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Discovery Health increases medical aid contributions

After January freeze.
DHMS says its increase is ‘substantially lower’ than those of ‘the next six largest open medical schemes’ in SA. Image: Moneyweb

Discovery Health Medical Scheme (DHMS) will increase the contributions on all plans by 5.9% from July 1. This comes after it deferred any increases in January for six months. It was the “first and only” open medical scheme to do so.

It says the 5.9% increase “recognises the full impact of medical inflation on the scheme, and ensures that the scheme can offer affordable contribution increases in 2022 and beyond, which are expected to be below market averages”.

“By deferring the contribution increase to 1 July 2021, members saved in excess of R2.2 billion and will only experience an increase of 2.95% in their total contributions paid to the scheme during 2021.”

DHMS says “this is substantially lower than the next six largest open medical schemes in the industry, whose members have experienced an average increase of 5.5% in total contributions paid over the same period”.

The drivers of the 5.9% increase are as follows:

  • +3.3% for “tariff inflation” based on projections of the prevailing CPI rate for the year;
  • +3.0% for the “additional healthcare demand for managing Covid-19 waves”;
  • +2.0% for the cost of procurement and rollout of Covid-19 vaccines for members;
  • -0.9% for the “net impact of the decrease in non-Covid-19 demand occurring during peaks of the pandemic”, which is “substantially offset by the latent return of non-Covid-19 demand and supply expected from Quarter 3”; and
  • -1.5% for the “impact of Discovery Health’s advanced risk management techniques and participation in the scheme’s wellness programme, Vitality”.

Main member contribution

2020 2021 July 2021 Change
Executive Plan R7 257 R7 257 R7 688 5.94%
Classic Comprehensive R5 954 R5 954 R6 309 5.96%
Classic Delta Comprehensive R5 362 R5 362 R5 681 5.95%
Essential Comprehensive R5 003 R5 003 R5 301 5.96%
Essential Delta Comprehensive R4 507 R4 507 R4 775 5.95%
Classic Smart Comprehensive R4 327 R4 327 R4 585 5.96%
Classic Priority R3 814 R3 814 R4 041 5.95%
Essential Priority R3 278 R3 278 R3 472 5.92%
Classic Saver R3 290 R3 290 R3 485 5.93%
Classic Delta Saver R2 628 R2 628 R2 784 5.94%
Essential Saver R2 615 R2 615 R2 770 5.93%
Essential Delta Saver R2 085 R2 085 R2 209 5.95%
Coastal Saver R2 608 R2 608 R2 763 5.94%
Classic Smart R1 954 R1 954 R2 070 5.94%
Essential Smart R1 400 R1 400 R1 483 5.93%
Classic Core R2 449 R2 449 R2 594 5.92%
Classic Delta Core R1 960 R1 960 R2 076 5.92%
Essential Core R2 104 R2 104 R2 229 5.94%
Essential Delta Core R1 681 R1 681 R1 781 5.95%
Coastal Core R1 946 R1 946 R2 062 5.96%
KeyCare Plus R0-8 550 R1 207 R1 207 R1 279 5.97%
KeyCare Plus R8 551-13 800 R1 659 R1 659 R1 758 5.97%
KeyCare Plus R13 801+ R2 450 R2 450 R2 595 5.92%
KeyCare Core R0-8 550 R949 R949 R1 005 5.90%
KeyCare Core R8 551-13 800 R1 183 R1 183 R1 253 5.92%
KeyCare Core R13 801+ R1 809 R1 809 R1 916 5.91%
KeyCare Start R0-9 150 R914 R914 R968 5.91%
KeyCare Start R9 151-13 800 R1 538 R1 538 R1 629 5.92%
KeyCare Start R13 801+ R2 394 R2 394 R2 536 5.93%

Discovery says all plan benefits and hospital networks will remain unchanged and that “as a result of the mid-year increase, members will be allowed a once-off concession to upgrade to any Discovery Health Medical Scheme option effective 1 July 2021”. These need to be submitted by June 15.

All plans with a medical savings account will have a 5.9% increase on their savings contributions, which will also increase their savings account balance from July 1.

Discovery says members who “have reached their Above Threshold Benefit (ATB) before 1 July 2021 will remain in their ATB and continue to access the associated risk funded benefits”.

“The additional medical savings account allocation will be carried over to the next year or can be used for healthcare expenses not funded from the member’s ATB in 2021.”

Importantly, “limits, co-payments, deductibles and thresholds were increased on 1 January 2021, and will remain at their current levels for 2021”.

Smoother increases going forward

Discovery says the 5.9% “contribution increase is better aligned to healthcare utilisation experience expected over 2021, and partially accounts for the return of latent non-Covid-19 demand already experienced this year”.

Because of this, it says “future contribution increases will therefore require a lower contribution adjustment than other medical schemes in the market, creating smoother contribution increases for members in 2022 and beyond”.

It says that over time “DHMS has offered its members greater value through contribution increases that have been consistently lower than the industry average”. This equates to 17.3% “additional value” – in effect, its increases have been 17% lower than the next six largest schemes.

In its communication to financial advisors, Discovery is incentivising sign-ups to Vitality and Discovery’s Gap Cover products.

Until June 30, DHMS clients who are not yet on Vitality or Gap Cover “can join at no additional cost for three months”.

COMMENTS   33

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Doing their bit to give the ruling party more to expropriate.

“By deferring the contribution increase to 1 July 2021, members saved in excess of R2.2 billion and will only experience an increase of 2.95% in their total contributions paid to the scheme during 2021.”
The reason they didn’t go with a 2.95% increase from January is to ensure a higher base for next year’s increase. So they focus on the zero increase and squeeze that lemon for ALL the juice that’s in there. But over the long term they do not lose out. Esp when you consider how much they have saved as a result of COVID. Management and shareholders will certainly enjoy the shared value from this…

That was what I thought when they first announced the deferred increase, however, unlike most commenters, I will wait 6 months to see what their increase for next year will be instead of just giving an emotional, witless response. If their increase for next year is much the same as all the others, that will be the time to whinge.

Indeed. Over 12 months, Discovery’s increase has been lower than any of the other major providers. Lets see what happens next year. To the whiners – remember, in almost all cases, you have a choice of medical aid provider. If you so despise Discovery, feel free to move elsewhere.

wish i was in the uk where medical care is free

Soon be free in the SA BUT the queues will be long with less doctors and other medical services available…. opportunities for sagomas to make money!

Free??? you will pay for it via your taxes and an NHI Levy !!!

4.7 million people currently on the waiting list for routine operations and procedures.

To call them medical aid is a misnoma, they are risk adjusters.

Absolutely! And you need to be an actuary to understand their billing and benefits.

When you have so many options you know it is all to confuse the public. Even us in Medical Profession have stopped trying to understand them

Medical care is free in South Africa (or at least affordability based) you just got to join the queue. I know numerous individuals who have enjoyed great medical care at state hospitals – these are of course based in the Western Cape.

Also my experience in the UK is the you still need to have medical insurance, as you can get the basic for free, but anything above that is a massive waiting list so you go private anyway.

Inflation is a funny thing, in a world were we have a sound money supply and policy we would hardly ever experience inflation and when we do it would be temporary as it would go hand in hand with deflation.

Why would a product of non increasing quality or efficiency increase in value other than a shortage? The answer is simple it would not.
What would then cause a product’s price to reduce besides a competitors better quality product and ability to supply it?
Again it would not.

The reason we are seeing inflation is due to the unsound monetary system where central banks are Expropriating Through Inflation by printing more money and their by diluting the existing supply’s real value.

Whilst it does give the government more money and control, it creates an ever increasing unequal society.

Over the last 50 years the US dollar has depreciated by 98.7%.

The unions have been smart because they know that their members are loosing out and they are trying to at least win if not break even with inflation that the government through the central bank is causing.

When will the rest of you fight for inflation based wage?

To call them medical aid is a misnoma, they are risk adjusters.

Nice of them to announce it to MoneyWeb before telling their members about the actual increase.

As far as I can see, the only notification we had from Discovery was on 16 October, when they said “We will announce this contribution increase during May 2021, and it will not be higher than 5.9%.” No indication until now of the actual increase. Although, obviously, they went for the maximum 5.9%.

The drivers of the 5.9% increase are as follows:

+3.0% for the “additional healthcare demand for managing Covid-19 waves”;
+2.0% for the cost of procurement and rollout of Covid-19 vaccines for members;

Eish they are really falling over backwards to secure vaccines for their members who now have to travel to god forsaken places to get vaccinated.

Next step will be vaccines from Cuba and China.

they also committed to Government that for every medical member’s vaccine, they would pay for one non-member’s vaccine. Coming out of the funds from their paying customers. How nice. Easy to be charitable with other peoples’ money.. They should instead tell every paying member that they can bring a non-medical-aid colleague/friend/family-member with to get vaccinated for free..

I sure the doctors, are going to increase their rate to as medical aids r slow to pay them, just like the typical landlord in this country that does not pay your deposit back.

No elective surgeries done in lockdown . Please Discovery tell us how much this saved in claims !! Would be nice to know …….

Elective surgeries are just delayed. The expense will come sooner or later.

The nutritional supplements industry, the church, and medical insurance companies peddle the same merchandise. They sell peace of mind and the fallacy of control over unforeseen events. Nobody will insure us against a foreseeable event. Some people spend so much money on peace of mind that they can’t afford a glass of red wine and a lamb chop on the fire. They have crossed the line between the meaning of life and the cost of staying alive. This situation creates anxiety that pushes us back to step one of the negative feedback loop.

Moral of the story? – buy cheap insurance and expensive red wine.

Anyone who believes that any medical insurance company, peddling a so called medical aid, has their interest at heart, is delusional. This is a money making racket second to none and the medical doctors are in on the act. Some medical professionals are now working their own determined hours thereby reducing their availability and simply charging the max as there is no alternative eg R7,500 for a ONE HOUR consultation with a cardiologist (imagine).As you rightly point out, they peddle in so called “peace of mind” and nothing else. The best alternative is to rather than waste money on a medical aid, save and invest that money and spend wisely on maintaining a healthy diet and lifestyle then you wont need a medical aid, i have.

Precisely …. Mr Gore has been a very sharp operator – nett worth about $480 million total annual compensation about R20 million.

……maintaining a healthy diet and lifestyle then you wont need a medical aid…

I have bad news for you my friend. Diet and lifestyle are no guarantee at all. Your genes are a prime determinant and the rest is either plain dumb luck or happenchance.

Another way of looking at is “you get what you pay for”. It is a fine line – finding the balance between living in the now and planning for the future. But like everything in life, cheap, is well, cheap. Cheap wine, cheap insurance – both are problematic.

1 week to go and it will be 4 months and still waiting for them to pay PMB claims !!
Almost 200 emails and maybe R200 airtime.
Not even a registered complaint at the CMS could speed them up.
How some staff are even allowed near a computer to write emails baffles me !!

Thx but no thx – I don’t fall into the category of people who can afford Discovery Medical aid – Those can continue to support Mr Adrian Gore and the exorbitant salary he pays himself

Medical aids are very, very well regulated by law. Medical aids are non-profit. Your premiums do not fund Mr Gore. But frankly, I’d be happy if they did. I can afford Discovery medical aid, and I thank my lucky stars that people like Mr Gore exist to provide a service and fill a gap created by our failed government. The alternative would be a public hospital. Good luck with that. And to those who worship at the feet of the UK NHS – do yourself a favour – read this: “This is going to hurt” by Dr Adam Kay. Its an hilarious and very entertaining read. But it’s also the truth about the NHS. If the Poms cannot get it right, can you imagine what the ANC version is going to be like. I shudder.

Fantastic job Discovery, but only for yourselves.
WHAT are you doing for your members WRT vaccination. What a scam.
Have followed your ‘instructions’ to the letter. But nothing heard, and IMPOSSIBLE to get hold of anyone for feedback.

Lots of whining and negativity in this thread. Its true its a grudge purchase and Discovery probably the best of a bad bunch, but you cannot live without medical aid in this country. I happily pay my premiums every month. With two young children I’ve claimed many years of premiums worth in claims over the years. As Sensei says, buy the cheapest plan. As for Gore well done to him for building a powerful business in SA with an entrepreneurial spirit, he could be paid double what he gets and I wouldn’t care. We need more people to build successful businesses in SA. And no I’m not a Discovery employee or agent. In terms of vaccines they have the money to buy vaccines for every one of their members but they cant bypass govt. Their vaccination centres are set up and ready to go, but the supply is short.

End of comments.

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