Medical scheme hikes

Cape Town - The pressures of the current economic climate, a rise in claims from members, the high cost of healthcare technology, and the fact that medical schemes have to pay for the treatment of PMBs at private hospitals and private doctors at cost all contribute to a spike in medical scheme contribution costs.

Many schemes are under pressure, and are forced to increase their member contributions, while trimming their benefits – always an unpopular thing with scheme members.

Bestmed announced a 10.98% average increase on 7 October for the year 2017. The increases range from 9.89% and 12.35% on the various options.

CEO of Bestmed Dries la Grange called the increase "very competitive" and said that Bestmed was somewhat less affected than other schemes by a high claims pattern. He also said that Bestmed benefited from being a member-owned administrator with a huge focus on wellness.

Bonitas announced an 11.9% increase for all Bonitas options on 29 September.

Poor economic growth, increased interest rates, inflation and basic costs of living put pressure on consumers, said Dr Bobby Ramasia, principal executive officer of Bonitas.

He also mentioned other contributing factors to the financial pressure, which are a falling rand, the rising cost of hospital admissions, fraud, wastage and abuse, and the cost and increased use of Prescribed Minimum Benefits (PMBs).

Discovery Health Medical Scheme announced an average increase across its 22 different options of 10.2%, with hikes ranging from 7.8% to 14.9% on the various options. The increases are weighted according to the number of members belonging to the specific options.

The 11% average increase (ranging from 8.9% to 15%) announced by Momentum Medical Scheme, one of the three largest open schemes in SA, is also a weighted average across its five options – currently ranging from the entry-level Ingwe option, available at R305 and R638 for a principal member, depending on their earnings.

Genesis Medical Scheme announced the lowest increase in the open medical scheme market of 4.7%.

Benefits of self-administration, prudent risk management, positive operational performance and healthy membership growth were contributing factors that made this low contribution increase possible, said Dennis van der Merwe, Principal Officer of the scheme. He also mentioned that the rand value of the increases were between R80 and R100 per month per adult member depending on the benefit option.

Fedhealth’s average increase for 2017 is 12.3%. It was announced on 10 October.

Medihelp announced a 10.9% overall increase on 27 September. Unlike many other schemes, their increase is the same across the board for all options.

Medshield announced an average 9.6% contribution increase for 2017 on 5 October. Dr Stanley Molabi, the Principal Officer for Medshield mentioned that it was one of the lowest in the industry, and went hand in hand with significant benefit enhancements. He also mentioned that Medshield had a solvency ratio of 52%, far above the legal requirement of 25%.

The table below details of some of the announcements on contribution increases from some of the schemes (not all schemes have announced their increases):

For details on the contribution increases and benefit changes on your specific option you have chosen within your scheme, it is advised that you contact your scheme directly.