Category Healthcare
SUB CATEGORIES General  |  HIV |  Medical Schemes | 

Medical Scheme’s continued growth in troubled times is heartening

13 October 2020 Makoti Medical Scheme

Businesses urged to work together to grow SA economy

Hendrick Makgopela, principal officer of Makoti Medical Scheme, says that while it has been a difficult year at every level and economic conditions remain tough, now is the time for responsible employers to ensure that they have appropriate and reliable medical scheme cover in place for their employees.

“Once business returns to some sense of normality after the COVID-19 pandemic, which it will, you will need many more capable hands to help you catch up on all the productive time that has been lost,” he adds. “As businesses our most important objective should be to work together in turning the South African economy around.”

“Despite the COVID-19 pandemic and the subsequent financial hardships experienced by so many individuals and companies during 2020, it is heartening that Makoti Medical Scheme has continued to grow while steadily building its reserves,” notes Mr Makgopela.

“Our membership has increased by no less than 25%, and we have now reached a healthy solvency ratio of 62%, which is well in excess of the Council for Medical Schemes’ required minimum of 25%. With a young average age of 31 years, and a low pensioner ratio of less than 1% the scheme continues to thrive. This compares most favourably to the industry average beneficiary age on open schemes of approximately 35 years, and a pensioner ratio of 9.5%. These are both essential attributes that ensure Makoti’s highly favourable claims-to-loss ratio thereby contributing to the healthy solvency ratio of the scheme,” he states.

According to Mr Makgopela, the scheme’s increases have remained consistently low over the past five years, with 2021 being no different. Next year Makoti will be implementing a contribution rate increase of 6.5% on its Comprehensive Option, and a 5.5% increase on the Primary Option.

“It is important to understand the percentage increase relative to the Rand value amount per member per month,” he noted. “To put this in perspective, on the Primary Option contributions will start from only R294 per member per month, while a family comprising a principal member, adult dependant and a child will pay less than R1 000 per month. For the Comprehensive Option, contributions start at R1 976 per member per month.”

Makoti, which has a proud 44-year track record, serves the healthcare needs of the transport, motor manufacturing, consumer goods and the hospitality industries. Some of the biggest brands in South Africa have entrusted the health and wellbeing of their employees to the scheme. These include companies such as Nissan, RCL Foods, Volvo, PG Bison, Mintek, Group 5 Construction and Vector Logistics, to name but a few.

Special features that set the scheme apart include:
• Makoti members never have to fund any co-payments – no matter whether they are in hospital receiving treatment, or utilising out-of-hospital services. This wallet-free environment is an absolute win for lower income earners.
• One of Makoti’s greatest appeals lies in its benefit richness, which provides unlimited general practitioner consultations and freedom of choice in choosing a healthcare service provider.
• To ensure greater convenience and further savings for members and employers alike, Makoti can integrate its service offering with the on-site primary healthcare services of employers.
• Child dependants pay child rates up to the age of 25, providing they are full-time students or financially dependent on the principal member.
• The scheme is one of the most accessible to first time entrants, as it provides quality medical cover at highly affordable rates.
• Unlike most medical schemes in this market, Makoti covers all chronic conditions, not just PMBs, and offers generous acute medicine benefits. The scheme also provides over-the-counter medicine benefits and covers homeopathic medicines.

Mr Makgopela says the Primary and Comprehensive options provide access to unlimited private primary healthcare cover through an extensive network of general practitioners on a national basis. “This means that members never run out of benefits and always have access to general practitioner consultations at their selected GP for any clinically necessary services. In addition, they also have access to acute medication throughout the benefit year.”

“Dependants have the option to select a different GP to that of the principal member, ensuring that all the beneficiaries in the family can visit a network doctor of their choice, as and when required. The Comprehensive option provides the same cover as the Primary option, but with additional richer benefits including access to specialist consultations, private hospitalisation cover as well as cover for maternity benefits in private hospitals.”

“Makoti has made considerable inroads through the years in broadening access to healthcare and we have made enormous strides when it comes to extending highly flexible medical scheme protection on an affordable basis to employees and their beneficiaries,” asserts Mr Makgopela.

The scheme has entrenched itself within the low-cost market over a period of 23 years. During this time Makoti and its healthcare administrator, Universal Healthcare, have refined its products to deliver unmatched value for money underpinned by stability, absolute reliability and a high degree of flexibility. Managed care provider, Enablemed, on the other hand, has developed and nurtured relationships with healthcare service providers nationally.

“Makoti’s overall aim is to prevent illness wherever possible by pro-actively and timeously dealing with healthcare issues. This is made possible through registering and regularly following up with members with chronic illnesses and is done in consultation with members’ chosen general practitioners. The wellbeing of members is ensured in this way while the costs of care are reduced.

“Sound corporate governance, innovative product benefits, highly affordable contributions and impressive reserves that are well above legally required limits, have all assisted to strongly position Makoti within the lower income market.

“Makoti is passionate about providing personal attention to each and every one of its valued members. While we make quality healthcare more affordable and accessible to our members, we are also completely committed to their care and wellbeing,” concludes Mr Makgopela.


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