So… you are probably waiting for me to say that we have finally found a medical aid that will pay for everything, and it is free! Sounds a bit like the masses think NHI will be. Sorry to burst all your bubbles, there is no such option. So until we get that, please read on and delve into the fascinating world of your medical aid changes for 2020.

As medical aid brokers a role we take on is assisting our clients understand their benefits. This is especially true when they change their structures and benefits. So as exciting as it sounds, reading through brochures and engaging on webpages will empower you and deepen your understanding of your medical aid. We encourage everyone to do this as it makes our interactions powerful and effective.

If you are a client please send us a request for a comparison schedule. This provides a detailed comparison between your plan with other options available on that medical aid. Please remind us of your current option that you are on when you do.

As a reminder this is your one and only opportunity to change your medical aid plan. This will take affect on 1 January 2020. Once again your premiums have increased, so reflect on what your medical aid has provided to you and what you are getting out of it.

Medical Aid Advice for 2020

If you are looking save on medical aid costs then consider a network option. These shouldn’t negatively affect your cover however you must consider is where your network hospital is and whether your current providers (specialists or providers, GP’s dentists etc…) are on this network.

Remember that networks don’t pertain to life threatening emergencies. These are covered at any private hospital. Thereafter a patient will be transferred to a network hospital. Please also remember that an ER is not considered to be in-hospital. Only once you have a band around your wrist (allocating a bed in a hospital) does your bill get covered through risk, before then it is on a casualty benefit or is paid from savings. Check your brochure to see how yours is paid.

Your role is to learn about your benefits. Please also start to negotiate rates with specialists & providers. They can and often do decrease these when asked and if not then you know where you stand and can either choose to pay or go to another provider that is willing to engage. This will extend your savings and decrease the amount your medical aid pays. This bodes well for future increases on your premiums.

Gap Cover

Networks and co-payments are enforcing the market for Gap cover. This is a self-fulfilling insurance as it is creating a market for itself. All medical aids now offer it as a sub-product from their own stable. I encourage clients to consider Gap cover as a matter of course. It relieves pressure to work within networks.

I am not going to go into detail on Gap cover here. I do advise all clients have this as I have seen its worth, especially if you are planning on having kids or have regular scans (Scopes, ‘oscopy’s etc…).

Please engage with a medical aids website, brochures and other resources provided. They can really assist you in learning about what is and isn’t covered.

Changes below are sorted in order of Discovery Health first (most clients) and then all the others alphabetically.

Discovery Health

Discovery Health (DH) hasn’t done major changes for 2020. They have tweaked their Classic Comprehensive Zero MSA to merge with a new plan called Classic Smart Comprehensive. This is a blend of the Classic Smart networks with the threshold of the Comprehensive options with Discovery.

Average weighted increase for 2020 – 9.5 % (2019 – 9.2 %)

Largest increases were on the Executive, Comprehensive and the KeyCare Plus (lowest income band). Resources are all on their website – www.discovery.co.za – if you are a Discovery client please do create an online profile and also download the app on your phone. This is vital and will also make things smoother to engage with Discovery.

As above, if you are considering a change their Classic Smart is a great value for money offering. Read through the brochures and compare your options to decide. Vitality has had some interesting changes and enhancement’s so please look through these updates as well (not included here).

Deadline for changes is early December 2019. Do not leave this too late!

Fedhealth

If you are still with Fedhealth you will note that there are still issues around their introduction of the MediValut and MediWallet. I could explain it here but it would take two pages and then there would still be a whole lot of questions. One thing is important, you need to accept their T&Cs in order to make use of this. So please do one of the following:

  1. Click on this link to download the form to do this manually; OR
  2. Go to the Family Room and agree to these online; OR
  3. Use USSD on your phone by dialing *134*999*memberno# – so put your member number in at the end after the 999*.

Here is a video to learn more about this as an option.

Then if you want an opinion – this provides you, as a member, with flexibility. I say this as you can choose to up your hospital cover while not having to pay for savings. Remember that New-Age medical aids offer Savings (MSA’s etc…), that are purely your own money given back to you and then charging you a premium each month for. Fedhealth decided to give you the option whether to pay for this or not. If you choose to access this then you start paying for it.

Then if you do run out of these savings, they then provide you with some other benefits that are then paid for by the scheme. So when you compare it as an option it has a place and you just need to learn how to use it. We are here to help where needed.

Average weighted increase for 2020 = 10.6 % (2019 – 8.5 %)

Highlights and changes to note for 2020:

  1. They don’t have a hospital plan anymore.
  2. All options have some ‘savings’ benefits.
    1. These are accessed through either your MediVault or Core Risk benefits.
  3. By choosing GRID – you are electing to use only network hospitals for planned procedures.
    1. By Choosing the ELECT option on your new plan you are ‘electing’ to pay the first R 12,000 on any planned procedure (NB Not for emergencies). This results in the 25 % savings on monthly contributions.

Fedhealth & Sanlam Reality:

Sanlam’s Rewards programme – Reality is accessible through Fedhealth for an extra charge. For more information please visit their website.

Bonitas

As with most others – nothing major has happened to their benefits or their structure of benefits.

Average weighted increase for 2020 = 9.9 % (2019 – 8.9 %)

Please always remember to refer to your brochures when changing plans. With Bonitas if you choose to go with the Select plan option, this means that you need to use a network of hospitals. This will provide a 15 % decrease in your 2020 premium.

Highlights and changes to note for 2020:

  1. BonCap – increase of non-network Co-payment to R 10,000;
  2. Hearing aid benefits are rolled over every 5 years – this is based on an international study that showed hearing aids have a 8 year lifespan;
  3. Back surgery, hip and knee replacements now have a R 10,000 co payment;
  4. NB to note – BonFit is now a complete Select option – so network only for hospitals;
  5. They also have a ‘rewards’ or voucher platform that has been introduced.

As with all things, go through your brochures and online platforms to learn more as these benefits are there for you to use. They have decreased cover on their options to 100% of the Bonitas rate. So please note this, especially if on BonComprehensive. My advice is to implement Gap Cover if you are on Bonitas.

As with all the others, please refer to Bonitas website for more information and details on your options.

They also have a YouTube Channel where they have loaded videos on their options for 2020 – if that doesnt work please search for Bonitas Medical Aid in YouTube.

Medihelp

There doesn’t appear to have been any massive changes for 2020. It does appear that they have done some work on their App and their rewards programme which are good stickiness options if you are with them. They are eoncouraging the use thereof so please go online and/or download the app from your AppStore/GooglePlay etc…

Average weighted increase for 2020 = 11.9 % (2019 – 9.9 %)

Please always remember to refer to your brochures when changing plans.

Highlights and changes to note for 2020:

  1. Introduction of HealthPrint – a health and wellness partner and basically their Rewards programme. They seem to have included all their extra benefits in this programme, including maternity. Please read all fine print and engage on what it offers as there are costs eventually even if the initial intro is free.
  2. It is also a platform to plug some other products they are offering through partners.
  3. They do offer their casualty benefit across options – nice to remember and utilise when after-hours or on weekends.
  4. Large discount to premium when choosing their network options.
  5. Even their ‘hospital-plan’ Prime 1 gives you a savings benefit.

As with all the others, please refer to Medihelp’s website – for more information and details on your options.

Medshield

Once again they have not made any major changes on their existing plans and benefits. It is also good to see that their increases on premiums lower than 2019. This has also allowed them to increase benefits that you all make use of (Eg: Contraceptive, dentistry etc…).

Increases for 2020 = 9.9 % (2019 – 12.5 %)

Highlights and changes to note for 2020:

  1. They have offered a hospital network for Medivalue and Mediplus. If you choose this then you will NOT have an increase for 2020. They are going to be called Compact (network) and Prime (freedom of choice).
  2. They are also going digital with their SmartCare benefit – an online and nurse based consultation service across all options. A good way to decrease your costs to see a GP.
  3. As with all medical aids they are imposing more stringent networks on specialists;
  4. They have also implemented a rewards programme that you can either have it for Free or pay a premium for. As with all rewards programmes, please review all the T&C’s as there are charges and this is with an external provider.

There does appear to be some interesting new plans (MediCurve) however as they are waiting for approval for them you wont find many details on these. This does mean that they will need to give members some extra time to choose to move. So please keep a look out for these new options and let us know if you want more information.

As with all the others, please refer to Medshield’s website for more information and details on your options.

Momentum Health

Nothing major has happened to their benefits or their structure of benefits.

This means that you can decrease your premium significantly, especially if you are healthy and don’t have any chronic conditions.

Average weighted increase for 2020 = 8.2 % (2019 – 10.7 %)

Please always remember to refer to your brochures when changing plans.

Highlights and changes to note for 2020:

  1. New option called Evolve. This is positioned as a hospital plan for young and healthy singles and couples. Once you add kids it starts to get expensive (R 1,294 per person on this option, including kids). Also 100% network based.
  2. As with all options on Momentum, you can add the Health Saver and other complementary benefits. By far the most compelling and complete offering in the market for flexibility and control over your medical needs.
  3. They also have the best network of hospitals in the North of Johannesburg on their Associated option.

The major thing with Momentum Health is to structure your benefits properly to get the most out of this. You can also engage with their rewards programme, Multiply, this will also provide extra benefits. They have made good strides in enhancing this. Just do your homework and make the most out of it.

I do like and have made use of their Hello Doctor product that they give as 24-hour support. Look it up if you are on MH and make use of it. It is an app that you load on your phone.

As with all the others, please refer to Momentum Health’s website – for more information and details on your options.

Profmed

One of the most stable schemes out there. It does help that they are a ‘closed’ scheme in that you need to be a ‘professional’ or have a professional qualification to be a member. There were no major changes.

Average weighted increase for 2020 = 9.7 % (2019 – 8.9 %)

Their website is full of info and they have also brought out an app for their members. Here is a link to a good comparison of their options that one can use to compare where you are and other options quite easily.

Highlights and changes to note for 2020:

  1. Only pay for three kids on all options except the ProActive.
  2. ADHD is now a chronic condition on all options except the ProActive.
  3. They increased their coverage on Midvices for on their maternity benefit.
  4. They are punting the use of their network option – Savvy. A good 10 % saving on your premium – removes the increase for 2020. As before, check the network of hospitals before jumping across.
  5. Also punting their online capabilities – so engage with App and on their website etc…

A reminder that Profmed does offer Momentum’s Multiply rewards programme. Get into this as it is quite a good rewards programme, I use it with my Momentum medical aid. As above, if you are going to do this then you must learn about it as you do pay for it.

As with all the others, please refer to Profmed’s website for more information and details on your options. Here is a direct link to their page on contributions.