Medical Aid Review Time!

December is fast approaching, and with it comes the commencement of the medical aid review period. Medical aid providers have recently disclosed their contribution increases for the year 2024. Before delving into those details, it’s essential to address a topic that has been at the forefront of everyone’s thoughts: the National Health Insurance (NHI).

In June this year, a significant milestone was achieved when the NHI bill was passed in parliament. The objective behind this initiative is to ensure universal access to healthcare services for all citizens, as well as refugees, and asylum seekers. The NHI aims to bridge the healthcare gap, granting individuals without medical aid coverage and lower-income earners access to private healthcare services. Simultaneously, it is anticipated that the implementation of NHI will alleviate the strain on the public healthcare system, providing a more comprehensive and inclusive healthcare framework for the nation.

How will NHI affect medical aids? The goal is for both public and private sectors to work together in a way that strengthens the current healthcare system, without placing any additional burden on consumers’ already stretched pockets. According to the bill, medical aids will only be able to offer healthcare services/products that the NHI cannot provide. Even though the bill has been passed, it will still be a few years, if not longer, for it to be implemented. Medical schemes will be given sufficient notice on the type of services that they will no longer be able to cover.

Onto year-end reviews; there has been some interesting changes in the medical aid industry particularly amongst the Big 5: Discovery, Bonitas, Momentum, Bestmed, and Medihelp.

Momentum and Bestmed have introduced new plans named Fusion and Beat 3 Plus respectively. The Momentum Fusion is designed to provide basic medical aid cover for low-income earners, whereas the Bestmed Beat 3 plan is for members looking for generous maternity benefits and extensive in-hospital and day-to-day cover.

Meanwhile Discovery has restructured its Comprehensive plan series to only include Classic Comprehensive and Classic Smart Comprehensive. Members on the Discovery Comprehensive plans will be defaulted to one of the two plans from 1st January 2024 unless an alternative plan is chosen. Affected members will have up to end March 2024 to change their plan. Discovery Saver members will also see a 5% reduction in medical savings contribution in 2024.

Bonitas is now the only medical aid to cover depression as a chronic condition on plans as part of their initiative to promote mental health awareness. Normally depression is covered on the top medical aid plans as part of the chronic (ADL) additional disease list.

Please see below the contribution increases per scheme.

Average Contribution Increase
Bestmed 9,6%
Bonitas 6,9%
Discovery 7,5%
Medihelp 15,96%
Momentum 9,6%
Fedhealth 10,8%
Medshield 8,9%

For more detailed informational regarding medical aid changes, please be on the lookout for the email communication to follow. Note that the deadline for all plan changes and income verification is 30 November.

Please contact Lorraine Mashale (admin@maximushealth.co.za / 011-656-2910) for more information.

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