New co-payment policy for specialised radiology in 2025

Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) scans are crucial for diagnosing and monitoring various medical conditions. These scans provide detailed images of the body's internal structures, aiding in accurate diagnosis and effective treatment planning.

From 2025, a new co-payment policy has been introduced for specialised radiology services, specifically MRI and CT scans. This update aims to balance the need for advanced diagnostic imaging with the financial sustainability of the healthcare system.

Key changes to the benefit

• The benefit remains limited to two scans per person per year.
• A co-payment of R1,000 per scan has been introduced for both in-hospital and out-of-hospital investigative MRI or CT scans.
• The co-payment will not apply if the MRI or CT scan is:
  • Classified as a Prescribed Minimum Benefit (PMB).

The introduction of a co-payment is designed to manage the high costs associated with these advanced imaging techniques while still providing essential diagnostic services to members. By exempting scans related to PMBs, the policy ensures that critical diagnostic needs are met without additional financial burden.

For more detailed information about the coverage and benefits, you can refer to the official Engen Medical Benefit Fund guide.