What is a medical scheme rate?
A scheme rate is a medical aid’s portion of a claim that is their agreed rate that they will pay according to their rules and regulations.
The medical scheme / aid rate in some cases may not be payable by the medical aid if savings are depleted, in which case Sirago cannot provide cover for, as we cannot take the place of the medical aid, but rather compliment your medical aid.
Who identifies what the value is of the scheme rate?
Each medical aid has their own list of rules, regulations and agreed rates with various types of medical professionals / providers. Each medical aid determines their own medical scheme rate.
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