The Council for Medical Schemes (CMS) has released its annual industry report, showing how registered medical schemes in South Africa weathered the Covid-19 pandemic in 2020.
In the report, the CMS also gives a breakdown of industry data across all medical plans, including the number of beneficiaries attached to the different plans within each medical plan.
South Africa now has 76 registered medical schemes, down two from 2019 following two mergers. These 76 schemes had a total of 8.89 million beneficiaries in 2020, compared to 8.99 million in 2019, a decrease of 1.15% year-on-year.
The number of beneficiaries covered by restricted schemes increased by 45,525 beneficiaries and the number of beneficiaries covered by open schemes decreased by 148,752 beneficiaries between 2019 and 2020, i.e. a net loss of 103,227 beneficiaries for all schemes combined.
Discovery remains the nation’s largest open medical plan, with 1.33 million members and 2.76 million beneficiaries. Next is the Bonitas Medical Fund with 333,141 members and 710,157. Momentum Medical Scheme is the third largest open scheme with 152,228 members and 293,457 beneficiaries.
Of the three largest plans, mid-level or standard medical aid plans are proving to be the most popular, according to CMS data.
For Discovery, its Classic Saver plan is by far the most popular, with 680,000 beneficiaries (25%) attached to the plan. Half of all Discovery beneficiaries benefit from a Saver plan, which bundles medical savings for a higher monthly contribution (a portion of the fee goes toward savings). 1.37 million beneficiaries are attached to these types of plans.
The least subscribed type of plan is the leading Executive plan, which has only 8,240 members and 17,000 beneficiaries. The Classic Smart Comprehensive plan is the least popular overall, with 467 members and 958 beneficiaries.
After delaying annual dues increases for 2021 by six months until July 1, 2021, Discovery said the 7.9% annual dues increases for 2022 will not be implemented until May 1, 2022.
Deferring increases for 2021 and 2022 means that members will have a real effective increase in total dues of 2.9% in 2021 and 5.3% in 2022.
The prices below are monthly dues for primary members.
Discovery Medical Plans 2020
| Plan | Members | Beneficiaries | price 2022 |
|---|---|---|---|
| Classic saver | 308,970 | 680 184 | R3 485 |
| Coastal saver | 172,053 | 386,250 | R2 763 |
| Key Care Plus | 208,859 | 365,712 | R1,279 – R2,595 |
| Essential Saver | 141,708 | 302,754 | R2,770 |
| Full Classic | 111,632 | 239,654 | R6 309 |
| Classic priority | 78,484 | 174,025 | R4 041 |
| coastal core | 76,359 | 172 129 | R2 062 |
| Essential Core | 49,036 | 107,039 | R2 229 |
| Classic core | 48,210 | 104,414 | R2 594 |
| Classic Smart | 47,602 | 94,353 | R2,070 |
| Essential Smart | 38,854 | 45,490 | R1 483 |
| KeyCare Core | 15,950 | 26,389 | R1,005 – R1,916 |
| Complete Essential | 12,738 | 23,272 | R5 301 |
| Executive | 8,237 | 17,057 | R7 688 |
| Essential Priority | 5,203 | 10,653 | R3 472 |
| Starting KeyCare | 6,151 | 8,007 | R968 – R2 536 |
| Classic Intelligent Complete | 467 | 958 | R4,585 |
| Total | 1,330,513 | 2,758,340 |
South Africa’s second largest open scheme, Bonitas, has most of its members (%) on the Standard and Primary schemes. These are simple plans that have day-to-day coverage and hospital coverage.
Similar to Discovery’s top-tier option, the BonComprehensive plan has the lowest beneficiary base.
In September, Bonitas announced a weighted average increase of 4.8% for its medical plans in 2022. The increases will vary across the group’s plans, with the BonStart contribution fee decreasing by 7.9%. This can be attributed to the low cost-benefit ratio and the plan’s younger member profile, Bonitas said.
Bonitas Medical Plans 2020
| Plan | Members | Beneficiaries | price 2022 |
|---|---|---|---|
| Standard | 114,297 | 250 255 | R4 230 |
| Primary | 89,445 | 211 137 | R2 654 |
| BonSave | 35,548 | 83 150 | R2 950 |
| BonCap | 48 206 | 74,843 | R780 – R2 982 |
| BonEssential | 11,228 | 25,139 | R2 033 |
| BonComplet | 9,110 | 18,115 | R4,570 |
| GoodClassic | 9,134 | 16,212 | R5,677 |
| BonFit Select | 5,739 | 12,406 | R2 230 |
| Hospital standard | 5,347 | 10,002 | R2 592 |
| BonComplet | 5,087 | 8,898 | R8 217 |
| Total | 333 141 | 710 157 |
Among Momentum members, the custom option has proven to be the most popular. The plan provides coverage for hospitalization in private hospitals with no overall annual limit, giving customers the flexibility to choose to have access to any hospital or choose to receive a discount on premiums by choosing to use a specific list of private hospitals.
The premium Summit option is the least subscribed.
Momentum announced in September that it would be freezing its fees until September 2022, so the prices below reflect what members will pay for the first eight months of the year. Thereafter, a 6% fee hike will be implemented, he said.
Momentum Medical Plans 2020
| Plan | Members | Beneficiaries | price 2022 |
|---|---|---|---|
| Custom | 70,796 | 163,786 | R1 706 |
| incentive | 31,263 | 67,775 | R2 224 |
| Ingwe | 44,000 | 52,186 | R455 |
| expander | 3,171 | 6,170 | R5 231 |
| To evolve | 2,623 | 2,957 | R1,345 |
| Mountain peak | 375 | 583 | R10,642 |
| Total | 152,228 | 293,457 |
Read: Here’s how many people left South Africa’s biggest medical aid programs last year