being given the opportunity to transfer to Medshield Medical Scheme without being subjected to waiting periods.
Attempts yesterday to obtain comment from Gen-Health, whose website claims that the scheme was started in 1991, and liquidators Tutor Trust CC, proved
unsuccessful.
Incensed former member Rory O' Connor, of Port Elizabeth, who was put on chronic medication about two months ago, told Weekend Post that after
discovering that Gen-Health had not paid medical costs incurred during the past seven weeks, he now owed R7000 in medical bills.
Even though I am scrambling to find another medical aid and am now in the red for all this money, I may even be one of the lucky ones. I spoke to a pathologist about this and was told that another former member will now owe R50000, O'Connor said.
He said the scheme had not paid his accounts despite taking his monthly premiums during the same period.
He said indemnity clauses built into medical services and accounts meant that he is liable for any outstanding costs should his medical aid scheme default on
payments. I got the shock of my life when I found out about this.
Broker Michael Stow, principal of Hold Consulting, said his company had received a number of calls from concerned former members.
Among other concerns, I take issue with the regulator and administrator of Gen- Health for not informing members of the situation earlier. This would have
put members in a position to seek treatment at a state hospital, defer treatment if possible, or find alternative ways to fund treatment or medication, he
said.
Gen-Health's clients were primarily individuals, he said, as opposed to corporate clients. The sudden liquidation raised questions as to why the industry's regulator had not timeously advised people of the impending closure
of the scheme.
It could not have been that difficult to notify the clients, whether by SMS or from a call centre, of the situation. Many people have now been left high and dry, he said. - I-Net Bridge.