Sizwe Medical Fund has several aces up its health sleeve
DESPITE many colourful and persuasive marketing campaigns, there is a growing, general public perception that most medical aids are becoming increasingly unaffordable. Their products proliferate and are confusing; people find them complicated and have difficulty understanding the benefits and the limits.
Neo Khauoe, Sizwe Medical Fund’s Principal Officer, says it cuts through all the verbiage, slices away the complications and presents simple, easy-to-understand and straightforward products for those who otherwise would be unable to access medical aid. “Rich benefits and great value for money is what a medical aid with a community focus must offer,” she adds.
Sizwe was founded in 1978 by a group of mainly black doctors, including the late Dr. Nthato Motlana, to provide affordable cover to all South Africans. Today, it is one of the top 10, larger open schemes in the country and offers products that range from a particularly low-cost network option for those on a tight financial budget to a product tailored for the upper end of the market.
Sales and Marketing Executive Gaynor Britton says, “We offer products to suit the needs of individuals and families as they journey through life and as requirements and circumstances change.”
Khauoe, emphasises that since inception, Sizwe has remained committed to its philosophy to be a caring medical fund for the people, one focused on communities. It has also emerged as a major one-stop solution for entire staff complements.
“We are proud of our heritage which stretches over three decades and we pride ourselves on designing products that are simple to understand and easy to use. In short, we strive for simplicity in all we do. But this does not mean we are unable to cope with complicated challenges or bring new meaning to affordability,” adds Khauoe.
For the financial year which ended in December last year, Sizwe reflected a year on year increase in its solvency ratio from 34,40 percent to 45,90 percent, which is signifi- cantly above the industry norm of 33,3 percent. The fund was serving over 52 000 lives.
This year’s average contributions increase was 6, 9 percent, one of the lowest in the market.
In September 2012, Sizwe was placed under curatorship when the Council for Medical Schemes found a rapidly declining solvency ratio, financial and governance irregularities. Moreover the board of trustees had not been properly constituted.
When the curatorship ended on 15 December 2014, it signified the dawn of a new era for Sizwe Medical Fund. With a new Board of Trustees and Executive Management Team in place,
“Sizwe had certainly weathered the storm and was set on a path to normalcy, which brought confidence and certainty to members, intermediaries and corporates,” says Khauoe. “Notably, it has emerged from curatorship in robust health with improved offerings and several aces up its health sleeve.”
Conceding that the phrase “affordable healthcare” has become contradictory in meaning, Britton insists that Sizwe, which has a national footprint, is breaking the mound. “We have truly put the adjective ‘affordable’ back into medical aid schemes, when the general state of the economy made that seem impossible. We have grown with our expanding member base and indeed, have become a preferred medical aid solution for many who have been disillusioned by other funds.”
“One of our greatest strengths’’, says Khauoe, “is a great understanding of grass-roots needs. But I must emphasize that we are not just about our proud heritage of working closely with our communities. We continue to build relationships by listening to our members every day and we work hard at relationships with all our key stakeholders.” SIZWE MEDICAL FUND OFFERS: Savings Care Plan – out of hospital benefits paid from savings, the savings portion is 15 percent of monthly contributions, no overall in-hospital limit. Gomomo Care Plan – an entry level plan, good GP network, no overall in-hospital limit at network hospital. Primary Care Plan – excellent value for money with rich out of hospital benefits, unlimited hospitalisation, covers chronic conditions within the 26 PMBs, maternity benefits and wellness benefits over and above out of hospital benefits. Affordable Care Plan – generous benefits, unlimited in-hospital cover and additional chronic conditions. The choice of any healthcare provider in South Africa! Full Benefit Plan – comprehensive cover, additional chronic conditions, unlimited hospitalisation, a free choice of healthcare providers, additional dental, optical, wheelchair, oncology, auxiliary and maternity benefits.
Khauoe concludes, “We’ve come to really understand what our people need and want from a medical aid scheme. Our company’s ethos ‘Your Health in Caring Hands’ indicates the commitment, which permeates the organisation in caring for the health of our nation. It also reminds us of why we do what we do – to provide affordable and quality medical aid for all South Africans.”