Medicover keeps increases low without cutting benefits

Medicover is again setting the standard of providing comprehensive benefits at affordable rates.

For the fifth year in a row, Medicover has been able to keep its annual increase below 10%.  The overall average increase for 2007 will be only 8.38%. This increase is yet again below the industry norm. Despite an industry trend of reducing benefits or adding co-payments or deductibles to benefits, Medicover has maintained its offering of benefits whilst enhancing the healthcare fund, and health savings account on Bona Plus and Titan, for out of hospital expenses. Rand for rand the increase on all plans is minimal.

Medicovers Core Focus for 2007 will remain unchanged with Medicover continuously striving to ensure that its offering is simple, yet effective, and totally transparent.

Since its inception in 1994, Medicover has grown steadily to more than 53 000 principal members covering more than 140 000 lives.  In 2006 alone, the growth has been approximately 1000 members a month. In July 2006 Medicover merged with KDM, Klerksdorp Medical Scheme and opened an office in Klerksdorp. A Cape Town office is on the cards for early in 2007.

Key differentiating factors:
1. Medicover is a self-administered scheme with low administration fees and is transparent in the application of funds.
2. Medicovers solvency level currently stands at 68% with reserves in excess of R700 million. 
3. Medicover has achieved a consistent AA- rating from Global Credit Rating over the past four years.
4. Medicover set the trend of making payments to service providers and members on a weekly basis.
5. Continuing with the initiative introduced in January 2005, members only pay contributions for their first three child dependants.
6. With the introduction of CarewarePBM, a fully integrated Pharmaceutical Benefit Management module within the current Medicover administration system, Medicover can now offer a more efficient and cheaper administration of medicine claims.
7. Medicover has outperformed its budget by a considerable margin in the previous financial year, despite high pressure from providers, hospitals and members.
8. The low-cost Bona and Bona Plus options offer members the best of all worlds hospital benefits, the prescribed minimum benefits, chronic care, dentistry, optometry and various other benefits - for a similar contribution to what other schemes charge for hospital plans only. These options are also structured to optimally make use of tax benefits.

The Medicovers COMPREHENSIVE COVER for 2007 includes:
1. Extensive private hospital cover on the most comprehensive plan, Alta, which offers unlimited private hospital cover at 300% of the Medicover Tariff

2. Separate stand alone insured risk benefits for:
 External prostheses and medical appliances (Members are now able to claim for the Mirena device from this benefit).
 Out of hospital radiology benefits entitling members to generous cover for diagnostic scans including MRIs and CAT scans.
 In and out of hospital psychological and psychiatric treatment.
 Chronic Medication covering the 26 Prescribed Minimum Benefit Chronic Diseases on all plans and an additional 40 chronic conditions on Titan and Alta.
 Remember, Medicover members are entitled to obtain their chronic medication from any registered dispensing service provider, again offering our members freedom of choice.
 Dentistry which is managed by DENIS (Dental Information Systems)
3. AN EXTENSIVE LIST OF DAY TO DAY EXPENSES IN THE FORM OF A HEALTHCARE FUND. Members are now able to claim for prescribed contraceptive medication from this benefit and members on the Alta option are able to claim for Pharmacy Advised Therapy from the benefit.  Remember, that members on the Bona Plus and Titan plans are still able to claim for PAT from their Health Savings Account.
4. A HEALTH SAVINGS ACCOUNT on the BONA PLUS and TITAN PLANS. In 2007, the HSA benefit available on the Bona Plus and Titan plans has been increased with the benefit equating to approximately 15% of the total monthly contribution on Bona Plus and approximately 20% of the total monthly contribution on Titan.
5. In addition, the Healthcare Fund sub-limit on frames has been increased on all plans.
6. COVER for EXTREME and PROFESSIONAL SPORTS.
7. COMPREHENSIVE MANAGEMENT of DIABETES for members on all 4 plans as they are entitled to join the Centre For Diabetes and Endocrinology at no extra charge.
8. SPECIALIST HIV MANAGEMENT through our partnership with Optipharm.
9. A MATERNITY PROGRAMME which provides expectant mothers with wellness and risk management benefits as well as free gifts and discounts for maternity/baby products.

Medicover has positioned itself as a no-frills, no-fuss Medical Scheme providing an affordable system of health care management.  Medicover is dedicated to serving its members and protecting its service providers.