Medical aid costs in 2023 – what to expect

If you belong to a medical plan, it is likely that you have received a letter informing you of the contribution increases for 2023. If you think the increase is too high, you have time to change plans, but you must sure you are comparing apples to apples.

Earlier this year, the Council for Medical Schemes issued guidelines advising medical schemes to try to keep contribution increases below inflation, with a cap of 5.7%. But over the past decade, increases in Medicare premiums have outpaced inflation by about 4%.

To help members weather the cost of living crisis, some medical plans with healthy reserves have chosen to implement deferred increases. This means that members will only see their 2023 premiums increase from April next year. Discovery Health and Momentum Health Solutions announced deferred contribution increases. While Discovery is hedging its bets and won’t announce the quantum of the increase until late February next year, Momentum Health Solutions has announced an average dues increase of 6.4%.

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Damian McHugh, executive director of marketing at Momentum Health Solutions, points out that Momentum Medical Scheme has not cut any benefits to accommodate a smaller increase in premiums.

Discovery Health chief executive Ryan Noach says it’s important that the contribution increase accurately reflects underlying price and usage changes for 2023.

“The eventual increase will be in line with medical inflation, which is typically 3% to 4% higher than consumer price inflation (CPI), although members will experience an actual annual increase between the CPI and CPI + 2%, taking into account the carryover,” he says.

Lee Callakoppen, the chief executive of Bonitas, said the scheme would delay increases until April 1, with an effective average increase in contributions of 4.8%.

“It’s always a delicate balancing act between keeping the increases as low as possible while keeping the diet stable,” says Callakoppen. Bonitas has over R7.4 billion in reserves and has recruited over 190,000 new members over the past three years.

Members of the Bestmed Medical Scheme will see a weighted average increase in contributions of 8.5%, alongside a weighted average increase in the benefit cap of 5.7%. Leo Dlamini, Senior Director of Bestmed Medical Scheme, explains that changes for members in 2023 include coverage of mammograms on all options, an increase in the age of dependent children from 21 to 24, and payment of dues for the first three children only. Bestmed experienced a 3.5% growth in its primary members, bringing the total number of beneficiaries under its care to 209,000.

Medihelp Medical Aid has seen net growth of more than 5% since the start of the year, with 200,000 lives covered. Ettie da Silva, senior manager of Medihelp, says that in the last quarter of 2021 and the first half of 2022, the program saw an increase in the cost of care, with utilization normalizing and returning to pre-Covid-19 trends.

“This presents a very different picture than the past two years, when the accumulation of reserves caused by lower utilization resulted in very small contribution adjustments in the industry.

“South Africa’s annual inflation rate is also higher than it has been for years and healthcare inflation is 3% to 4% above inflation. , with new technologies, the aging population of the industry and the rising cost of care driving it,” she said. said.

Medihelp will implement a weighted average premium increase of 7.51% for 2023 and dependent children are covered up to age 26 on most of its plans. DM168

This story first appeared in our weekly newspaper Daily Maverick 168, which is available nationwide for R25.