Affordability remains key influencer for private healthcare consumers

Scheme benefit updates strongly anchored to addressing ‘real’ member needs

With National Treasury forecasting a decelerated growth of 2.2% in 2022, affordability is set to remain the key influencer for private healthcare consumers in the coming year, particularly when it comes to monthly contributions payable towards medical scheme membership.  

This, says Josua Joubert, CEO and Principal Officer of CompCare Medical Scheme, is indicated in the sustained trend towards affordability as a primary concern in medical scheme selection but notes that this alone is not a strong enough qualifier.

Maintaining financial fitness

CompCare has announced a 5.75% average weighted contribution increase for 2022, just over one point higher than the 4.6% implemented in the previous period – an unprecedented time for the country’s economy under the effects of COVID-19.

On some options, such as the highly affordable NetworX option – which is ideal for international students and employees under the R10 000 per month salary band – the increase is as low as 3%.

“It is worth noting that in an effort to continue alleviating financial pressures for members, the annual increase remains lower than that of the 6.5% average weighted increase implemented two years ago ahead of the 2020 benefit year, in a pre-COVID-19 world,” says Joubert.

“This is all the more significant when considering that CompCare has been able to maintain an exceptionally high solvency ratio, coming in at 47.2% – well above the 25% required by the Council for Medical Schemes and considerably higher than some of the larger unrestricted schemes on the market. This translates to accumulated funds per member of over R24 000, with CompCare continuing to be ranked as one of the most financially sound schemes in SA.

“Affordability and financial stability form part of the foundation of worthwhile medical scheme membership. These must then be matched with cover that members can count on if medical schemes are to play the role for which they are intended.”

Joubert notes that the scheme’s claims ratio of 92.6 % is proof positive that members are receiving significant benefit from the cover afforded by their CompCare membership.

COVID-19 update

“Naturally, claiming patterns have been affected by the pandemic and the postponement of elective procedures. However, on the other hand, members have benefitted considerably from the scheme’s COVID-19 benefit, which has ensured that members are guaranteed the best possible care during the ongoing pandemic. CompCare has paid out just under R74m for COVID-related cases since the start of the pandemic in SA.

“To date we have had close on 3 500 COVID-positive cases among our membership base – tragically, 130 of our members succumbed to the virus. We continue to actively encourage our members to get themselves fully vaccinated as soon as possible. Currently 36.7 % of older members have received their jab but with such a young member base just 11.7% of members have been vaccinated when looking at the entire scheme. We cannot emphasise enough just how important it is for all members, and this very much includes young people, to get vaccinated as a matter of urgency,” says Joubert.  

2022 benefit highlights

Looking forward to the 2022 benefit year, Joubert notes that the scheme has conducted member surveys and financial advisor feedback sessions throughout 2021, and from this feedback has implemented significant benefit enhancements to add further value for members. “CompCare offers 15 benefit options, including the efficiency discount options that offer exceptional value when using network hospitals and pharmacies. An inflationary benefit increase has been applied across all these options to ensure that each and every member can benefit from enhancements, no matter which option they have selected to best suit their healthcare needs and budget.”

Here are some of CompCare’s most notable benefit highlights for 2022:

• All CDL chronic conditions will be paid from risk as from 2022 and not from the Annual Flexi Benefit. This enhancement is specifically being made to the Mumed, Selfsure, Symmetry and Dynamix options, including their Efficiency Discounted options. All other options in the CompCare range already cover CDL chronic conditions from risk.
• Furthermore, the scheme is removing the in-hospital pathology limit on the UniSave, Mumed, and Symmetry options including their Efficiency Discounted options, so this will now afford members an unlimited benefit.
• Exceptional value for money can be found on the entry-level savings option, Selfnet, which now also offers cover for eight antenatal visits with a GP, specialist or midwife payable from the risk benefit, so it will not cut into your day-to-day savings. In addition, a child emergency benefit is included, which allows for a visit to an emergency room for children younger than six years – even if all available medical savings are depleted.
• Enhancements on the Dynamix option for 2022 include in-room procedures for GPs and specialists to be paid from the above threshold benefit, with the limit having been increased by a full 10%.
• The Pinnacle option, a particularly good choice for corporate executives, now also includes in-room procedures for GPs and specialists to be paid from the above threshold benefit, while all procedural co-payments have been removed.
• Our outstanding kids benefit and child rate applied until the age of 27 for students and those who are financially dependent, will set us apart for young families wishing to lay a solid health foundation for children. 
• The scheme’s preventative men’s and women’s health benefits, as well as the wellness benefit continue to be among the best on the market and is ideal for those seeking value whilst maintaining a healthy and active lifestyle.
• CompCare is one of the only schemes in SA providing cover for injuries sustained during professional and adventure sports, as well as a search and rescue benefit.
• Ever mindful of the growing need for mental health support, CompCare’s comprehensive psychosocial and emotional wellness benefit is included across all options with access to a round-the-clock counselling helpline and referrals for face-to-face counselling when required.
• In furthering access to specialist care on all options, CompCare will not impose GP referrals or co-payments on dermatologist consultations for 2022.

“It remains to be seen just how far reaching the ongoing impacts of the pandemic will be. In the meantime, CompCare is forging ahead with benefit options that will address members’ real needs, providing them with access to the care they deserve in the here and now, protecting their health for the future and supporting them in achieving their wellness goals along the way.

“We have not forgotten that every membership number represents a human being who relies upon us to put their best healthcare interests first. We at CompCare take this responsibility very much to heart and it is our solemn promise that we will continue to show up for our members, in 2022 and well beyond, concludes Joubert.