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Healthy CompCare Medical Scheme strikes balance with measured approach

20 October 2022 CompCare Medical Scheme

2023 updates characterised by responsible increases and continued benefit enhancements

With healthcare utilisation starting to show signs of returning to pre-pandemic levels, as demonstrated by the experience of leading private hospital groups and medical schemes, CompCare Medical Scheme is proceeding with caution to ensure ongoing stability and meaningful benefit enhancements for members.

This is according to Josua Joubert, Chief Executive and Principal Officer of CompCare Medical Scheme who notes that consumers have been through a time of unprecedented uncertainty in recent years. “What is needed now is upfront transparency so that members will know exactly what to expect and feel safe in the knowledge that their medical scheme is well prepared, no matter what the future may hold.

“In designing the scheme’s new benefit updates and implementing contribution increases, we have considered multiple factors with the ultimate aim of remaining true to our members. This means striking the right balance between keeping contributions at an affordable level and safeguarding stability and member access to quality healthcare, now and well into the future.

“The interruption in healthcare usage during the pandemic is resulting in a surge in elective procedures and preventative care, among others. We are also mindful of global trends towards long-term health implications for those who had severe COVID-19.

“While CompCare, along with the rest of the industry, saw a spike in surplus reserves during 2020 and 2021 when claims reached an all-time low, we have started to note a significant rebound in healthcare utilisation to pre-pandemic levels as forecast by the Reserve Bank in late 2021*.

“It is with this in mind that CompCare has implemented an overall average weighted contribution increase of 8.9% for 2023 with a benefit limit increase of 5.7%. The scheme’s solvency ratio remains high above industry requirements at 37.8%. Current membership is at 36 600 beneficiaries with the average age of new members sitting at 29 years,” says Joubert.

Carl Yssel, Managing Partner at 3ONE Consulting Actuaries notes the importance of responsible increases in ensuring that members continue to gain access to appropriate benefits, delivered in a quality and clinically appropriate setting.

“While it can be very difficult for consumers to compare medical scheme products there are certain differentiating factors that can help you to make the right purchasing decision. Firstly, understand which healthcare benefits are paid from risk, and what will be covered by your medical savings account. With more benefits covered under risk, members have greater flexibility and coverage for other healthcare needs not covered by the scheme.

“Secondly, while it may be viewed by some members as a sacrifice in convenience, provider networks really can make an enormous difference to your annual healthcare spend – in some cases up to 25% of total contributions. This is something that the budget-conscious consumer should certainly consider.

Yssel adds that when seeking value, options that offer market-leading price points, such as the UniSave option from CompCare, will set you up with a great basket of benefits for your healthcare rand.

“I mention UniSave in particular given its popularity, which is attributable to the excellent value for money that it provides. This makes it one of the most competitive options in the market in recent years and it is certainly one to look out for,” he notes.

Touching on the scheme’s benefit updates for the year ahead, Joubert asserts that CompCare remains at the forefront of wellness when it comes to meaningfully meeting the needs of members.

“This should come as no surprise, since we are the medical scheme of choice for adventure seekers and professional sportspeople, and our wellness benefits are well known for being ahead of the curve. An example is the addition of a lipogram to improve the detection of heart health risks as part of the preventative care benefits, all of which continue to be paid from the scheme’s risk pool.

“CompCare is passionate about supporting families in their healthcare needs, whether that’s your loved ones at home or your ‘work family’, without whom the wheels simply wouldn’t turn. With this in mind, we have increased access to quality healthcare on our NetworX option, which now offers an unlimited Overall Annual Limit and the funding of physiotherapy benefits from the Annual Flexi Benefit.

“With contributions starting as low as R472 per month, this is the ideal solution for corporate employers looking for an affordable, high-quality benefit package for their blue-collar employees. This option is equally well suited to international students and remains the option of choice in this market,” he says.

Joubert notes that CompCare has added no less than seven valuable new benefits for moms, newborns and kids, adding to the scheme’s already exceptional family benefits. The following new benefits will be available across all options, except NetworX, in 2023:

• The implementation of Paed IQ on all options will provide access to a 24/7/365 paediatric telephone healthcare advice line for parents of children under three years.
• Newborn hearing screening will be funded from risk.
• A newborn congenital hypothyroidism test will be funded from risk.
• Three additional paediatric visits will be paid from risk to monitor a newborn’s milestones in their first year of life.
• Basic dentistry and GP consultations will be paid from risk for children under the age of 6.
• Members can obtain a breast pump (up to a maximum of R3 000) from savings.
• In addition, children playing sports can obtain a mouthguard, funded from savings – a benefit that most other schemes do not offer.

“We also wish to remind our members that CompCare’s comprehensive psychosocial and emotional wellness benefit is available on every option, including the efficiency discounted options, so that the mental wellbeing of all members is taken care of. In the wake of the pandemic, we know just how important this is.

“In addition to providing wellness benefits that support members in living their best life, we remain 100% committed to being there for those what-if moments and we can say with full confidence that we have made the necessary preparations for this,” concludes Joubert.

*Sources: https://bit.ly/3TfBZ76

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