Here are all your Discovery medical aid price hikes for 2020

Health insurer Discovery has published its full price adjustment schedule for medical aid members in 2020, showing a 9% to 11% increase across its plans.

Discovery Health Medical Scheme is the largest open medical scheme in South Africa, covering nearly 2.8 million beneficiaries, with an open medical scheme market share of approximately 56%.

Due to the increased cost of providing healthcare in South Africa, the medical aid industry typically hikes fees at a rate of CPI + 4%. With CPI currently sitting at 4.0%, this would put the industry average at around 8% for 2020.

Stats SA will release new inflation data on Wednesday (18 September).

Discovery’s price hikes come at a time of uncertainty for the medical industry, with the passing of the National Health Insurance (NHI) Bill last month adding to some anxiety in the private healthcare sector.

While the bill makes provision for medical aids to remain in South Africa, the wording of the piece of legislation is ambiguous in their role.

Under the NHI, medical aids will have a significantly reduced role in the country’s healthcare, providing ‘complementary’ or ‘top-up’ coverage for services that are not covered by the NHI.

The NHI director-general previously stated that this is because it would be inappropriate for the state to legitimise buying cover for services that are already covered by the NHI.

Government has made it clear that the R280 billion spent on private healthcare should be added to the pool of R230 billion spent by government on public healthcare, leaving many wondering where private companies like Discovery, Momentum and Netcare will fit in.

Discovery’s take on the bill has been optimistic, with its reading of the bill taking it to mean that medical aids will be available as an option to those who do not go the route of using the NHI’s services.

“The NHI Bill makes the point that this ‘complementary role’ for medical schemes will only apply once the NHI is ‘fully implemented’ and that it defines ‘referral pathways’ to which it will apply, indicating that where patients choose not to follow the referral pathways, the NHI will not reimburse their care, and that they can then claim from private health insurance,” Discovery said.

“These elements of the NHI Bill all speak to a continued and important role for medical schemes, and we will engage actively and constructively to make these points and to ensure an ongoing critical role for medical schemes and for private healthcare providers as the process goes forward.”

The group has called for clarity on where exactly medical aids fit into the scheme.

Here are the full contribution changes (for the primary member).

Executive

Plan 2019 2020 % change
Executive Plan R6 541 R7 257 10.9%

Comprehensive

Plan 2019 2020 % change
Classic Comprehensive R5 368 R5 954 10.9%
Classic Delta Comprehensive R4 834 R5 362 10.9%
Essential Comprehensive R4 509 R5 003 11.0%
Essential Delta Comprehensive R4 062 R4 507 11.0%
Classic Smart Comprehensive R4 327

Priority

Plan 2019 2020 % change
Classic Priority R3 501 R3 814 8.9%
Essential Priority R3 010 R3 278 8.9%

Saver

Plan 2019 2020 % change
Classic Saver R3 021 R3 290 8.9%
Classic Delta Saver R2 412 R2 628 9.0%
Essential Saver R2 400 R2 615 9.0%
Essential Delta Saver R1 915 R2 085 8.9%
Coastal Saver R2 373 R2 608 9.9%

Smart

Plan 2019 2020 % change
Classic Smart R1 794 R1 954 8.9%
Essential Smart R1 285 R1 400 8.9%

Core

Plan 2019 2020 % change
Classic Core R2 248 R2 449 8.9%
Classic Delta Core R1 799 R1 960 8.9%
Essential Core R1 931 R2 104 9.0%
Essential Delta Core R1 543 R1 681 8.9%
Coastal Core R1 770 R1 946 9.9%

KeyCare

The KeyCare Plus ranges have changed once again for 2020, therefore no price increases are shown below, just the new fees for 2020.

Plan 2020
KeyCare Plus 0 – 8 550 R1 207
KeyCare Plus 8 551 – 13 800 R1 659
KeyCare Plus 13 801+ R2 450
KeyCare Core 0 – 8 550 R949
KeyCare Core 8 551 – 13 800 R1 183
KeyCare Core 13 801+ R1 809
KeyCare Start 0 – 9 150 R914
KeyCare Start 9 151 – 13 800 R1 538
KeyCare Start 13 801+ R2 394

The full contribution schedule is embedded below:

Discovery Medical Aid 2020 by BusinessTech on Scribd


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Here are all your Discovery medical aid price hikes for 2020