Healthcare, what should I be asking?

Photo by Julien Flutto on Unsplash

If ever you have hoped to see a living example of resilience, you will find it amongst the men and women in our nation’s agricultural community. In the face of a pandemic that brought the world to its knees, many South African farmers have not only managed to survive, but also to thrive.

So much so that the Agbiz/IDC Agribusiness Confidence Index reached a record high of 75, from 64 in the first quarter of 2021. Thankful for the rare combination of big yields and higher commodity prices, the sector is generally enjoying this much-needed boost.

However, we are not yet out of the woods, and many of the nation’s farmers are making use of this opportunity to assess priorities. So, when it comes to your healthcare cover what are the big questions you should be asking? Josua Joubert, CEO and Principal Officer of CompCare Medical Scheme sheds some light on this important topic.

Question 1:

How do I know what healthcare cover I really need?

Everyone has different needs and there is no blanket rule unfortunately, however a good baseline is a medical scheme option that will cover in-hospital procedures and pay standard medical scheme tariffs. If opting for a hospital plan or savings plan however, be sure that you are aware of any limitations. Some options may, for example, require you to make use of particular healthcare facilities within a preferred hospital network, with which special arrangements would have been made in order to obtain the best possible value for members.

If you are keeping it simple, opting for a hospital plan like CompCare’s MEDX option is a solid choice with unlimited hospital cover at any private hospital, cover for the 27 chronic conditions that form part of the minimum benefits every scheme must cover, as well as a comprehensive cancer benefit.

Question 2:

What is important when choosing a medical scheme for myself, my family or my employees?

There are multiple factors you need to consider.

1) Cost
This is, now more than ever, one of the key considerations – after all, we cannot overlook the importance of financial health. At the same time, you need to ensure that your medical cover adequately meets your needs so that you are not at risk of being caught short. It is therefore a matter of striking the right balance for your needs specifically.

2) Stage of life
If you are young and in good health, then it might not be advisable to spend your hard-earned income on a really comprehensive option with benefits you are unlikely to use. For those who have children, an option like CompCare’s SYMMETRY would be a good choice as it provides a special children’s range of benefits covering everything from baby wellness visits to childhood immunisations, school readiness assessments, pre-school eye and hearing tests and a dental screening. An extra visit to an emergency room is also included for children every year. In addition, a consultation with an occupational therapist, a fitness assessment and exercise prescription programme, as well as a nutritional assessment and healthy eating plan is offered especially for children. Children younger than six get unlimited GP visits and basic dentistry even if benefits are depleted. This kind of family-oriented option must also take into account the importance of excellent men’s and women’s health benefits.

On the other hand, if you feel great and mentally you are still in your 30s but you are celebrating your 63rd birthday next Saturday, it’s time to look at something like the DYNAMIX option from CompCare. This will ensure that you have the added safety net of above-threshold benefits in case you or your family have any unforeseen medical, specialist and dental expenses, as well as really comprehensive cover for 65 chronic conditions.

3) Research
All the sales talk in the world cannot make up for the value of hard fact when it comes to reliability in a medical scheme. Do your research and make sure you are placing your trust in a scheme you can count on. These are good questions to ask and the kind of answers you are looking for:

• How experienced is this scheme? CompCare has a proven track record of more than 42-years in the business of healthcare. However, I believe it is the personal interaction and the care we provide that makes a real and lasting difference to the members whose lives we touch every day.

• How financially secure is this scheme? At 47% the solvency ratio of the scheme is well in excess of the minimum 25% required by the Council for Medical Schemes, thereby living up to its independent ranking as one of the most financially sustainable schemes on the market.

• What is the average member age of this scheme? Average member age is XX.

Question 3:

Rising healthcare costs are given as one of the reasons for above inflationary increases in medical aid cover. Are there any initiatives in place to decrease and maintain healthcare costs?

Being a little ahead of the pack, in 2012 we brought efficiency discounts to the market, which allows for reductions of up to 25% of the normal contribution rate on certain options for members using Dis-Chem pharmacies and Netcare hospitals.

For savvy consumers these discounts translate into considerable savings. These options have been particularly well received by our clients who are looking to add value to the financial packages offered to staff members across the board.

CompCare was also first to market with two innovative benefits, namely the Prescription Exercise Benefit and the Nutritional Benefit. These special features provide members with the opportunity to regularly consult accredited biokineticists and dieticians listed on the CompCare network. These structured programmes are provided under the guidance of nutrition and exercise professionals and can work to considerably enhance their health and wellness.

The healthcare funding industry would be more sustainable and better able to serve its members if greater emphasis were to be placed on primary health and preventative care.

Question 4:

What are some of the highlights that demonstrate why CompCare offers the ultimate in value?

1. In 2021 CompCare implemented a member weighted overall average contribution increase of 4.6% across all benefit options, along with a host of enhanced benefits. In certain instances, our contribution increase was as low as 3.5%. On our most popular option, UniSave, the increase for 2021 was 4.8%, while on the entry level NetworX option it ranges between 3.5% and 5.1%, in line with salary bands.

2. We are one of few medical schemes to cover all costs relating to sports injuries, including injuries sustained when participating in extreme and adventure sports.

3. CompCare offers child rates until the age of 27.

4. The scheme has introduced virtual consultations to all benefit options via uConsult, a ground-breaking new platform. Members can now safely access confidential online consultations with their GP – and soon providers from other medical disciplines – from any device and any location, as well as being able to receive encrypted electronic healthcare documents.

5. With a range of 15 options on offer there is something that would suit every stage of life, pocket and lifestyle.

6. CompCare’s emotional wellness benefit, which is available free of charge on all options, provides a 24-hour helpline with trained clinical professionals, together with a referral for face-to-face counselling when required.

7. A leading medical schemes survey has consistently ranked CompCare among the top ten medical schemes in terms of longevity and sustainability.