A misconception has existed for years regarding the difference between health insurance, hospital plans and comprehensive medical aid, with many believing that these products are the same and provide similar access and benefits.
This misconception has prevented a large number of consumers from having access to private healthcare cover. Not having access to private healthcare cover when it is needed unfortunately comes with a multitude of costs, not all of which are financial. Without the medical schemes industry, the vast majority of South Africans would be unable to cover the expenses associated with a major medical event.
Understanding the different healthcare cover solutions available today against the current backdrop of the increases being positioned by medical schemes for 2024 - and the financial challenges being faced by South Africans - is key to making an informed decision. While complex, the medical scheme industry in South Africa provides healthcare to approximately 8.94 million people1.
Most recently, Momentum Health Solutions announced Momentum Medical Scheme’s product updates and annual price increase for 2024, which comes in at 9.6% (pending approval from the Council for Medical Schemes). While this figure may be considered high, it is important to understand the framework in which the medical schemes industry operates.
The COVID-19 pandemic impacted businesses considerably and while its effects have eased, the repercussions remain prevalent and continue to contribute to increased inflation within the sector. The parameters in which increases are calculated are wide, however, it is important to consider the key factors impacting the industry and wider financial landscape. Calculating increases aligned to the relevant factors is critical to ensuring sustainability and longevity of the Scheme and its ability to provide comprehensive cover to its members.
One of these factors is the increasing claims costs which directly impacts on the scheme’s solvency levels. Should a scheme implement a contribution increase below healthcare inflation, this would result in a knock-on effect, as operational costs are not adequately managed against inflation and therefore future increases will be higher than needed.
As a business, we are aware of the myriad of challenges facing consumers. At the same time, we understand the critical need for access to quality healthcare services. Momentum Medical Scheme prioritised the evolving needs of its members, as well as the long-term sustainability of the Scheme when calculating its proposed annual increase for 2024.
For example, Momentum Medical Scheme offers two hospital plans, the Custom and Evolve Options. While these plans are not unique in their design, what is unique compared to other schemes in the industry is that they allow members more flexibility and control over their healthcare savings. In addition, members can subsidise their savings contributions with free rewards from Momentum.
It cannot be disputed that prioritising your health and wellness is proven to yield various benefits both personally, as well as in the context of businesses and the morale of staff. Momentum Health Solutions has strengthened its focus on helping clients lead well-maintained, balanced lifestyles that reward and benefit them holistically. As a key player within the sector, we have seen that the notion of wellness has become somewhat of a buzzword, however, it should not be considered insignificant. The positive impact that materialises when people become more intentional with their overall wellness is significant.
As a healthcare administration company that prioritises wellness, we understand that we are a critical component and partner to clients in walking the wellness journey with them, both physically, emotionally, and mentally. 2024 will be a year of immense change for South Africa’s healthcare sector, however, we are geared to support these changes in a way that creates more healthcare for more South Africans, for less and creates a thriving healthcare system that benefits not only our clients, but all South Africans.