The six top-end medical aid plans offered by Discovery Health Medical Scheme (DHMS) continue to lose members with a 5% reduction between late 2020 and late 2021.
Executive, Classic Comprehensive, Essential Comprehensive, Classic Smart Comprehensive, Classic Priority and Essential Priority – the number of beneficiaries of these plans is 6% less than the same period.
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Since 2017, in other five years, the number of members and beneficiaries of these schemes has decreased by 24% and 28%, respectively.
The rate at which members are abandoning these top-end plans has remained stable since 2015, with reductions between 5% and 6%.
The impact of the Covid-19 lockdown and related job losses and pay cuts in 2020 meant a 10% reduction in members and a 12% reduction in beneficiaries that year.
These six plans contributed between R4 327 to R7 257 per month in 2021 (for key members).
All plans at a glance
|2021||2020||Changes in beneficiaries
|Executive||7 927||16 027||8 237||17 057||-6%|
|Classic wide||105 496||223 204||111 632||239 654||-7%|
|The essentials are comprehensive||12 235||22 121||12 738||23 272||-5%|
|Classic smart wide||454||874||467||958||-9%|
|Classic priority||74 947||164 791||78 484||174 025||-5%|
|Essential priority||5 075||10 129||5 203||10 653||-5%|
|Classic saver||316 36||694 333||308 970||680 184||+ 2%|
|Essential saver||154 565||330 891||141 708||302 754||+ 9%|
|Coastal Saver||169 966||380 185||172 053||386 250||-2%|
|Classic core||46 937||101 414||48 210||104 414||-3%|
|Essential core||50 719||111 202||49 036||107 039||+ 4%|
|Coastal core||73 193||165 129||76 359||172 129||-4%|
|Classic smart||55 372||110 256||47 602||94 353||+ 17%|
|Essentially smart||45 337||52 930||38 854||45 490||+ 16%|
|Key care begins||6 026||7 812||6 151||8 007||-2%|
|Key care core||16 903||28 462||15 950||26 389||+ 1%|
|What Care Plus||211 492||365 033||208 859||365 712||0%|
|Total||1 353 012||2 84 693||1 330 513||2 758 340||1%|
Source: DHMS Annual Report
The largest of these six high-end plans, Classic Comprehensive (R5 954 per major member, which includes R1 488 Medical Savings Accounts), has lost 35% of its members in the last five years. This number has accelerated from 30/31% level in last few years.
The two plans – Classic Smart and Essential Smart – continue to see strong double-digit growth among members and beneficiaries.
Together, these plans increased by 16% and 17%, respectively. Discovery describes the offer of smart plans as “the most affordable hospital cover, essential long-term medication cover and limited daily cover if you wish to use suppliers over a specific network”.
DHMS’s two largest plans with more than 527,000 members – Classic Saver and Keycare Plus (which are limited to a certain income band) – have maintained their growth trend.
Read: Losing Discovery Members is not the only medical project
Changes to the overall membership base will include new members joining DHMS, upgrading or downgrading existing members to the scheme, and members leaving the scheme altogether.
Overall, the number of DHMS members increased by 2% to 1.353 million by the end of 2021. The number of beneficiaries of the scheme increased by 1% to 2.784 million.
The DHMS refers to Section 33 (2) of the Medical Schemes Act and states that “every benefit plan must be self-supporting and financially sound in terms of membership and financial performance”.
It noted that seven of its plans were not implemented by the end of 2021:
|Net healthcare results||Net (deficit) / surplus|
|Executive||(R218.5 million)||(R200.5 million)|
|Classic wide||(R970.7 million)||(R728.1 million)|
|Classic priority||(R116.6 million)||R54.3 million|
|The essentials are comprehensive||(R30.3 million)||(R2.6 million)|
|Coastal core||(R164.5 million)||R30.8 million|
|Coastal Saver||(R250 million)||R133.8 million|
|What Care Plus||(R910.5 million)||(R356.6 million)|
DHMS states that “the performance of all benefit options is monitored on an ongoing basis to improve their financial performance”.
It further states that “when formulating benefit options, the financial stability of all options and the requirements of CMS [Council for Medical Schemes] Considered “.
“Different financial positions reflect the burden of different diseases in each option, among many other factors,” it adds.
“The scheme’s strategy for sustainability of the plan is a balance of short and long term financial considerations, fairness to both healthy and sick members and continued purchasing power of cover for members with different levels of income and healthcare needs.
“While the scheme is committed to complying with applicable law wherever possible, it is not only a personal benefit plan, but also intensively focuses on the overall stability and financial position of the entire scheme.”