Review of Discovery Health’s product changes for 2012

Discovery Health yesterday announced a headline increase of 8,9% across the board with minimal changes to their product offering, although a small proportion of members with special adult dependants will experience increases that are significantly higher than the average.

Overall there have been minimal changes to Discovery’s product for 2012 except that “members with special adult dependants, like elderly parents, will experience increases significantly higher than the average” says Butsi Tladi, Head: Health Inland region, Alexander Forbes Health.

Tladi and her team have summarised the main features of Discovery’s increases for 2012 as follows:

Contribution Increase

In determining the contribution increases the following factors and assumptions were considered:

Contribution Structure

Members’ contributions are determined based on their family composition i.e. distinguishing between the Principal Member, Adult Dependants and Child Dependants. Currently an Adult dependant is classified as any dependant over the age of 21 and includes blood relatives that are financially dependent on the Principal Member. The Adult Dependant enjoys a lower contribution than that of the Principal Member.

In 2012 Discovery will change the classification of Adult Dependant to include Spouses, Ex-Spouses and Full time Students up to the age of 25 and Disabled members. All other Adult Dependants will be billed at the Principal Member rate, the percentage increase for these Special Dependants in 2012 is as follows. The increases will range from 15% - 45% depending on the plan that the member is on. We expect this change to affect a small proportion of Discovery members.

The KeyCare and Executive members will be unaffected as the Adult Dependant rate is already the same as that of the Principal member.

KeyCare Income Brackets

With the anticipated tax credit system coming into being in the 2012 tax year, aiming to provide a tax benefit to those members below the 30% marginal tax rate, Discovery has decided to leave the KeyCare income brackets unchanged for 2012. Increases in KeyCare members’ salaries for 2012, could therefore result in an income bracket creep which would see these members’ increases exceeding the standard 8.9% increase.

Benefit Changes

The majority of benefits remain unchanged with limits increasing in line with the 8.9% increase. Targeted benefit changes for 2012 include those related to the Allied and Therapeutic Benefit. Benefits on the Executive, Comprehensive and Priority plans have been changed in order to:

1. Enhance cover for nursing and psychiatry benefits;

2. Offer more flexible cover for across different medical disciplines;

3. Provide unlimited cover for serious conditions

Psychiatrist will be covered through the Above Threshold Benefit with no sub limits.

All other Allied and Health Benefits will be subject to a combined annual limit. Homeopaths, Podiatrists, Speech Therapists, Occupational Therapists and Physiotherapists benefits which enjoyed uncovered limits in 2011 will be subject to the combined limit in 2012. Home nursing benefits appear to be greatly enhanced as they would be included in the overall sub-limit, however this may not be experienced by those members where multiple Allied Healthcare benefits are used.

Medsave Benefit

Members activate this benefit online and by completing a Vitality Check (screening tests) will qualify for up to 25% cash back on over the counter schedule 1 and 2 medicines prescribed by a Clicks pharmacist and purchased from any of the Clicks stores.

Hospital Network Changes

The KeyCare hospital network will see the removal of the Moot Hospital and the inclusion of Clinix Phalaborwa Private Hospital. No changes to the Delta hospital network were announced.

Online Tools

Discovery has introduced the following online tools for members and medical practitioners:

· HospitalXpress: This tool allows members to pre-authorise their hospital admission, complete admission documentation online and confirm whether the hospital and provider is part of the Discovery network arrangements;

· MedXpress: This tool is currently available and is a convenient delivery service for chronic and prescribed medication;

· PracticeXpress: This tools is available to medical practitioners as an iPad enabled suite of tools that provides the practitioner with an integrated medical history of the patient. It also allows a number of other functionalities such as online referrals, scripting and chronic applications. The practitioner can also minimise co-payments for the patient by reviewing plan benefits and searching for prescribed medicines that are covered by the patients plan type.

Vitality

HealthyFood Benefit

This has been linked to the Pick n Pay Smart Shopper card and Vitality members will now receive enhanced Smart Shopper points based on the Vitality status. The 25% cash back benefit will be maintained for healthy foods however the Medical savings Booster of 75% has been withdrawn.

HealthyCare Benefit

Vitality has partnered with Clicks to provide an additional 25% discount on a selection of products that promote health & wellbeing, this includes certain dental products, sun care products and nutritional supplements amongst others.

HealthyGear Benefits

Vitality has partnered with Adidas to provide a 25% discount on all products at an Adidas store and an additional discount at Totalsports for all Adidas products based on the members Vitality status.