Priciest Discovery Health plans still losing members

But two keep growing in double digits …
Over the last five years the scheme’s top six plans have seen member numbers drop 24%. Image: Moneyweb

The six top-end medical aid plans offered by Discovery Health Medical Scheme (DHMS) continue to lose members, with a 5% decline between the end of 2020 and the end of 2021.

The number of beneficiaries on these plans – Executive, Classic Comprehensive, Essential Comprehensive, Classic Smart Comprehensive, Classic Priority, and Essential Priority – is down 6% over the same period.

Read: Covid spurs Discovery to seek low income clients

Since 2017, in other words over five years, the number of members and beneficiaries on these plans are down 24% and 28% respectively.

The rate at which members are abandoning these top-end plans has been steady since 2015, with declines of between 5% and 6%.

The impact of the Covid-19 lockdowns and the related job losses and salary cuts in 2020 meant a 10% decline in members and 12% drop in beneficiaries in that year.

These six plans had contributions in 2021 (for main members) of between R4 327 and R7 257 per month.

All plans at a glance

2021 2020 Change in beneficiaries
Members Beneficiaries Members Beneficiaries
Executive 7 927 16 027 8 237 17 057 -6%
Classic Comprehensive 105 496 223 204 111 632 239 654 -7%
Essential Comprehensive 12 235 22 121 12 738 23 272 -5%
Classic Smart Comprehensive 454 874 467 958 -9%
Classic Priority 74 947 164 791 78 484 174 025 -5%
Essential Priority 5 075 10 129 5 203 10 653 -5%
Classic Saver 316 368 694 333 308 970 680 184 +2%
Essential Saver 154 565 330 891 141 708 302 754 +9%
Coastal Saver 169 966 380 185 172 053 386 250 -2%
Classic Core 46 937 101 414 48 210 104 414 -3%
Essential Core 50 719 111 202 49 036 107 039 +4%
Coastal Core 73 193 165 129 76 359 172 129 -4%
Classic Smart 55 372 110 256 47 602 94 353 +17%
Essential Smart 45 337 52 930 38 854 45 490 +16%
KeyCare Start 6 026 7 812 6 151 8 007 -2%
KeyCare Core 16 903 28 462 15 950 26 389 +8%
KeyCare Plus 211 492 365 033 208 859 365 712 0%
Total 1 353 012 2 784 793 1 330 513 2 758 340 1%

Source: DHMS annual report

The largest of those six higher-end plans, Classic Comprehensive (R5 954 per main member, which includes R1 488 to the medical savings account), has lost 35% of its members over the last five years. This number has accelerated from the 30/31% level in the last few years.

Two plans – Classic Smart and Essential Smart – have continued to see strong double-digit growth in members and beneficiaries.

Together, these plans are up by 16% and 17% respectively. Discovery describes the proposition of the Smart plans as “the most cost-effective in-hospital cover, essential chronic medicine cover plus limited day-to-day cover if you’re willing to use providers in a specified network”.

DHMS’s two largest plans which have over 527 000 members – Classic Saver and KeyCare Plus (which is restricted to a specific income band) – have maintained their growth trend.

Read: Discovery not the only medical scheme losing members

Shifts within the overall base of members will include new members joining DHMS, existing members upgrading or downgrading within the scheme, and members leaving the scheme altogether.

Overall, DHMS saw a 2% increase in members to 1.353 million at the end of 2021. The number of beneficiaries in the scheme was up 1% to 2.784 million.

DHMS refers to Section 33 (2) of the Medical Schemes Act and says “each benefit plan is required to be self-supporting in terms of membership and financial performance, and be financially sound”.

It notes that seven of its plans did not comply at the end of 2021:

Net healthcare result Net (deficit)/surplus
Executive (R218.5 million) (R200.5 million)
Classic Comprehensive (R970.7 million) (R728.1 million)
Classic Priority (R116.6 million) R54.3 million
Essential Comprehensive (R30.3 million) (R2.6 million)
Coastal Core (R164.5 million) R30.8 million
Coastal Saver (R250 million) R133.8 million
KeyCare Plus (R910.5 million) (R356.6 million)

DHMS says the “performance of all benefit options is monitored on a continuous basis with a view to improving their financial outcomes”.

It also notes that “when structuring benefit options, the financial sustainability of all the options and the requirements of the CMS [Council for Medical Schemes] are considered”.

“The different financial positions reflect the different disease burdens in each option, among many other factors,” it adds.

“The Scheme’s strategy on the sustainability of plans has to balance short- and long-term financial considerations, fairness to both healthy and sick members, and continued affordability of cover for members with different levels of income and healthcare needs.

“While the Scheme is committed to complying wherever possible with the applicable legislation, it also focuses intensively on the overall stability and financial position of the Scheme as a whole and not only individual benefit plans.”

COMMENTS   1

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If private individuals cannot afford the cost of their personal comprehensive healthcare anymore, how will they be able to finance the cost of NHI for everyone else? The government will have to raise tax levels to 110% of income for those individuals who do pay taxes.

It is easy to legislate it, but enforcing it will be a different issue altogether. If they want to finance their socialist redistributive destruction by extorting taxpayers, they will have to confiscate all passports and shut all airports.

End of comments.

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