Cutting Medical Aid Costs in 2017 – Keeping You Updated

January 11, 2017

There are 100 or so medical aids in South Africa – open and restricted. An open medical aid of which 59% of principal members belong, means that the scheme is open to the general public – anyone can become a member. Some open medical schemes have amalgamated. That is because it makes them less vulnerable to market volatility. That may lead to these medical aids cutting medical aid costs in 2017.

Six of these open schemes have shown a positive growth in membership numbers. However, in recent years many of them have recorded an operating deficit of R565.63m. With these grim statistics and with more over-inflation medical aid tariff increases hovering, medical aid members are left dazed and bewildered by the escalating costs of medical care.

These issues are being compounded because of the absence of a proper organisation in place to fight for the consumer’s interests and to question the decisions made by medical schemes on their behalf.

Cutting Medical Aid Costs

Cutting Medical Aid Costs in 2017

What can we expect from these medical schemes in 2017?

Medical scheme members are certainly going to have to prepare themselves for hefty increases in contributions as well as benefit cuts during 2017. South Africans are seriously going to have to do comparison shopping with medical aid plans and get several quotes. Planning up front is imperative for cutting medical aid costs.

Discovery Health, South Africa’s largest medical scheme, announced an average increase of 10.2% for its members. Bonitas, another medical scheme, announced an average premium increase of 11.9% across all its plan options.  The chief executive officer at Discovery says that the medical scheme has had to contend with sharp increases in medical inflation in 2016 and was expecting medical inflation to be 10 to 15% in 2017.

Members Left Paying Most of their Medical Bills

With medical costs rising, medical aid members who need to undergo medical treatments will find themselves facing massive medical bills that the medical scheme does not cover. Also, the medical schemes are seeing an increase in claims. They are reducing members benefits as these schemes try to remain financially stable in the face of these rising claims.

There are a few ways a scheme can meet the increase in claims, and that is to increase contributions, cut benefits or run down their reserves if these exceed the 25% of contributions.

Schemes like Momentum Health have fewer claims as their membership is growing. They also have a bigger number of younger members than other schemes. You can expect medical schemes with declining membership or with a bigger number of older members, to put through the highest contributions for 2017.

More Information on Members Left Paying Most of their Medical Bills:

During 2017, if you want to cut medical costs in 2017, there are some things you need to do. Before any medical treatment, discuss the medical scheme tariff with your specialist and know what you’re going to pay.

Certainly, there are going to be massive shortfalls in 2017 waiting for you without gap cover. Start the new year off understanding gap cover. Also, understand why you have to have gap cover if you want to cut medical costs in 2017.

If you’re going to have a medical procedure in 2017, ask your medical scheme to give you a list of Designated Service Providers – also known as DSPs – for the procedures. These providers have agreements with medical schemes for non-prescribed minimum benefits

What Can You Do?

With health care costs rising in 2017, medical aid members are going to need all the wisdom they can get. Know your medical scheme, so you know what benefits, waiting periods and exclusions you’re in for. Attend to common lifestyle diseases and work hard to become more healthy in 2017. Lastly, follow your medical scheme’s rules to stay in favour with them.


All info was correct at time of publishing