Metropolitan Medical Scheme
South Africa’s health system is made up of the large public sector as well as the private sector.
Healthcare can be anything from the most basic offered by the state to highly specialised private health services.
Because the public health sector in South Africa is under-resourced, with hospitals degraded and unfunded, with no x-ray equipment and in some instances no doctors and no electricity, you absolutely have to have a medical aid in South Africa.
The infrastructure in these hospitals has simply fallen apart because of people being appointed to positions they aren’t qualified for.
Public hospitals deliver services to about 80% of the population. The current government is trying to get a national health insurance (NHI) system going that will give health care to all the different socio-economic groups in South Africa, but no-one knows when this will come into effect.
Until then, without a medical aid in South Africa, you may as well write out your own death certificate if you become ill and land up in one of the many dysfunctional public hospitals.
Who Administers these different Medical Schemes?
Metropolitan Medical Scheme is the biggest administrator of medical schemes in South Africa. They offer their services to more than 20 clients, of which government departments, medical schemes as well as a number of blue-chip organisations are some.
With a proven track record of efficiency, Metropolitan Medical Scheme takes care of –
● claims processing
● client services
● scheme marketing
● secretarial and financial services and many more.
Metropolitan Medical Scheme is Pro-Active in the Lives of South Africans
Metropolitan Medical Scheme’s wellness- and administration services extend to more than 3 million lives. The Scheme looks out for the welfare of South Africans. For instance the death toll from the Eastern Cape winter initiation season 2015 rose to 21 people dying.
The National Department of Health looks at medical male circumcision as an important HIV-prevention method. In support of the Department’s efforts, Metropolitan Medical Scheme has implemented a circumcision awareness campaign. Clinical studies reveal that in South Africa, circumcision lowers the incidence of HIV infection by 60%.
The mission of Metromed is to simply provide all South Africans with quality healthcare and in so doing, bridge the gap between public- and private healthcare.
Offering their services to open- and restricted medical schemes, Metromed has a wholly owned subsidiary, Metropolitan Health Risk Management. This subsidiary guarantees all beneficiaries optimal health outcomes through an holistic health management approach. These include wellness services, HIV management, provider networks, disease risk management, insurance based health solutions as well as electronic benefit management.
The beauty about Metropolitan Health Risk Management’s services is a reduction in healthcare expenditure, as they work to increase productivity as the health of employees and medical scheme members improves.
Preventative and Primary Healthcare for ALL
Metromed may well meet the needs of many medical aids, but along with that, they are also looking to find ways that will mean even more benefits from exceptional health care. To achieve this, they form strong relationships with partners who have the same outlook towards health care as what they do. Their Metropolitan Health Alpha Pharm Venture is the perfect example of this. This is an initiative to form a network of pharmacy-based clinics whose mission it is to offer preventative and primary healthcare to all South Africans. Metropolitan also offer family funeral cover.
Metropolitan Medical Scheme is committed to keeping things simple and making a real difference in terms of cost savings with affordable, quality health care.
With their low-frills approach and streamlined administration, Metropolitan Medical Scheme keeps up to date with the latest technology. This ensures they can continually improve services to their customers so that they can offer the most cost-effective healthcare in difficult economic times.