Discovery Medical Scheme Evaluation
The dominant player in South Africa’s medical health insurance field is Discovery Health. More than two million people are members of a Discovery Medical Scheme; an increase of more than 56 000 members in 2011. The average age of membership is 31.8 years, which is three years younger than other open schemes.
Global Credit Rating
This medical aid has received the highest AA+ rating from the independent agency Global Credit Rating, which analyses a scheme’s ability to pay out its members’ claims.
Discovery also declared that 97.1% of hospital claims were covered in full in the past year and more than 90% of specialist interactions were within direct payment arrangements thereby reducing the amounts that members paid from their own pockets and increasing the reimbursements for healthcare professionals.
The health scheme has close to R7.5 billion in reserve and this cushion gives members the assurance that their claims will be paid out.
There are a wide range of health plans that the Discovery Medical Scheme offers. These begin with cost-effective basic plans and extend up to premium cover which delivers the highest benefits. The KeyCare Series was created with lower income salaries in mind and a main member can receive cover from R450 a month.
On the other end of the scale the Executive Plan main member pays a monthly contribution of R3 764 which ensures far greater cover and access to more benefits.
Between these two options you’ll find the Comprehensive Series, Priority Series, Saver Series, and Core Series each with specific benefits and a range of monthly contributions to appeal to a cross section of the South African public.
Considering your financial position
To plan medical cover you first need to consider your financial position and what you can afford to spend each month on health insurance. A hospital plan is preferred to no medical cover but a comprehensive medical scheme is the best option.
Your health, and that of your family, is vitally important and you should ensure that you have some kind of medical assistance in the event of an accident or illness. Don’t wait until you are sick before you sign up for a health insurance scheme as you won’t be entitled to all the benefits that an existing member will receive.
The Discovery Medical Scheme has launched a variety of innovative applications to improve their members’ experience in the healthcare system. This includes the introduction of HealthID, an iPad application available to doctors and specialists. With your permission they will have access to all your medical information and will quickly and easily view your health records, process your claims, prescribe medicine, produce scripts and also make referrals.
For members with smartphones there is an app that will allow, amongst other things, access to your own records online so that you can view benefits, order medicine, track your claims, manage chronic conditions and find healthcare professionals.
Discovery Vitality is the popular wellness programme that the Discovery Medical Scheme offers its members. The aim is to reward you for making healthy lifestyle choices.
They have collaborated with a variety of companies to allow members cheaper rates for movies, gym, flights, healthy food choices and equipment from sport stores. Woolworths has been added as a new HealthyFood partner and members registered on the Chronic Illness Benefit will qualify for money back on specific items purchased from Dis-Chem.