Some mem­bers will pay 17 per­cent more for health cover

Weekend Argus (Saturday Edition) - - FRONT PAGE -

The av­er­age con­tri­bu­tion in­crease an­nounced by open med­i­cal schemes for next year is cur­rently av­er­ag­ing 10.34 per­cent, but some mem­bers will face in­creases as high as 17 per­cent.

In ad­di­tion, mem­bers with gap­cover in­surance for the dif­fer­ence be­tween what their scheme pays and what a doc­tor charges for an in-hos­pi­tal pro­ce­dure may see their pre­mi­ums in­crease by as much as 19 per­cent.

This is ac­cord­ing to an anal­y­sis by Alexan­der Forbes Health, which pro­vides bro­ker­age ser­vices to med­i­cal schemes.

Since the first schemes an­nounced weighted av­er­age in­creases of 10 per­cent and 11 per­cent, many other open schemes have fol­lowed with in­creases of 11, 12 and even 13 per­cent (re­fer to the ta­ble, left).

Some re­stricted schemes, such as LA Health, have an­nounced in­creases of be­tween 8.4 and 8.9 per­cent.

Be aware that the av­er­age con­tri­bu­tion in­crease may not re­flect the in­crease for your op­tion, and that the in­creases range from 2.3 to 16.9 per­cent.

In ad­di­tion, Vic­tor Crouser, the head of health­care for the West­ern Cape at Alexan­der Forbes, says you need to know that, in an at­tempt to con­tain in­creases, schemes are:

• Re­duc­ing the por­tion of your con­tri­bu­tion that is paid to a med­i­cal sav­ings ac­count (mak­ing the av­er­age in­creases mis­lead­ing);

• Col­laps­ing the salary bands on some op­tions, with the re­sult that mem­bers of some low-in­come op­tions face in­creases of more than 25 per­cent;

• Chang­ing the net­works that you have to use;

• In­creas­ing co-pay­ments at rates that are well in ex­cess of the in­fla­tion rate; and

• In­creas­ing, at rates that are well above in­fla­tion, the thresh­olds at which you qual­ify for in­sured day-to-day ben­e­fits. You reach the thresh­old once your qual­i­fy­ing claims have ex­hausted the funds in your med­i­cal sav­ings ac­count and you have been through a self­pay­ment gap. – Laura du Preez

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