Discovery Medical Health Scheme is increasing its premiums by between 7.9% and 8.9%, depending on the member's medical plan.
Bonitas said its increase would be in the region of 10.9%.
Momentum Health Medical Aid Scheme's average increase is 8.9%.
Healthcare costs usually increase above inflation but salaries don't. Bonitas's principal officer, Bobby Ramasia, said yesterday the increases were due to price pressures on medical aids.
"As reported by the Council for Medical Schemes, the medical aid schemes regulator, the market has not been successful in attracting young, healthy people to join medical aid schemes, while expenditure on claims continues to increase at a rate of more than 11%," Ramasia said. Medical aid schemes are not-for-profit trusts. The money is pooled and shared, especially among the sickest members. The schemes need younger healthier members who claim less to subsidise the sick. But most medical aid schemes, with the exception of Discovery, did not grow last year.
Head of healthcare consulting at GTC, Jill Larkan, says cash-strapped consumers often buy cheaper medical aid options to balance their budgets.
She says:
"A medical aid option that covers 100% of medical aid rates does not mean 100% of the member's hospital bill will be funded. It means they pay 100% of the price set for doctors. If doctors charge above the set price, patients might have to pay for the extra portion;
"When members are is admitted to a hospital, they must ask nurses, medical aids and brokers if their condition is covered as a prescribed minimum benefit. These are chronic conditions and diseases for which doctors have to be paid in full and for which certain medications have to be provided to the patient;
"Members must find out if the medical aid scheme requires them to use a Network GP, Network specialists and/or Network hospitals or all three. If a member uses alternative doctors or hospitals, medical aid schemes will not foot the bill in full; and
"Gap cover is a R100 a month insurance policy that covers the difference between what medical aids pay doctors for in-hospital treatment and what the doctors in hospitals charge.
Source: The Times
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