Finding the sweet spot for medical scheme clients

By: Josua Joubert Chief executive and principal officer of CompCare Medical Scheme

Josua Joubert

With the final quarter of 2023 almost upon us, medical scheme clients will once more be searching for the sweet spot in healthcare cover. Yet most would likely be in disbelief that such a thing can even exist when it comes to a grudge purchase like medical cover. Looking at the status quo, it’s not hard to see why. On the horizon is the prospect of NHI, and while at this point it looks more like a mirage than a robust solution, the possibility of such a shake-up is casting fear in the minds of many. On the other hand, what we have in the here and now is a gaping divide between an insufficient range of low-cost options permitted in the market, and on the opposite side of the spectrum, costly medical scheme membership. There is little to nothing in the middle ground. Yes, the Council for Medical Schemes has been ordered to produce source documents on low-cost benefit option restrictions, which feels like progress. Still, it remains to be seen when real results will materialise from this and just how much change it will bring about. Medical schemes, on the other hand, are contending with numerous challenges, not least of which is the rise in healthcare costs, which year on year continues to be above inflation. Having said that, while experiencing no growth in the last decade, medical schemes have also not seen a drop in member numbers to speak of, from which we can only conclude that consumers with this level of buying power are not willing to part with their medical scheme membership just yet. This, however, does not mean they aren’t feeling the financial squeeze that is affecting the market at large. Healthcare advisors know that most clients can comfortably afford no more than half of their current contributions, and making that stretch means cutting costs in places where they would rather be spending, or better yet, saving. A grudge purchase by its very definition. So, how can you get your clients closer to that sweet spot where they spend less but still feel the full benefit of comprehensive healthcare cover? Efficiency discount options are a highly effective mechanism for achieving this and can save your clients up to 25% of their contributions. Having introduced the concept to the market more than a decade ago, we can certainly attest to the fact that schemes offering this cost saving are only seeing a rise in the demand for such products. More than that, efficiency discount options are fully transparent about the limitations they impose – such as which hospital or pharmacy group you can use – limitations which are not unusual among many other options in the market that don’t offer the same financial benefit. This further provides your client with a greater sense of ownership over their healthcare rand and just how far it can go. When it comes to getting your client to sign on the dotted line, there is a lot to be said for giving them the comfort – and the control – of knowing they don’t have to sacrifice the quality of their care or the attention to their wellness to put real savings within reach.

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