News

MEDICOVER KEEPS BENEFIT INCREASES LOW

For the fifth year in a row, Medicover has kept its annual increase below 10%.

Stephan Grobler, Principal Officer says, "The overall average increase for 2007 will be only 8.38%. This increase is, yet again, below the industry norm."

He adds that, despite an industry trend of reducing benefits or adding co-payments or deductibles to benefits, Medicover has maintained its offering of benefits whilst enhancing the healthcare fund, and health savings account on Bona Plus and Titan, for out of hospital expenses. Rand for rand the increase on all plans is minimal.

"Our core focus for 2007 will remain unchanged as we strive to ensure that our offering is simple, yet effective, and totally transparent."

Since its inception in 1994, Medicover has grown steadily to more than 53 000 principal members, covering more than 140 000 lives. This year the growth has been approximately 1 000 members a month. In July the scheme merged with Klerksdorp Medical Scheme and opened an office in the town. A Cape Town office is on the cards for early next year.

Medicover offers only four plans: ALTA, TITAN, BONA PLUS and BONA, which covers a broad spectrum of benefits, even for the cheapest option.

Among the key differentiating factors Grobler pointed to is that the scheme is self-administered with low administration fees and is transparent in the application of funds. It's solvency level currently stands at 68% with reserves in excess of R700 million. The scheme has achieved a consistent AA- rating from Global Credit Rating over the past four years.

"Moreover, Medicover set the trend of making payments to service providers and members on a weekly basis and, continuing with the initiative introduced in 2005, members only pay contributions for their first three child dependants.

"With the introduction of CarewarePBM, a fully integrated Pharmaceutical Benefit Management module within the current Medicover administrative system, Medicover can now offer a more efficient and cheaper administration of medicine claims."

He emphasises that the scheme outperformed its budget by a considerable margin in the previous financial year, despite high pressure from providers, hospitals and members.

"The low-cost Bona and Bona Plus options offer members the best of all worlds - hospital benefits, the prescribed minimum benefits, chronic care, dentistry, optometry and various other benefits - for a similar contribution to what other scheme charge for hospital plans only. These options are also structured to optimally make use of tax benefits."