Bestmed continues to deliver value for money to ensure its sustainability and continued competitiveness
Change is inevitable, trust is the only constant. One of the certainties in life is that costs will rise and, in recent years, the cost of healthcare has risen substantially. Medical inflation has, for a number of years, exceeded the Consumer Price Index (CPI) and, therefore, annual medical scheme increases are higher than CPI. However, in 2021 and 2022, many medical schemes opted to increase their contributions by less than CPI because they had accumulated reserves during the COVID pandemic. With claims returning to pre-COVID levels, schemes must safeguard their sustainability by managing reserves and ensuring that contribution increases are at levels that commensurate with claims and expenditure.
In navigating these changes, Bestmed has prioritised its members by continuing to offer comprehensive and rich benefits, as well as a 4.6% average benefit limit increase, further solidifying its reputation as a trusted provider.
Since the end of the COVID-19 pandemic, notes Leo Dlamini, CEO and Principal Officer at Bestmed Medical Scheme, healthcare claims have risen more rapidly. This is due to several reasons including: increased claims for treating long-term health complications related to the COVID pandemic, an increase in oncology prevalence and an increase in the prevalence of Fraud, Waste and Abuse (FWA).
“We've also seen growing demand for mental health services exacerbated by the pandemic (and post pandemic realities), alongside an increased prevalence of chronic conditions such as diabetes and hypertension, resulting in rising claims. Despite these challenges, Bestmed continues to achieve strong principal membership growth and has done so over the past five years, including the COVID-19 lockdown period. We believe this growth is indicative of Bestmed being among the most affordable medical schemes in the country, despite the ever-escalating cost of healthcare.”
Dlamini states that the Scheme’s offering goes beyond affordability. Bestmed has a strong membership service culture, which is proven by the numerous customer experience accolades received over the past few years. Bestmed has won, among others, the 2023 Board of Healthcare Funders Titanium Award for Excellence in Creating Access to Quality Healthcare, the Financial Intermediaries Association (FIA) Intermediary Experience Award 2022 for Product Supplier of the Year: Healthcare (was a top three contender for the same award in 2023), and ranked second in the Medical Aid Companies category in the Ask Afrika Orange Index® 2023-2024 and 2024-2025. Bestmed was also awarded the News24 Medical Scheme of the Year award for 2024.
“Among the upcoming key product changes that members should take note of is the enhancement of our internal prosthesis offerings with endovascular and catheter-based procedures. Drug-eluting stents will now be funded on all our options, subject to the limits for vascular prosthesis on each option. Both single and dual chamber pacemakers will also be funded on all options. We have also adjusted the preventative care benefits on the Rhythm1 option for mammograms and pap smears to be covered on this option from 2025. This means that these two preventative benefits are now covered on all 14 of our product options,” states Dlamini.
“The structure of the specialised diagnostic imaging benefit has also been changed, where MRI scans, CT scans and nuclear/isotope studies will now have a combined family limit per annum for in-hospital and out-of-hospital on all options, except Rhythm1 where it is only covered for approved prescribed minimum benefits (PMBs).”
In addition, dependants, up to the age of 24 years, are still regarded as child dependants, where previously dependants who were registered students up to the age of 26 years were covered at child dependant rates. The existing benefit for members only paying for three children and the rest being covered for free, remains in place.
“Bestmed’s core priority remains that of providing value-for-money medical cover for our members, whilst also managing the medium to long-term sustainability of the scheme. While we recognise that the proposed (subject to CMS approval) contribution increase of 12.75% on average for all options in 2025 is higher than previous years, we are confident that it is the right thing to do given the increased demand (utilisation) for healthcare services by our members as well as the increasing cost of healthcare which is largely beyond our control. The 2025 contribution increase must be considered in the context of Bestmed’s average increase over the past five years, which is 7.0%. This is marginally less than the market average for the same period. Also, whilst the annual percentage increase is an important lens through which one compares what different medical schemes are changing, the rand amount (absolute number) is what the member will experience. Rand for rand, Bestmed’s benefit options will remain competitive in 2025 and beyond,” adds Dlamini.
“We have prioritised maximising value for our members, while continuing to grow and remain competitive within the industry. As we celebrate the milestone of our 60-year anniversary, we commit to continue to be attentive to and serve our members for the next 60 years and beyond,” concludes Dlamini.