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Maximising purchasing power from your health cover

23 September 2021 Health Squared

Could SA’s recovery exceed our expectations? It starts at microlevel

While South Africans are impatient to kickstart our country’s trajectory towards prosperity, many face the challenge of ensuring their family’s health needs are properly provided for, often on diminished household budgets.

“Many people have had to tighten their belts on salary cuts, while most employed people are digging deep and working harder than ever to keep things on track under extraordinary, and often stressful, conditions,” says Bianca Viljoen, spokesperson for HEALTH SQUARED Medical Scheme.

“Times of adversity can stimulate innovation and efficiency in surprising ways. The pandemic has also highlighted the tremendous difference organisations and individuals can make in the lives of others during tough times.”

According to Viljoen, this has been reflected in the healthcare funding industry. For example, long before regulations compelled it, HEALTH SQUARED was the first scheme to cover Covid-19 tests irrespective of the result, thus encouraging responsible testing behaviour early on to help prevent community spread of such a contagious virus.

“We then extended our commitment to include payment relief during the most severe lockdown restrictions, as well as free and unlimited psychosocial support to all members throughout the pandemic.

“To support members into 2021, the Scheme also announced some of the industry’s lowest contribution increases, ranging between 0% and 6% across options, and has committed to cover the Covid-19 vaccine in full for members on all benefit options as part of our sustainable, member-centred approach to healthcare funding,” Viljoen explains.

Looking ahead, some analysts anticipate growth as international investors look to South Africa’s commodities for security this year. From a microeconomic perspective, building an enabling economic environment at this level starts with the health and wellbeing of individuals in the workforce and their families, Viljoen says.

“Now is a crucial time to be selective in choosing health cover, and there are two main considerations that are increasingly driving purchasing behaviour. The first is value for money where more and more consumers are taking a critical look at the return on investment that their contributions represent. The second consideration is flexibility, a trend that has been accelerated by the unpredictability of the Covid-19 pandemic.

“Medical scheme members now want the certainty of flexible and adaptable options that are able to ensure cover from every angle in both predictable and unpredictable times. As people seek better value, they are gaining more insight into the workings of their cover and are asking more questions of their medical schemes and brokers to determine how they can achieve the best possible value for their health cover needs,” she says.

“In our experience, this has been echoed in a growing preference for cover that uniquely combines both traditionally structured benefits with medical savings accounts. As a result, these mixed benefit structures offer the best of both worlds, as broader cover can be achieved more affordably and without compromising quality private healthcare.”

For example, on the market-leading Prosper and Optimum options, which are ideally suited to young growing families, HEALTH SQUARED offers a family of two adults and a child access to cover representing more than 10 times their annual contributions.

“When looking at options for health cover, you are planning for the unexpected. Ask yourself, if your family had a major health event, what percentage of your healthcare costs would your membership contribution represent.”

A member on HEALTH SQUARED’s Aspire Hospital option, for example, recently experienced a major healthcare event and required over R700 000 worth of healthcare. Thanks to extensive, well constructed healthcare cover, the member’s contributions for a 12-month period was effectively a mere 4% of the total value HEALTH SQUARED covered during this period.

“Empowering our members to be optimally healthy for the long-term is key to our sustainability as a scheme. Through various partnerships, the scheme forms part of the broader Agility HealthPocket solution that offers more benefits and prioritise the holistic wellbeing of members, because we see the tangible business sense of investing in health. The advanced systems underpinning the solution’s claims management focuses on patient outcomes and best practice, which significantly lowers healthcare risk and costs by providing proactive and integrated support to members when they need it,” Viljoen says.

According to Viljoen, making the most productive use of time and resources is a necessity as many people find they have less spare time on their hands juggling the priorities of their careers, running a home, spending time with family.

“Time is at a premium and further value is created for medical scheme members when their cover has the capability to integrate with real cash-back rewards, holistic health, wellness and financial services,” she points out.

HEALTH SQUARED members enjoy this advanced level of service integration through the Agility HealthPocket solution, as the cover, processes and systems work together to prevent unnecessary out-of-pocket payments, with complementary gap and co-payment insurance cover and rewards.

“We should not be too quick to underestimate our country’s achievements over this time, and the individual contributions millions of people who make up the great South African workforce. Many of us have had to economise, learn new skills and create more value. If we are to make the most of the impetus the pandemic has brought to the working world, our health and wellness must be prioritised,” Viljoen adds.

“The healthcare funding industry has a responsibility to grow affordable, relevant and holistic cover solutions to ensure our country’s growth is supported for the future.”

Quick Polls

QUESTION

Do you believe this is the toughest period for financial advice in many years?

ANSWER

Yes, it’s hard to navigate the challenges and difficult to adapt. I’m struggling.
No, I have managed to navigate the challenges and have adapted. I’m good.
50/50. I just feel like whether we like it or not, we have to ready ourselves for change… be resilient and scale for the future. It’s not about survival of the fittest anymore but survival of the quickest. We just have to move on with life.
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