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Navigating Your Healthcare Costs: A Closer Look at South African Medical Scheme Price Increases for 2024

South Africa’s medical aid schemes have recently announced their price increases for 2024 and other key changes. 

A medical scheme, often referred to as a health insurance or medical insurance plan, is a comprehensive and structured financial service designed to provide individuals and families with access to high-quality healthcare services while offering financial protection against the potentially exorbitant costs of medical treatment. This vital tool serves as a safeguard for your well-being and peace of mind by ensuring that you can receive necessary medical care without the burden of overwhelming medical expenses. 

Why are medical aid scheme prices increasing? 

Year after year, we witness the unwavering ascent of medical aid scheme prices, leaving many individuals and families wondering about the reasons behind this persistent trend. These annual price hikes are not arbitrary; they are intrinsically linked to a complex interplay of economic factors that impact the ability of medical schemes to function effectively. In South Africa, this trend is particularly evident, driven by factors such as medical inflation, the rising cost of living, and the ever-increasing price of petrol. 

Medical Inflation in South Africa

One of the primary culprits behind the continual rise in medical aid scheme prices is medical inflation. This specific type of inflation is associated with the increasing cost of healthcare services, medicines, and medical technology.

In South Africa, medical inflation has consistently outpaced general inflation rates, placing added financial pressure on medical schemes. The demand for state-of-the-art medical treatments, cutting-edge technologies, and qualified healthcare professionals contributes to these elevated healthcare costs, necessitating higher premiums from members to sustain the quality of care they receive. 

The Rising Cost of Living

The cost of living, encompassing housing, education, food, and transportation expenses, continues to soar. This leaves individuals and families with less disposable income to allocate to their medical aid premiums. As a result, medical schemes often need to adjust their prices to align with this new economic reality. Failure to do so could result in an inability to cover the increasing costs of healthcare services, putting the financial stability of the scheme at risk and leaving members underinsured. 

Escalating Petrol Prices

The relentless surge in petrol prices is yet another factor affecting medical aid scheme prices. Higher fuel costs impact various aspects of healthcare, including transportation for medical staff, delivery of medical supplies, and even the logistics of patients getting to healthcare facilities. These increased expenses often need to be absorbed by medical schemes, which, in turn, necessitate premium adjustments to accommodate the financial strain. 

Balancing Act

Medical schemes operate as intricate financial ecosystems. They must strike a delicate balance between managing the financial contributions of members, covering the ever-escalating costs of healthcare, and ensuring the long-term sustainability of the scheme. Annual price increases become a necessary measure to maintain this equilibrium. 

The Average Weighted Increase

 Medical Scheme

Weighted Increase 

 

Fedhealth 

10.40% 

 

Medshield 

8.90% 

 

Discovery 

7.50% 

 

Bonitas 

6.90% 

 

Momentum 

9.60% 

 

Bestmed 

9.60% 

 

Medihelp 

16% 

 

Sizwe 

10.40% 

 

Compcare 

 To be announced. 

 

Disovery’s 2024 Changes

Discovery has a weighted average increase of 7.50% across their plans. Discovery Health is a leading South African medical insurance company that offers a wide range of plans to meet the needs of individuals and families. Discovery Health is known for its innovative products, such as its Vitality wellness program, which rewards members for making healthy choices. Discovery Health is also committed to providing its members with access to high-quality healthcare and has a network of over 75,000 healthcare providers across South Africa. 

Innovative Home Loan 

A new impressive offering by Discovery Banking is their ”innovative home loan”, which gives Discovery’s clients an integrated offering with competitive home loans (discounted interest rates), instant access to credit, and protection of their investments. 

Virtual Urgent Care  

For the highest level of convenience, members have access to a dedicated panel of emergency room doctors providing immediate virtual care for urgent medical conditions 24/7. Appropriate urgent care consultations will be funded by the Scheme. KeyCare Start Regional members must access urgent care through the KeyCare Online Practice. Non-urgent care is funded from day-to-day benefits. 

Virtual Physical Therapy  

Evidence-based physical rehabilitation will be done online via video and supported by Artificial Intelligence technology. Which allows patients to seek the physical rehabilitation their need in the comfort of their home conveniently extends the connection. Virtual Physical Therapy is funded from available day-to-day benefits. 

 Mental Health Assessment Benefit

All members now have access to a mental wellbeing assessment via the Discovery Health app. Members’ mental health risks are evaluated based on the results of the assessment and clinical data giving them access to: 

  • Pro-active virtual coaching. 
  • Virtual and / or face-to-face consultations with Premier Plus GP or Psychologist. 

Vitality 

Discovery Vitality will be introducing Checkers 60/60 online delivery services as the new additional Healthy Foods Partner during the latter half of 2024. 

There is also an incentive to get more members active with the reduced once off Activation Fee (R499) to encourage Gym Membership.  

Discovery has expanded its Fitness Network to include: 

  • Yoga. 
  • Pilates 
  • Africa Padel. 

The Discovery App

The Discovery App will be improved with new enhanced functionality, which will include all the benefits of activating gym contracts and booking sessions. 

One of the most drastic changes made by the medical aid company is slashing the medical savings account (MSAs) on its most popular plans. Classic Saver and Essential Saver, have half a million members between them. The following decrease has been made to these two plans MSAs: 

  • Classic Saver:  will decrease from R12 180 this year to R10 020 for next year. 
  • Essential Saver: the MSA will decrease from R5796 this year to R4008 in 2024. 

 

 

   

The Discovery Health Plan  

 

 

 

 

The 2024 Price Increase 

Executive 

Executive 12.9%  increase.

 

Comprehensive 

 

There will only be the following two options for next year: 

  • Classic Comprehensive increases by 11,9% 
  • Classic Smart Comprehensive (15% Medical Saving Account) increases by 11,9% 

 

Members on the Essential & Delta Comprehensive options will be defaulted unless they make an option selection. Please look out for the relevant information. 

 

Priority  

 

  • Classic Priority increases by 9,9%. 
  • Essential Priority increases by 9,9%. 

 

Saver 

 

The Medical Savings Account (MSA) will be reduced by 5% for all Saver Options. 

 

 The increases shown below are shown after the decease has been applied: 

  • Classic Saver and Classic Delta Saver increases by 3,0%. 
  • Essential Saver and Essential Delta Saver increases by 3,8%. 
  • Coastal Saver increases by 6,3%. 

 

Core 

 

  • Classic Core and Classic Delta Core increases by 9,9%. 
  • Essential Core and Essential Delta Core increases by 9,9%. 
  • Coastal Core increases by 12,9%. 

 

Smart 

  • Classic Smart increases by 8,9%. 
  • Essential Smart and Essential Dynamic Smart increases by 8,9%. 

 

KeyCare 

  • KeyCare Plus increases by 10,9%. 
  • Keycare Core and KeyCare Start increases by 9,9%. 

 

FlexiCare 

 

  • FlexiCare increased by 8.5%. 

 

Bonitas

Bonitas Medical Aid is one of the leading and well-established medical aid schemes in South Africa. It has been in operation for over three decades and has earned a reputation for providing comprehensive healthcare coverage to its members. Their have increased their 2024 offerings by an average of 6.9. 

Mental Health

Bonita’s has included a mental health programme across all of their plans for 2024 along with including depression as a chronic condition. Another major change is policy holders’ access to Panda, a digital platform that is available through the Bonitas App. Which gives members an easy access to: 

  • Expert help. 
  • Mental health information. 
  • Community support. 

Benefit Booster

With the benefit booster, members will have access to additional funds to use for out-of-hospital expenses. These funds can be used for additional GP visits and acute medicine. 

  • Standard, standard select, and Bonsave : have access to up to R5000 in medical savings. 
  • Primary and Primary Select: access to R3500 medical savings. 

Be Better Benefit 

Bonitas has added a range of screenings and tests to their offerings. Members have access to the following tests: 

  • Annual wellness screening per a beneficiary (blood pressure, blood glucose, BMI and cholesterol.)
  • Flu Vaccines. 
  • HIV tests. 
  • Lipograms.
  • Mammograms. 
  • Pap smears.
  • Prostate screenings. 
  • Pneumococcal vaccines. 
  • Whooping cough booster. 
  • HPV vaccines. 
  • Stool test fir colon cancer. 
  • Dental fissure sealants. 
  • Free online gearing screening. 
  • Contraceptives value (up to R1950). 

    Mother and Child Benefit 

    Bonitas has added a comprehensive maternity programme that included: 

    • 24/7 online advice. 
    • Online pregnancy webinars. 
    • Bonitas baby bag. 
    • Maternity consultations and scans. 
    • Newborn hearing screenings. 
    • 24/7 advice for parents with children under 3 years old. 
    • Childhood immunisations. 
    • Paediatric and GP consultations 

    Emergency Room Consultations 

    Members now have access to two emergency room consultations and treatment per a family for 2024. The following plans have an additional two emergency consultations for children under 6: 

    •  Standard. 
    • Standard Select. 
    • Primary. 
    • Primary Select. 
    • Bonsave.  
    • Bonfit Select. 

    HPV Vaccines 

    Policy holders across all of Bonitas’s plans have access to the Human Papillomavirus (HPV) vaccine to help prevent cervical cancer. The doses are: 

    • Two for females (9-14 years old).
    • Three for females ( 15-20 years old).

    Chronic Medicine Management 

    Bonitas has extended their Standard option to the Bonitas Pharmacy network. This enables members to get their chronic medication from a network pharmacy member. 

    Child Dependents

    The child dependents age has been increased to 24 years old, whether the child is still studying or not. 

    Bonitas Health Plan

    Contribution Increases 

    Edge 

    Bonstart 3% increase 

    Bonstart Plus 3% increase 

    Hospital 

    Bonessential 7.1% increase. 

    Bonessential Select 6.7% increase 

    Hospital Standard 8.9% increase. 

    Income-based 

    Boncap 5.5% increase. 

    Savings 

    Boncomprehensive 9.6% increase. 

    Bonclassic 9.6% increase. 

    Bonsave 6.8% increase.  

    Boncomplete 9.6% increase. 

    Bonfit Select 2.7% increase. 

    Traditional 

    Primary 7.2% increase. 

    Primary Select 7.2%. 

    Standard 8.4% increase. 

    Standard Select 8.4% increase. 

     

    Bestmed

    Bestmed is a well-known and respected medical aid scheme in South Africa. Founded in 1988, it has gained a strong presence in the healthcare industry and offers a range of healthcare plans to meet the diverse needs of its members. Bestmed has an average weighted increase across all its plans of 9.6%. 

    Benefit Limits and Sub-Limits 

    Bestmed has increased it’s benefit limits and sub-limits by 5%. 

    New Beat 3 Plus Option 

    An optometry benefit has been added to the New Beat Plus Option, available every 24 months. This option includes benefits for supplementary services and savings that account for 25%. 

    Out-of-hospital Benefit 

    Include specialised diagnostic imaging (MRI Scans, CT Scans, Inotrope studies and PET Scans):  

    • One scan per lumbar and cervical spine region will be funded from the existing specialist diagnostic imaging benefit. 

    Preventative Care  

    Intrauterine Device (IUD) insertion (including consultations and procedures) by a family practitioner (fp) or gynaecologist has been added to the following plans (once every five years):

    • Beat 2. 
    • Beat 3.
    • Rhythm 1.
    • Rhythm 2. 

    Consultation fee: will be funded with the pap smear procure on the Beat 4 plans and across Pace range (1-40. 

    Glaucoma Screening:  Beneficiaries who are 50 years and older are able to go for a glaucoma screening one a year at a network optometrist. The cost will be paid from the preventative care benefit on the following plans:

    • Pace 2. 
    • Pace 3. 
    • Pace 4. 

    Tempo Benefit 

    Bestmed’s Tempo Wellness programme has been enhanced by additional features and functionalities such as:

    • On-demand exercise classes. 
    • Self-assessments relating to mental health issues. 
    • Fitness and nutrition challenges. 

    Each of these new features and functionalities is available to members via the online Tempo Fitness, Nutrition and Emotional wellbeing journeys. 

    Other important changes 

    From the 1 of January 2024 Netcare911 will be the new emergency ervice providers. The Beat EDO and Rhythm hospital network will change. Mediclinic and National Hospital Network (NHN) will replace Netcare and Life Healthcare. 

    Bestmed’s Health Plan 

     

    2024 Price Increase 

    Beat Plans 

    Beat 1 

    • Network 9.5% increase. 
    • Non-network 9.5% increase. 

    Beat 2 

    • Network 9.5% increase. 
    • Non-network 9.5% increase. 

    Beat 3 

    • Network 9.5% increase. 
    • Non-network increase 9.5% increase. 

    Beat 3 Plus: N/A 

    Beat 4: 9.9% increase. 

     

    Pace Plans 

    Pace 1: 9.5% increase. 

    Pace 2: 9.9% increase. 

    Pace 3: 9.9% increase. 

    Pace 4: 9.9% increase. 

     

    Rhythm Plans 

    Rhythm 1: 9.5% increase. 

    Rhythm 2: 9.5% increase. 

     

    Medihelp

    Medihelp is a prominent and well-established medical aid scheme in South Africa, known for its comprehensive healthcare coverage and a commitment to providing quality services to its members. Medihelp’s average weighted increase across all of their  plans is 16%, with all their benefits increasing b 5%. 

    Benefit consistency 

    Medihelp’s product range and benefit structures will remain as is in 2024: From comprehensive, to savings, to vital plans. The existing full basket of added insured benefits will also stay intact, as well as the care extender benefit that will activate after undergoing health tests and screenings. 

    Family contributions  

    Families will continue to benefit from paying for only two children under the age of 18 on MedVital, MedAdd, and MedPrime in 2024. Child dependant rates will apply to child dependants until they reach the age of 26 years and MedElect will still provide student cover for under a R1 000. 

    Treatment of major depression  

    Another benefit package on offer will be for the treatment of major depression out of hospital instead of hospitalisation. This will be available in consultation with the treating psychiatrist on a case-by-case basis. 

    CoCare Centres of Excellence

    Partnering with quality hospitals and medical professionals, Medihelp will in the future offer a number of care baskets for specific procedures. These CoCare Centres of Excellence, consisting of a carefully selected interdisciplinary team of medical professionals, will start rolling out in 2024. When members apply for preauthorisation for procedures such as cataract surgery, they can consider this care basket alternative to cut down on potential out-of-pocket expenses. 

    Disease Management programme  

    To assist members living with high cholesterol, diabetes, and high blood pressure, Medihelp will be offering a Disease Management programme. Non-compliance to treatment regimens can have serious health implications for these members, especially insofar as doctor’s visits, pathology, and medicine are concerned. Medihelp’s Disease Management programme will be integrated with the Member Zone to assist members in complying with treatment and the risks associated with these diseases. 

    DNA analysis  

    Medihelp will be using drug-gene testing or pharmacogenomics where needed to assist high-risk patients in managing their medication. In these cases, the test will be funded from the core benefit. Any member on the MedSaver option will be able to fund the DNA test from their savings account. 

    MedVital and MedMove! PMB benefit  

    Facet joint injection, functional nasal surgery, hernia repair, and varicose vein will be included in MedVital and MedMove PMB benefit. 

    Medihelps’ Health Plan 

    2024 Price Increase 

    Vital Plans 

    MedElect student 17.90% increase. 

    MedMove 17.50% increase. 

    MedVital Elect 15.43% increase. 

    MedVital 16.06% increase. 

    Savings Plans 

    MedAdd Elect 17.32% increase. 

    MedAdd 19.90% increase. 

    MedSaver 16.79% increase. 

    Comprehensive Plans 

    MedElect 17.90% increase. 

    MedPrime Elect 13.90% increase. 

    MedPrime 13.90% increase. 

    MedElite 16.50% increase. 

    MedPlus 16.50% increase. 

    Sizwe

    Sizwe Medical Fund, officially known as Sizwe Medical Fund & HealthCare’s, is a South African medical aid scheme that has been serving its members since its establishment in 1978. Sizwe Medical Fund is recognized for its commitment to providing comprehensive healthcare coverage to its members. 

    Sizwe Healthcare Plan 

    2024 Price Increase 

    Comprehensive Plans 

    Titanium Executive 9.5% increase. 

    Platinum Enhance including EDO 9.5% increase. 

     

    Comprehensive Traditional Plan 

    Plus 9.5% increase. 

     

    Traditional Plan 

    Value including the EDO 13% increase. 

    Gold Ascend 8.5% increase. 

     

    New Generation Plan (savings)  

    Access Saver 8.5%. 

     

    Hospital Plan 

    Access Core 13% increase. 

     

    Income Based Plan 

     Essential Copper 12% increase. 

     

    Clarity Employee Benefits is an authorized Financial Services Provider – FSP No. 51007. We specialize in medical aid, please do not hesitate to contact us if you are in need of health insurance guidance or advice. 

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