Restricted membership medical schemes offer members multiple benefits

During the last couple of months of each year, most medical schemes in South Africa release their annual contribution increases for the following year, coupled with adjustments to the benefits members can expect. Compared to the last two years, when members enjoyed relatively low, single digit increases in medical scheme contributions, the outlook for 2007 seems grim.

To date a number of medical schemes have announced increases of between 7% and 13%, with the average increase soaring from 6,9% in 2005 and 6% in 2006 to a high of 9% in 2007 - well above the CPIX of around 5%.

Continuing the trend formed over the last decade, the average contribution increases for open medical schemes were once again higher than those of the restricted schemes.

"It stands to reason then that those looking for consistently lower contribution increases should consider joining a restricted medical scheme should they have access to one," says Bruce Dickson, Principal Officer of the Chartered Accountants (SA) Medical Aid Fund (CAMAF).

CAMAF is a restricted medical scheme for professionals within the accounting and law environments and has been in existence for more than 50 years. The scheme has made considerable effort in keeping its contribution increases at less than six percent year on year.

"We have, since 2005, kept our contribution increases between 5,8% and 5,9% while continuing to enhance benefits and services. In anyones book, this is a commendable achievement and something that our members have come to expect from us."

According to Dickson, lower average contribution increases are not the only advantage of belonging to a restricted medical scheme. Much of the expected service levels and specifically tailored benefit design have to do with the intimate knowledge of a specific membership group, which tends to be the case in restricted membership schemes.

"We know our members and their needs, says Dickson. One example of how we utilise this knowledge can be demonstrated in the Schemes exceptional optometry benefits. Approximately 80% of our members wear glasses or contact lenses. Our members, whether they are young or old, therefore appreciate the comprehensive and generous benefits for optometry."

Another example is in the psychological benefits. It is well known that both the accounting and legal professions are stressful and often characterised by long hours, complex work and demanding study schedules. "The psychological benefits, particularly in terms of stress and stress-related issues, is therefore of vital importance when it comes to the wellbeing of our members," says Dickson.

In addition, CAMAF has designed their post-hospital benefits in such a way that they actively encourage rapid recovery. "Time is of the essence for accountants and lawyers as many charge hourly or daily consulting fees. Days spent in recuperation imply days of lost income. These benefits are therefore not designed to save the Scheme money, but rather to remove unnecessary hurdles and to assist our members health restoration as quickly as possible," explains Dickson.

Yet another advantage of belonging to a restricted membership scheme relates to cost. Most restricted medical schemes do not work through third parties, such as healthcare consultants or brokers, which means that members can save on related commissions. "With CAMAF, the additional advantage to this is that it allows members one-on-one, direct contact with the Scheme, which is more personal and, we feel, more controllable," says Dickson.

Since lawyers and accountants are generally people who like to be in charge of their own lives, CAMAF has made it as easy and cost-effective as possible for them to be proactive when it comes to the management of their health. Concierge is a loyalty programme which offers members immediate access to a wide range of exclusive benefits ranging from entertainment to personal grooming and the honing of a healthy body and mind.

Through Concierge, CAMAF members can choose between Virgin Active, Planet Fitness, Health Connection and Run or Walk for Life membership. There are also discounts in the offing on anything from cellular phone contracts, hairdressing services and products, pet insurance, educational toys to nutritious, fully prepared meals delivered to your home or office.

"We believe that medical schemes should play a greater role in assisting members in improving their lifestyle in order to enhance their professional and personal lives. Its an intelligent approach to healthcare and, in our market, it is well understood and appreciated," concludes Dickson.