Discovery has announced the changes to its medical aid schemes in 2019 – including a 9.2% weighted increase in prices across its plans.
This increase is larger than the hike seen in 2018, which carried a weighted average of 7.9%, but was lower than the double-digit hike seen in 2017, when prices jumped 10.2%.
Discovery Health Medical Scheme is the largest open medical scheme in South Africa, covering nearly 2.8 million beneficiaries at 31 December 2017, and with an open medical scheme market share of approximately 56%.
According to Discovery, it estimates total medical inflation for 2018 at between 11.2% and 12.2%, with the variance due to utilisation trends in different health plan options.
“However, risk management by Discovery Health and the ongoing positive impact of the Vitality wellness programme on members’ health, will reduce medical inflation by 2%, resulting in contribution increases that are within the corridor of 3% to 4% above CPI after allowing for the required adjustment for VAT,” it said.
With CPI sitting at 5.1% in July, a CPI + 4% increase puts the industry range at 9.1%
One of Discovery’s partner insurers, Aon South Africa published some of the changes that Discovery clients will see in 2019, which includes the introduction of a new plan called KeyCare Start, which aims to be the lowest entry point into private healthcare.
The table below outlines what you can expect to pay for your medical aid, representing a rough estimate based on the weighted increase. According to industry representatives at the presentation, while the weighted average is 9.2%, Comprehensive and Executive schemes will see increases higher than this.
Other products, like KeyCare, for example, would be lower. KeyCare will see a 6.9% increase, Discovery said.
Executive and Comprehensive schemes will see an average 9.9% increase, while Priority, Saver, Core and Smart schemes will see an average 8.9% increase.
Full prices are expected to be released at a later date.
|Classic Discovery plan||2018 price (principal member)||Average increase||2019 estimate|
|Executive||R5 950||9.9%||~R6 540|
|Classic Priority||R3 214||8.9%||~R3 500|
|Classic Saver||R2 773||8.9%||~R3 020|
|Classic Core||R2 064||8.9%||~R2 250|
|Classic Smart||R1 647||8.9%||~R1 795|
|KeyCare Access (R0 – R5 050)||R697||6.9%||~R745|
Medical aid schemes in South Africa are in a difficult position amid competition inquiries into the sector, and major changes on the way with the implementation of government’s National Health Insurance plans.
In early July, the Competition Commission published its provisional findings of its market inquiry into the country’s private healthcare sector, saying that the players like Discovery and Netcare were far too dominant.
While the full report is expected later in the year, the preliminary findings recommended several interventions to restructure the market to make it more competitive.
Medical aid schemes are also facing government intervention with the publishing of the Medical Schemes Amendment Bill in June, which outlined 10 major changes coming for the industry. This includes:
- The abolishment of co-payments;
- The abolishment of the role of brokers;
- The abolishment of Prescribed Minimum Benefits (PMBs);
- Preventing unequal benefit options;
- Cutting down which businesses can identify as medical schemes;
- Creating a central beneficiary registry;
- Ensuring that the rich help subsidise the poor, the young subsidise the old, and the healthy subsidise the sick;
- Medical schemes not operate for profit, and that any cost-savings be passed on to patients;
- Making it easier for customers to cancel their membership; and
- Making minimum education requirements before someone is allowed to join a board of or become a CEO of a medical aid scheme.