Category Healthcare
SUB CATEGORIES General  |  HIV |  Medical Schemes | 

2019 Bestmed Medical Scheme Annual Increases

05 October 2018 Bestmed Medical Scheme

An average of 8.9% increase in Bestmed’s 2019 member contributions

Bestmed Medical Scheme, South Africa’s fourth largest open medical scheme, announced an average contribution increase of 8.9% for 2019 at their product launch events held in all major regions today. This announcement comes shortly after Bestmed has been voted as one of the top three schemes across the industry in the prestigious Ask Afrika Orange Index® survey. The Ask Afrika Orange Index® is the largest and most widely referenced customer satisfaction benchmark survey done in South Africa.

Pieter van Zyl, acting CEO of Bestmed, explained that this year’s increase of 8.9% is on par with the current medical inflation corridor, with four of the Scheme’s product offerings recently named as the “Best” in the market, according to the results of the Grant Thornton Capital Survey. “The past year, we have again experienced material rising costs in the medical industry, and this affected members immensely, while putting pressure on the industry as a whole. We endeavour to keep our increases at a minimum, bearing in mind our members' means, without compromising access to quality healthcare. Caring for the healthcare needs of approximately 196 000 lives entrusted to us, coupled with excellent service, enable Bestmed to effectively deliver to members’ expectations," said van Zyl.

The latest amendment to the Value-Added Tax (VAT) Act stipulating the increase in the VAT rate from 14% to 15% was implemented since 1 April 2018. As of this date, the cost of service providers such as doctors, specialists and hospitals, all medicines and consumables billed to medical schemes have increased by 1%.

Bestmed’s decision to not pass on the increased VAT burden to our members with a premium increase for the remainder of the year meant that the Scheme incurred higher than planned healthcare costs for the 2018 financial year. “However, we continued to manage our financial obligations at no disadvantage to our members”, adds van Zyl.

The medical schemes industry continues to make a significant contribution to providing access to quality healthcare to South Africans. As South Africa’s largest self-administered scheme, Bestmed is able to keep its administrative costs at a minimum. This ensures that more than 90% of income received from members’ contributions are paid towards medical scheme benefits.

Summary of key benefit changes on specific benefit options for 2019:
• A 50% frame benefit increase for member value at a PPN provider.
• Additional maternity benefits with 2 x 2D ultrasounds, antenatal iron and folic acid tablets and post-natal consultation.
• Day-to-day dentistry improvements: 10% increase in out-of-hospital basic and specialised dentistry limits.
• Preventative care: for screened beneficiaries, 3 dietician consultations and 3 biokineticist consultations per annum.
• HPV vaccinations: HPV vaccination implemented on options previously without this benefit.
• Spinal prosthesis merge: combination of spinal prosthesis and artificial disk limit increases.
• Dental and oral surgery: beneficiaries aged 7 and younger - extraction and restoration benefits at day hospitals.
• A new Diabetes Management Programme will be introduced to the benefit of all members

“We continuously review our biggest single claims and noted an increase in premature births with 4 out of the 10 biggest value claims related to premature births. The trauma associated with premature births, or complications at birth, are of real concern and we will continue to do everything possible to provide peace of mind to members who find themselves in such an unfortunate position. In an attempt to reduce the number of traumatic premature births, Bestmed will introduce a carefully designed ante-natal program to ensure mothers maintain optimal health before and during pregnancy” adds van Zyl.

“In addition, Bestmed will launch its new and improved wellness program which includes additional assessments that will benefit members of all ages. These assessments are aimed at identifying health risk areas of the entire family and will not just focus on adults. By areas assessment of babies and children, parents will be able to take note of potential health risks and Bestmed will assist with sound management of any risks identified.

The assessments include inter alia the following:
• Antenatal and post natal assessment of mother and baby
• Assessment of growth and developmental milestones achieved
• Healthy infant, baby and toddler feeding programmes and nutritional assessments
• Sound immunisation programmes

Families will receive a detailed report that indicates their health status and/or their identified health risks with suitable interventions recommended to address the findings if deemed necessary.

“Furthermore, the newly developed broker and member apps which form part of our digitalisation strategy, are ready to be downloaded. These apps contain effective features that have been synchronised with the features of our new administration system where we are now starting to note efficiencies and better response times. This will be a guaranteed positive experience for brokers and members.

Bestmed continues to prioritise the health status of its members through their personalised and customer-focused services to all members aligned with its brand promise: Personally Yours.” van Zyl concluded.

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