South Africans demand sustainable medical aid
• There is a growing need for schemes that last throughout all the phases of a member’s life
South African healthcare consumers today require medical scheme options that can meet their medical cover needs throughout all phases of their lives — from when they are highly active young people to when they mature and also become parents, according to Dr Johan Pretorius, chief executive of Universal, administrators of CompCare Wellness medical scheme.
“Medical schemes consequently need to be able to provide a highly flexible range of cover options that can meet the consumers’ every need, and through each stage and economic phase of their lives. In other words, the medical scheme needs to consider how they can become each individual’s life-long healthcare partner, rather than just delivering another form of healthcare cover,” says Pretorius.
“Affordability, value and service are non-negotiables, but so too is the need for medical schemes to understand what is really important to their members.
“A medical scheme that is fully attuned to the needs of each of its various target markets will remain a few steps ahead of members on their journey through the many different phases of their lives, and be able to more precisely meet their needs and requirements,” adds Pretorius.
According to Pretorius, the complex nature of medical scheme options and the distinctive needs of the new-age medical scheme member have required a serious re-look at the way medical schemes products are structured.
“Typically, a scheme that is in touch with the needs of members will understand the importance of delivering on a broad spectrum of product options, ranging from primary healthcare and hospital options, to traditional and new generation product options, with at least some of these catering for the member’s own medical savings account.
“Of equal importance in today’s market is the choice of alternative products offering discounted premiums, such as CompCare’s ED-Efficiency Discount options. In this instance, premiums are discounted by up to 25%, with the provision that Dis-Chem Pharmacies are used for chronic medication and Netcare hospitals are chosen for elective procedures,” explains Pretorius.
He says CompCare is known not only for providing some of the most affordable options currently on offer on the market, but also for innovative design and comprehensive benefits. The scheme understands the value of a holistic, primary healthcare approach that is focused on preventing illness while promoting health accessibility to every member of the family, at every stage of their life, independent of the availability of day-to-day benefits.
“What medical scheme members want above all else is the best benefits at the right price, good service, as well as a willing ear and helping hand when they need it the most. This does not necessarily have to come at the cost of the sustainability of the scheme.
“CompCare is prudent when it comes to spending the funds of its members and the careful, yet member-centric approach of the scheme has ensured that solvency levels are aligned with the Council for Medical Schemes’ minimum 25% requirement year after year, notwithstanding rising healthcare costs,” says Pretorius.
In order to deliver services and benefits that are well above that which is offered in the industry the scheme partners with Universal, an administrator that has established itself as a leader in providing evidencebased, integrated healthcare services.
“Everyone is looking for cost-efficient options that are not only affordable but also sustainable. It is our belief that we have delivered on this need,” says Pretorius.