Discovery Health Medical Scheme members continue to enjoy substantially enhanced 2023 benefits at 2022 rates for the first 3 months of the year.
Contributions will increase on 1 April 2023 by 7.9% for 85% of Scheme members, including members on the Keycare, Smart, Core and Saver Plans, and by 9.9% for members on the Priority, Comprehensive and Executive plans.
The weighted average contribution increase for 2023 for the Scheme will be 8.2%. In real terms, taking into account the delayed increase in 2023, members pay 6.2% more than December 2022 rates on average during 2023.
DHMS’ unique approach to contribution increases has improved affordability for its members, limiting increases to CPI+1.9% over the past 3 years, while prioritising sustainability for members beyond 2023 by ensuring the Scheme is accurately priced.
Johannesburg, Wednesday 22 February 2023: Today, Discovery Health Medical Scheme (DHMS) announced the annual increase in member contributions for 2023. The Scheme used its strong reserve position to maximise affordability for members by delaying the annual contribution increases for a third year in a row, with the increases for 2023 effective from 1 April 2023. This allowed members to enjoy the enhanced 2023 benefits while paying 2022 rates for the first three months of the year.
On 1 April 2023, the DHMS contributions will increase by:
7.9% on all KeyCare, Smart, Core and Saver Plans
9.9% on all Priority, Comprehensive and Executive Plans
“Eighty five percent (85%) of DHMS members will experience a 7.9% increase in their contributions, while the remaining 15% of members will experience a 9.9% contribution increase,” explains Dr Ryan Noach, CEO of Discovery Health. “This represents a highly competitive weighted average increase in contributions of 8.2% for 2023, whilst sustaining contributions in line with medical inflation in DHMS.”
As a result of the three-month deferral of the 2023 contribution increases, members will pay the 2023 contribution rates for only nine months of the year. The deferral means that, in comparison to the contributions paid in December 2022, the average contribution paid by a member in 2023 will effectively increase by 5.9% for the KeyCare, Smart, Core and Saver plans, and by 7.4% for the Priority, Comprehensive and Executive plans.
“The differentiated increase across plans takes into account the higher disease burden on the Priority, Comprehensive and Executive plans, reflected through higher hospital admissions, oncology claims and chronic illness costs. The increases on these plans allow the Scheme to maintain the industry-leading value of the benefits at contributions that are on average 19.8% below industry contributions for equivalent benefits.” says Noach.
DHMS has deferred annual contribution increases for three years in succession, resulting in significant savings for members during 2021, 2022 and 2023, cumulatively reducing contributions by R8.6bn for all members over the three Covid years,” says Dr Noach. “This has limited increases for members to 1.9% above CPI over this three year period, significantly below the prevailing medical inflation which is 3 to 4% above CPI.”
DHMS is prioritising sustainability for its members beyond 2023
The contribution increases for DHMS in 2021, 2022 and 2023 have ensured that contributions remain in check with medical inflation, underpinning sustainability and mitigating risks of the scheme showing losses, and ultimately requiring price catch-up. The deferral of the increases utilising the higher solvency as a ‘shock absorber’ has the effect of reducing the effective annual increases for members. This strategy allows the Scheme to maintain its long-term sustainability, avoid future price shocks and benefit cuts, and addresses affordability for members.
The value of this strategy has been recognised by members and their financial advisers, and is reflected in DHMS’s growth over the last two years. Since January 2021, the Scheme’s membership has grown by 47,500 beneficiaries, while most competitors have shrunk during this period.
“The health of members joining the Scheme represents a flight to quality and is critical for the sustainability of the Scheme. Considering that the new members joining the scheme are on average younger and healthier, for every 1% annual growth in the membership, the Scheme benefits from a 0.5% reduction in the cost of claims.”
Members have access to enhanced 2023 benefits at 2022 contributions for first three months of 2023
In September 2022, DHMS announced new and enhanced benefits that have been available to members since 1 January 2023.
“As a Scheme that is deeply invested in every member’s health, and fundamentally believes in preventative healthcare, DHMS was deeply concerned by the precipitous reduction in healthcare screening during Covid-19. Consequently, DHMS is excited to deploy its excess solvency by introducing the WELLTH Fund for members, significantly enriching benefits. The WELLTH Fund represents an unprecedented investment in the long-term health of DHMS members by funding preventative and screening healthcare costs, allowing members to fully understand their health risks.”
The following 2023 benefit enhancements are available to members:
The introduction of the WELLTH Fund, providing members with up to R10,000 per policy for a wide range of health screening and preventative healthcare services. In 2023, more than 126,000 policies have already unlocked their WELLTH Fund, with over R56 million in WELLTH Fund claims paid by the Scheme to date.
A 25% increase in Oncology Benefit thresholds.
A Disease Prevention Programme to support members who are at risk of developing diabetes or cardiovascular disease. The 12-month management programme offers members risk benefits for GP consultations, dietitian consultations, prescribed pathology and health coaching by healthcare professionals.
The new Essential Dynamic Smart Plan, which is the most affordable plan in the digitally enabled Smart Series. The new Smart Plan is enabled by the new Dynamic Smart Hospital network, an innovative offering that guides members to the highest quality of hospital care in real time, based on their location, treatment needs and health status.
In April 2022, DHMS became the first Shari’ah compliant medical scheme in the market. Members are able to elect to have their health plan administered in accordance with principles that are Shari’ah compliant.