Medihelp offers 10% saving on network options in 2013

Medihelp has included a network option on its Dimension Prime range of benefit options which will cost members on average 10% less in subscription fees in 2013.

This means that Medihelp’s annual weighted average increase of 11.2% for 2013 will amount to increases of between 0% and 2.4% for those members who choose one of the Dimension Prime network options next year.

A comparison between the Scheme’s standard Dimension Prime range and its Dimension Prime network options is as follows:

According to Anton Rijnen, Principal Officer and CEO of Medihelp, services for the Dimension Prime network will be provided primarily by private hospital groups. “With 59 hospitals in our countrywide Dimension Prime network, members can rest assured that quality hospital care will be available to them. They will enjoy exactly the same services and benefits as those members on our standard options,” he says.

In addition to its Dimension Prime network options Medihelp has made various enhancements to six of its seven benefit options. In general, the following enhancements have been made:

· Maximum benefit limit amounts have increased by approximately 6% on average on all options.

· Benefits for child birth at home included on all options.

· Hip, knee and shoulder replacements for non-PMB cases are now included on the Dimension range.

· Consultations at contracted specialists to be covered at 130% of the scheme tariff on the Dimension range.

· The co-payment on adenoidectomy and/or tonsillectomy has been removed from the Dimension range.

According to Rijnen, preventative care has become an important component of Medihelp’s strategy towards ensuring the general health and well-being of its members. In this regard, the Scheme has boosted its already substantial preventative care benefits on its Dimension range and Medihelp Plus option with the following enhancements:

· Benefits for circumcision in doctors’ rooms.

· Benefits for neurostimulators.

· Bone mineral density tests for females 50 years and older.

· Standard immunisation for children younger than seven years added to the Dimension Elite and Medihelp Plus benefit options.

Rijnen says increased premiums for 2013 will vary according to the specific option members choose and the number of dependents they have registered. “In evaluating the increases, factors such as the various enhancements made to the benefit options as well as inflationary-driven expenses in terms of hospitalisation, specialists and medicines should be taken into account. Another factor that plays a role is the increased utilisation of services, which causes medical inflation to rise faster than the CPI rate,” he says.

In terms of membership, the average age of Medihelp’s members has declined by 4.2 years to 36 years since 2011, bringing it in line with the industry average of just over 30 years. In addition, Medihelp has again been awarded an AA- (AA minus) rating for its claims-paying ability by the Global Credit Rating Company. The Scheme has also been able to maintain its position as the leader in client service after being named the medical scheme that renders the best client service in South Africa by the Ask Afrika Orange Index 2012.

In terms of non-healthcare expenses as a percentage of net contributions, Medihelp achieved 11.5% for 2012 which is comfortably below the industry average. For members this means that Medihelp’s primary focus remains on their healthcare needs, affording them real value for their monthly contributions. “Our primary aim remains to maintain a balance between cover, quality of care and cost,” says Rijnen. “We will continue to explore all avenues that will contribute to the continued sustainability of Medihelp and the value experienced by its members,” he says.