Dental cover continues to be eroded despite medical aid premium increases that are well over inflation‚ the South African Dental Association (SADA) says. The Times reports that responding to increases in medical aid premiums of between 10% and 12% for 2017‚ SADA points out that while premiums are increasing‚ payments to dentists continue to decrease‚ reflecting what it sees as the “low priority” medical aid funders afford to dentistry.
SADA notes that dentists only received 2.34% of the total funds paid out to healthcare providers in 2015. This was down from 2.42% in 2014. “With the exception of dental procedures covered under Prescribed Minimum Benefit (PMB) limits‚ funding for dentistry is considered low priority to medical schemes‚” SADA asserted.
In contrast to above inflation increases in premiums‚ average increases in dental tariffs year on year has been between 5% and 6%.
The report says SADA is concerned that there has been no growth in the benefit structures available for dentistry. Dental professionals‚ it says‚ “are under pressure to deliver high quality service in keeping with international standards whilst struggling to meet practice overhead expenses in light of consistently declining medical aid benefits”.
KC Makhubele‚ CEO of SADA‚ said: “Oral diseases qualify as major public health problems owing to their high prevalence and incidence. There is a synergic relationship between oral health and overall wellness. The recognition of well-known and established signs and symptoms of oral diseases may assist in the early diagnosis and prompt treatment of some systemic diseases and disorders. Dentists and dental specialists play a fundamental role in the oral health of the nation and play a crucial role in the early diagnosis of many acute and chronic conditions‚ as well as the prevention. We are therefore very concerned that medical aid funders appear to view oral health as such a low priority.”
The report says he urged medical aids to reconsider the dental benefits they provide.
[link url="http://www.timeslive.co.za/local/2016/12/12/Dentists-get-less-money-even-as-your-medical-insurance-premiums-go-up1"]The Times report[/link]