Contribution Increase for 2017
A Weighted average between 7.8% and 14.9%
|Plan option||Increase 2017|
Discovery Health Focuses in 2017
1. Increasing contributions equitably across its membership base without compromising on benefits
2. Expanding the Smart series with access to the Classic Smart plan and Essential Smart Plan for only R1100 per month – 24 % more affordable than the competitor
3. Unique and enhanced benefits for the Classic/Essential Smart include:
- Unlimited GP consultations
- Acute medicine benefit
- Dental check-up
- Eye test
- Sports injury benefit
- Screening and prevention benefits
- Extended Smart provider and hospital network
4. Coastal Saver medical savings account changed from 25% to 20 % annual MSA.
5. Targeted benefits for at-risk members:
- Enhanced individualise approach to the Screening and Prevention Benefit,
- Health check benefits for members with results that are out of range for their glucose and cholesterol tests.
- Breast cancer and cervical cancer screening with one mammogram or breast MRI test per year, annual Pap smear and BRCA testing (once off).
What’s new in 2017?
The average 2017 contribution increase announced for Momentum Health members is 11%.
Momentum Health has maintained medical scheme benefits (and increased limits) in line with its strategy not to reduce members’ access to benefits.
One of the client-centric healthcare offerings from Momentum that serves to complement the medical scheme experience is its Health Returns offering. In conjunction with Multiply, Momentum’s rewards and wellness programme, it will enable greater monetary rewards (of up to R2 000 per family per month) and more choice in terms of how and on what clients spend these monthly rewards to enhance their health and state of wellness.
Extending healthcare cover to staff and domestic workers will form part of the holistic, client-centric healthcare solutions available from Momentum during 2017.
1. Major Medical Benefits
- The overall annual limit will be increased to R1 190 000 per family.
- Annual sub-limits for in-hospital benefits have also been increased.
2. Chronic and Day-to-day Benefits
- Out-of-network GP, casualty or after hours visits – co-payment will be R100 per visit and no longer 10% of the event.
- Chronic and Day-to-day benefits will continue to be provided by the Ingwe Primary Care Network or Ingwe Active Primary Care Network providers
1. Major Medical Benefits
- Annual sub-limits for in-hospital benefits will be increased, except for oncology.
- The Custom Option co-payment that applies per authorisation will increase to R1 200.
- Co-payments payable for the specialist referral procedures/treatment will increase to R500 per authorisation if the procedure/treatment is performed out-of-hospital. If the procedure/treatment is performed in-hospital, the co-payment will be increased to R1 200. An additional R700 co-payment will apply if you do not obtain an appropriate GP referral
- The costs of anaesthetists for gastroscopies and colonoscopies will be covered up to R425, subject to pre-authorisation.
2. Chronic Benefits
- Chronic Benefits are still subject to registration and Scheme authorisation. If you are currently registered for a chronic condition, please remember that scripts are valid for 6 months and you need to submit a new script to us and your pharmacy once your script expires.
- Remember that you need to obtain your chronic benefit from your chosen chronic benefit provider.
3. Health Platform Benefits
- The additional free early detection and preventative care benefits available on the Health Platform continue in 2017.
- Your international emergency cover will increase to R7.66 million for 2017.
An average premium increase of 11.9% announced across all plan options.
Research amongst consumers showed a need for more options with more traditional benefits.
Structural changes have been made to Standard and Standard Select and a brand new option BONCOMPLETE has been launched for 2017.
- Standard and Standard Select: savings account has been removed and has been changed to Day-to-day benefits
- Separate benefits not impacting on utilisation
- Savings account and above threshold benefit
- Additional benefit for basic dentistry
- Cover for 31 chronic conditions
- Childhood illness. Infant paediatric and maternity benefits
- Annual wellness screening and R1450 for Wellness Extender
- No co-payments for CT and MRI’s
- Contributions from R2923 for principal member
Call us on 021 943 5302 or email us at [email protected]
Visit our website for more information: www.verso.co.za