Is it fraudulent to use a medical scheme
membership card belonging to another person to obtain benefits?
Yes, medical scheme identity theft is fraud. It is a crime involving
theft and the misrepresentation of an identity. It is effectively the theft of
an individualís benefits which may cause financial loss to providers and/or medical schemes. .
Medical identity theft.
Medical identity theft occurs when someone uses your name, medical scheme
card and medical scheme number or other personal information to obtain
healthcare treatment, consultations, investigations and medication or any
services related to your benefits. It may be with the knowledge and consent of
the member of the scheme or the use of medical identity by a criminal or criminals.
Without the knowledge of the victim this involves the falsifying of medical
records the submission of false claims for medical benefits made to your medical
scheme, again using your personal information.
Some identity theft cases occur as a
result of healthcare providers, family members or friends gaining possession of
your medical scheme membership card.
all beneficiaries who have copies of your card never to lend the medical
scheme card out and to keep it safe at all times.
What should you do if you lose your medical
scheme membership card?
report it to your medical scheme, your employer if they
pay your medical scheme premiums and your general practitioner or other healthcare providers who have submitted
claims on your behalf.