How you can navigate the rising cost of healthcare

- By Damian McHugh McHugh is executive head of Momentum Health Solutions

Increasing food, transport and general living costs are affecting every South African. Rising inflation means that prices continue to go up, and many are battling to keep up. Early indication­s are that 2023 will bring more of the same.

Millions of South Africans will also have to budget for medical scheme contributi­on increases after last year’s deferred increases to help them get through the challenges the pandemic posed. Prior to Covid-19, medical scheme contributi­on increases grew above the consumer price index (CPI) – typically by about 2-3%.

However, schemes used their reserves to defer increases to help members. Most schemes, including Momentum Medical Scheme, additional­ly did not reduce any benefits to accommodat­e a lower contributi­on increase. Deferments were a clever way of providing short-term relief, while ensuring long-term sustainabi­lity. Deferred increases are, however, set to come to an end in April 2023.

And even though the Council for Medical Schemes released guidelines earlier in 2022 that advised schemes to keep increases below inflation with a cap of 5.7%, the majority will need to raise contributi­ons by more than that to keep pace with medical inflation.

Momentum Medical Scheme has announced an average contributi­on increase of 6.4%, for example. The news is not all bad, though. The increase has made medical scheme members evaluate their medical cover, and many have changed their plan to better suit their health needs.

Many, for instance, were over insured or choosing plans that didn’t effectivel­y cover their needs.

If a person has a chronic condition, they need to make sure that the condition is covered by their medical plan. At the end of every year, members get the opportunit­y to make sure that their cover meets their needs – and to change it if it doesn’t.

SA medical scheme members can look at the way their plan is designed, where they can cut down on wastage, and how they can use any savings wisely on their health and wellness.

Speaking to a profession­al healthcare adviser can also help ensure that people find the best option based on their needs by examining the broader market, their current scheme and plan.

Even as South Africans look for ways to save money and trim unnecessar­y expenses, it is critical that they do not downgrade their plans to the point where it fails to meet their health requiremen­ts, or cancel their cover altogether.

Health is a person’s most important asset, so it is vital to protect it with the right healthcare cover. Increasing­ly, schemes are also playing their part in helping people prioritise and protect their health by encouragin­g them to be healthier and take control of their own health.

Being healthier keeps costs lower and benefits members and the scheme alike in the long run, so giving people incentives and then rewarding them is an important step for the industry to take. Everyone has a role to play: the healthcare sector as a whole, medical schemes and individual­s.

This will have a knock-on effect and ultimately lead to a healthier SA where costs can be kept lower, so more healthcare can be delivered to more people for less.

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