Medical schemes asked to cap annual increases at 3.9%

Only entities that were already in financial distress before Covid-19 may ask to exceed the increase limit

Medical schemes are starting to announce their contribution increases for next year.

The Council of Medical Schemes says only schemes that were already taking strain before Covid-19 may require increases in excess of 3.9%.
The Council of Medical Schemes says only schemes that were already taking strain before Covid-19 may require increases in excess of 3.9%.
Image: 123RF/RAWPIXEL

The first three large open medical schemes have announced average annual contribution increases of 3.9%; 4.6% and 5.9% for 2021.

This comes as the Council for Medical Schemes (CMS) has issued a circular encouraging schemes to keep their contribution increases flat or in line with inflation.

“In cases where schemes are unable to freeze their contribution increase for 2021, CMS recommends that schemes should limit their increases to 3.9% in line with CPI,” says Dr Sipho Kabane, the council’s chief executive and registrar.

Only medical schemes that were already in financial distress before Covid-19 may require increases higher than the recommended 3.9%, the CMS says. “Such schemes must provide the CMS with a detailed motivation for such an increase,” Kabane says.

Momentum Medical Scheme came in with the lowest average annual contribution increase of 3.9%; followed by Bonitas with an average annual contribution increase of 4.6% while Medshield Medical Scheme announced an average 5.9% increase.

Momentum Medical Scheme

“Momentum Medical Scheme’s average age of members sits well below the industry average, and our long-term claims forecast allows us to keep contribution increases lower than the majority of our competitors,” explains Damian McHugh, head of growth and marketing at Momentum Health Solutions.

The administrator for Momentum Medical Scheme, Momentum Health Solutions, allowed members to fund their contributions from their HealthSaver accounts, which meant members who had positive balances could retain their medical aid cover, even if they have experienced cash flow shortfalls due to sudden unemployment or illness.

Going forward, Momentum Health Solutions has introduced enhancements to the HealthSaver+ account that will allow you to earn up to 10% interest, depending on your Healthy Heart Score and activity level. Conversely, you could enjoy interest rates as low as 0% on credit. An annual fee of R36 will give you access to Hey Jude, a concierge service that helps you with anything from finding a taxi or searching for a particular product to organising a birthday party.

One of the more unique innovations Momentum Health is introducing after Covid-19 is the ability to donate GP visits to those in need. To do this, you use your HealthSaver funds to buy a voucher that recipients can use to see any doctor on the NetcarePlus GP network.

Bonitas

Lee Callakoppen, principal officer of Bonitas Medical Fund says the scheme is freezing the contribution increase on its BonFit Select plan and will have a weighted increase of 4.6% across all plans. The highest increase is 7.1%. “Members on our growth options, which contribute to 91% of business, will only experience an increase of 3.9%. I think, looking at the pricing and the benefit richness we offer in comparison to the market, the changes for 2021 will be well received,” he says.

Earlier this year, the scheme launched the Bonitas Member Mobile App, providing free virtual care for all South Africans. This included access to GP consultations for a range of conditions, including Covid-19, as well as free delivery for chronic medicine. Callakoppen says the app gives you access to a virtual nurse, advice in an emergency, auxiliary and home- based care and comprehensive support for any condition.

Looking ahead, he says he predicts that depression and post-traumatic stress, which has historically been on an upward slope, will increase further in time. “We have a resource hub on our website to help people understand the conditions and steps they can take to remain mentally healthy. The app also has a screening tool to help identify warning signals of mental distress. For those who need medical treatment, the focus is on ensuring that care for the mental illness is provided effectively,” he says.

Medshield Medical Scheme

Thoneshan Naidoo, principal officer of Medshield Medical Scheme says members on the MediPhila plan will experience “an affordable R84 increase in their monthly premiums, with a maximum increase of R350 on our top end plan”. He expects this increase to be “well below the industry average”.

This might well have been the case last year when Discovery Health, Bonitas and Momentum Health announced increases of 9.5%, 9.9% and 8.2% respectively but may not hold true in an environment where the regulator has encouraged increases capped at 3.9%.

Other medical schemes are expected to announce their 2021 contribution increases in the month ahead.

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