THE last few years have seen challenging economic conditions, which has cast a cloud over the open medical schemes market, according to South Africa’s self-administered medical scheme, Bestmed.
On Tuesday, the scheme announced its product enhancements, preventative benefits and contribution changes for 2023 across its value-for-money Beat, Pace, and Rhythm product ranges.
Despite the tough trading environment, it said it would continue to focus on providing competitively priced (value for money), quality and superior healthcare cover for its valued members in 2023.
Leo Dlamini, CEO/Principal Officer at Bestmed Medical Scheme, said their commitment to offering their members value for their medical aid contributions while remaining competitive in the market were key drivers for the 2023 benefit enhancements and changes.
“Over the past few years, we invested substantially in preventative care benefits for our members,” Dlamini said.
The scheme said this announcement followed its 3.5% growth in principal members for 2021, bringing the total number of beneficiaries under its care to 209 000. It attributed the growth to its consistent value for money as well as the scheme’s improved customer satisfaction as validated by external market research, and the scheme having some of the lowest contribution increases in the country among open medical schemes for 2021 and 2022.
Bestmed has announced an average weighted contribution increase of 8.5%, alongside an average weighted benefit limit increase of 5.7% and has maintained the richness of its benefits and competitiveness of its product range.
The scheme said it wanted to continue offering long-term benefits to members, ensuring they have cover when they require medical attention, from paying doctors to covering hospital stays.
Additionally, the scheme said it wanted more of its members to access its preventative care benefits that help keep them healthy and prevent possible medical issues that may arise from not having access to these benefits.
Dlamini said they had introduced changes to their product benefits while enriching some of their existing benefits.
“Our members already have access to an extensive range of preventative care benefits across our product range. These include vaccinations, mammograms, paediatric immunisations, female contraceptives, a back and neck programme, and baby growth and development assessments,” Dlamini said.
“Preventative healthcare empowers people to take a proactive approach to manage their health, providing far-reaching and long-lasting health benefits. It also helps avoid the trauma of members having to put their lives on hold while going through, sometimes, difficult treatment that may involve going in and out of hospital. This also assists in reducing costs for the scheme, which bodes well for future pricing of contributions and benefit enhancements.”
Bestmed said it was also encouraging more members to improve and maintain their overall health in 2023 by introducing an additional wellness journey, the Emotional Wellbeing Journey to its two existing Get Active (fitness) and Nutritional Health Journeys. Dlamini said that heading into 2023, they were focusing on providing members with additional wellness benefits via their Tempo wellness programme suitable for members from the age of 16.
Last month, Bonitas Medical Fund announced its own 2023 product line up. Lee Callakoppen, Principal Officer of Bonitas, said their average increases for the year would have been 5.9% - well below the current inflation rate of 7.6%. He said the good news was that they put a price freeze on contributions for the first quarter of 2023 to offer their members some respite. He said this effectively meant an increase of 4.8% over the 12 months.
Callakoppen said it was always a delicate balancing act between keeping increases as low as possible while maintaining the stability of the Scheme.
The guidelines, set out by the Council for Medical Schemes (CMS) in Circular 44 of 2022, requested medical schemes to keep contribution increases for 2023 below CPI. However, over the past decade, medical scheme contribution increases have outpaced inflation by around 4%.
Bonitas said it was delighted to have kept these well below CPI itself.
Bonitas said it boasted excellent financial indicators from high solvency ratios, strong reserves and a high claims-paying ability. It said it was not only financially sound with over R7.4 billion in reserves but, over the last 36 months, it had signed up 190 000 new members.
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