Another three large open medical schemes have announced an average contribution increase of close to 10 percent or above for next year, following similar increases by four large open schemes last week.
But members of three open schemes have been spared high increases: their medical schemes have announced average increases of between 5.4 and 7.5 percent.
This week, Fedhealth announced an overall weighted average increase of 9.9 percent for next year across all options, with option increases ranging from minus 7.5 percent to 14.5 percent.
Alexander Forbes Healthcare reports that Medshield has announced an average increase of 9.6 percent and Topmed has announced an 11.3-percent average increase, with its option increases ranging from nine to 13 percent.
Three other large open schemes have announced lower increases: Sizwe will increase its contributions by an average of 7.5 percent, Genesis Medical Scheme by 5.5 percent, and Hosmed by 5.4 percent, according to the healthcare brokerage.
The increases on Sizwe options range from 3.94 percent to 9.8 percent, Hosmed’s range from 3.3 percent to eight percent, and the Genesis option increases are from 3.6 percent to 6.8 percent, Alexander Forbes reports.
The brokerage also records the average increase for next year on the restricted scheme for local authority employees, LAHealth, as six percent, with option increases ranging from 5.5 percent to nine percent.
Genesis maintains its trend of having increases well below the overall scheme average. The scheme says it has also made significant enhancements to dentistry, external prosthetic and endoscopy benefits.
Genesis chief executive Brian Watson says that about one-third of households with medical scheme cover spend more than 10 percent of their monthly income on medical scheme contributions. He says the debilitating effects of the continual above-inflation increases, as measured against the Consumer Price Index, often result in members downgrading their level of health cover or abandoning it altogether.
Watson says Genesis has maintained low increases because it is one of the few open medical schemes in South Africa that is self-administered. It practises prudent risk management and fiscal discipline, he says.
Fedhealth has announced that, over the next three years, it will simplify its options. Jeremy Yatt, the principal officer of Fedhealth, says the scheme will, at the end of three years, have an option range that shows a natural progression from in-hospital cover for a prescribed minimum benefit level of care only, up to unlimited cover and a choice of the level of day-to-day funding in line with members’ needs.
This year, Fedhealth began to phase out its out-of-hospital expense benefit, which is paid from the risk pool. Yatt says none of the 10 largest open medical schemes other than Fedhealth pays day-to-day benefits from a risk pool; they all offer day-to-day cover from medical savings accounts, with some options having an above-threshold benefit that comes into effect when the savings account is exhausted.
Yatt says Fedhealth will replace the out-of-hospital expense benefit with enhanced savings levels, which means that members will have more day-to-day spending than they currently enjoy with a out-of-hospital expense benefit/medical savings account combination.
A great benefit of the savings account is that any unused balance at the end of the year carries over to the following year, while the out-of-hospital expense benefit did not carry over.
Fedhealth has also simplified in-hospital co-payments across its options and has introduced a loyalty programme in partnership with Sanlam: Sanlam Reality.
Other medical schemes that have announced contribution increases for next year to date are:
* Bestmed: 9.8 percent;
* Discovery Health: 8.6 percent;
* Medihelp: 9.4 percent; and
* Momentum Health: 8.6 percent.
According to Alexander Forbes the simple average of all the weighted average increases announced so far for open schemes is 9.02 percent.
Remember that you should not make too much of comparisons between the percentage increases on different schemes, as the base contributions to which the increases are applied vary widely across schemes and options, as do the benefits and the increases in benefits for next year.
CORRECTION
In Personal Finance on October 3, we incorrectly reported that the average increase on Medihelp was 10.6 percent. The average increase is, in fact, 9.4 percent, with a range of between seven and 11.8 percent.
Medihelp has launched a new savings option, Unify, and has transformed its Dimension Prime 2 option into a hybrid option by increasing the amount in the savings account and adding insured day-to-day benefits.
The discount available on the Dimension Prime 1 and Dimension Prime 2 options if you agree to use a network has increased from 20 percent to 22 percent, Medihelp says.
The low-cost Necesse option has also been augmented with the addition of an extra income category, it says.
On Medihelp’s flagship traditional option, Dimension Prime 3 and its 20-percent cheaper network alternative, a 100-percent benefit for generic medicine use has been introduced.