Picture: 123RF/nito500
Picture: 123RF/nito500

Two large, open medical schemes have announced contribution increases of 9.2% and 8.5% for 2019.

Discovery Health Medical Scheme (DHMS), the country’s largest medical scheme, will put up its contributions by a weighted average of 9.2%, which Alexander Forbes Healthcare’s Victor Crouser says members will experience as an increase of between 9.9% and 6.9%, depending on the option to which they belong.

The scheme, which covers more than 2.7-million lives, also announced enhanced benefits for chronic conditions and cancer.

Fedhealth, which covers about 144,000 lives, announced a weighted increase of 8.5% and has also "revolutionised" its benefit, turning savings accounts upside down and offering members the choice to use networks in return for discounted contributions.

Jeremy Yatt, the principal officer of Fedhealth Medical Scheme, says the scheme has introduced four new benefit packages in its FlexiFED range. Fedhealth’s new options still need to be approved by the Council for Medical Schemes.

Jonathan Broomberg. Picture: FREDDY MAVUNDA
Jonathan Broomberg. Picture: FREDDY MAVUNDA

Dr Jonathan Broomberg, CEO of Discovery Health, says the scheme’s administrator estimates total medical inflation for 2018 at between 11.2% and 12.2%, depending on the utilisation of benefits within different options and including the effect of the one percentage point increase in VAT.

However, programmes to manage health risks and the positive effect of Discovery’s Vitality wellness programme on members’ health, have resulted in the scheme’s inflation rate running two percentage points lower.

Broomberg says this has enabled the scheme to increase its contributions by four percentage points more than the current inflation rate. The CPI index is currently 5.1%.

Broomberg noted in particular the increases in members’ use of benefits for chronic illnesses and oncology.

"Claims data for Discovery Health Medical Scheme shows that the incidence of cancer in women has nearly doubled since 2008, and for men it more than doubled. At the same time, advances in medicine and medical technology, while having a positive impact on patients’ lives, increase costs substantially, since they are often more expensive than the older treatments they replace."

Broomberg says DHMS’s increases have typically been one percentage point below those of the rest of the open scheme industry. He says maintaining this differential over time means members on average paid 16.4% less for the same or better benefits this year, than members of other schemes.