Members and beneficiaries of the most popular plans offered by Discovery Health Medical Scheme (DHMS) will see sharp cuts to their medical savings accounts (MSAs) from 2024.
The group sold this in its announcement about the increases for 2024 by highlighting that practically four in every 10 scheme members (39%) will experience an increase in contributions of less than 4% from January.
Read/listen: Here’s how much more Discovery medical aid members will pay next year
There are no changes to MSA percentage allocations on the Executive, Comprehensive and Priority plans. The MSA contributions will increase in line with the plans.
The cuts will be made on the two most popular plans (excluding entry-level KeyCare) – Classic Saver and Essential Saver – which have around half a million members between them, including the network provider variants (Classic Delta Saver and Essential Delta Saver). The Classic Saver plans will see contributions increase by 3%, while the Essential Saver ones will be 3.8% higher.
However, buried in its announcement about the increases are the changes to MSA allocations from 2024. DHMS simply mentions the allocations for each of the five plans (the four mentioned above plus Coastal Saver, which is close to a network plan in itself).
To achieve the sub-4% increases for these plans, it has cut the allocation to the MSA from the net contribution paid by five percentage points.
For the Classic Saver plan (including the Delta variant), the allocation is reduced from 25% to 20%, Essential Saver (and Delta) from 15% to 10%, and Coastal Saver from 20% to 15%.
How these hits translate …
This means that for a main member on the Classic Saver, their MSA will drop from R12 180 this year to R10 020 next year.
On Essential Saver, the MSA will reduce from nearly R6 000 this year (R5 796) to R4 008 in 2024.
These are material reductions.
In the case of Essential Saver, the cut is 33% (from 15% to 10% allocation), on Coastal Saver it is 25%, while on Classic Saver the drop is 20%.
Where the change becomes even more acute is in the allocation to the MSA for children.
On Classic Saver, the MSA decreases from nearly R5 000 (R4 872) this year to R4 020 in 2024. On Essential Saver, it goes from R2 316 to just R1 596. In rand terms, this means a reduction of 18% for Classic Saver and just over 30% for Essential Saver.
Mothers will know exactly how little R1 500 a year in medical aid savings is.
‘Optimisation’ and new benefits
According to Discovery Health CEO Dr Ryan Noach: “The increases in gross contributions … allow for optimisation of Medical Savings Accounts [MSAs] on the Saver Series plans, considering the affordability challenges and the introduction of new benefits for DHMS members, previously funded from MSA.
“These include virtual urgent healthcare and cognitive behavioural therapy [CBT] online for depression and anxiety.”
Had DHMS not implemented these reductions to the MSA allocations, the contributions for these plans would’ve increased by between 8% and 11%.
This would’ve meant a big jump from its current average increase of 7.5%. Without those MSA changes, the average increase would’ve been 10.25% (excluding Classic Smart Comprehensive). DHMS excludes this plan from its calculation to get to the 7.5% too.
Change or stay put?
The structural change to the Classic Smart Comprehensive plan, with the introduction of a MSA from next year, means contributions to this specific plan will jump by 32%.
A plan that currently costs R5 441 will be R7 163 in 2024.
This is a slightly unfair comparison in an analysis like this, but the lived reality of members on the Classic Smart Comprehensive plan will be a nearly R2 000 jump in contributions for the main member.
Those members will need to carefully consider whether to remain on this plan (which is a different proposition from January) or change to another plan.
Read: Medical schemes told to keep 2024 contribution increases to 5% or less
“While the long-term sustainability of DHMS is paramount, we remain extremely sensitive to the economic environment and affordability pressures that Scheme members are currently facing,” says Noach.
“We are keenly aware of the far-reaching impacts of increasing inflation, high interest rates and low GDP growth on households and businesses in our country.
“With this in mind, we strive to maximise value for members of the scheme whilst maintaining the long-term sustainability of the medical scheme.”
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COMMENTS 28
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Discovery hides the cuts in their formulary every year. So when you read that they cover 200% or 100% of specialist or in-hospital rates for example it looks like the same cover year on year but in their formulary they have cut what the actual rate is or they reduce the medicine price list or content. Please do an investigation where you compare formulary rates and content including specialist rates and cover year on year vs. premium increases. When I requested this info from a Discovery broker they stopped communicating with me.
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Not sure I understand your remark too well. Prices for most drugs can be obtained from their website. In terms of your tax or monthly statement the scheme rate is indicated in a separate column.
Gap cover is pretty useful if there are hospitalization events.
Medical aid in general is a very opaque system and it is not really easy to compare plans from different companies. It’s a question of claim and learn.
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Many doctors will say off the record that Discovery is bullying them. Is that kind of behaviour serving the cause of private health care in SA? Discovery must be careful that they don’t become the reason for NHI.
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I’m specialist anesthesiologist and I can unequivocally tell you that all medical aids in South Africa are the same save for one thing: Discovery is a true bully.
We all have to be on the Discovery network or else they pay patients instead of Doctors. If you’re on the network you have restrictions on how you practice. Plus they don’t pay PMBs to network doctors.
Every year those restrictions increase like a slow boil. 20 years from now they will not allow us to give anesthesia because it will be deemed unnecessary. Just like Scopes are becoming harder to fund.
I’m not on any other network except Discovery. If they stop paying patients like all other medical aids I will be out the door in a New York minute.
I write off co-payments to my patients. So my patients never lose out.
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So are you still a member or when did you quit??
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I’d love to know how alternative medical plans compare, as there might be better plans at competitors of Discovery. If this continues I may have to look at switching.
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Have a look ay Genesis.
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Make sure you look into GAP cover with some of Genesis plans. I write off quite abit of co-payments in my practice.
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There is merit in your thought, but you must never underestimate the Discovery marketing machine – they know how to get employers on board and in the end you belong to Discovery because you are diplomatically forced to.
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Break free – start your own business and be the BOSS !!!!!
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Have a look at BestMed, I was with them from 2017 to 2022, and mostly they had a fairly decent offering on their higher end plans, and way better offerings than Discovery. I absolutely despise Discovery, they don’t even offer dental as a separate benefit, its within your savings and once thats depleted then youre done for…just you and paying cash all the while coughing up monthly premiums for something that has no more day to day savings by mid year.
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Make sure you have GAP cover with some of BestMed plans. Especially if you see specialists.
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Will members continue to pay for these schemes once Discovery ushers in NHI?
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Discovery is not ushering in NHI. They are the only med aid that i know fighting against it. MHI will destroy medical cover for every one in SA.
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I cannot understand how anybody can expect to have their medical aid contribution be less than medical cost inflation – minor productivity gains aside, the scheme administrators will have to grow their profit or the shareholders will be vengeful.
The Savings Account has always been a sop – it only helps with the members’ cash flow at the start of the year. After that it is a low interest loan to the scheme. (Check contribution cost with and with out the SA. A+B = A and B)
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Bottom line, from one of the first early 1990s Discovery members, the continuous, year after year above substantial inflation increases are catching up with this bunch, wonder how many actuarial science gurus Discovery allows into these decisions.
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Most will agree that petty-cash box management is not as simple as it looks, and costs money to run and keep for limited benefits. Imagine medical aid world where the equivalent problem is resolved, where majority nonsense mathematics is eliminated. Discovery + Aspen + any local top courier, yes BIG idea but competition boys would probably need hospital plan after sh . . . . . . themselves.
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I dont think the point is to not expect increases…the issue is the benefits and the increases are not in alignment…we are paying more for less!
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Some of the other medical aids are going up by over 23% (for less benefits)…..and so in my opinion, DH has done very well.
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Outrageous racist comment!!!!!
Why is this ex Zimbabwean racist even allowed on this site!!! Every comment made has racist undertones !!!!!!!!!!!
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Discovery se (na my mening) versuikerde verduidelikings t o v die premie verhogings en 5% vermindering in sommige planne se Mediese Spaar Rekening maak die mediese dekking al hoe meer onbekostigbaar. As jy n berekening doen van slegs n gemiddelde groei van 9% oor n termyn van 20 jaar, gaan die premies totaal en al onbekostigbaar wees. Dan sluit dit nie eers die laat aansluiting boetes in wat op sommige persone van toepassing gemaak word nie, en nooit hersien word nie. Dit gaan meebring dat al hoe meer mense geen keuse gaan kan uitoefen nie en net van die Nationale Gesondheids Skema gebruik kan maak. En ons weet almal wat daardie uitkoms gaan wees.
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I like to think I’m good at analytics, but I gave up trying to understand medical aid price structures and rules long ago. Whatever name tags they apply to the structure, in effect a big chunk goes to day-to-day and gets consumed super fast, after which you are alone with your bank account and some hope of a tax advantage. A next portion goes to what is on their side a hospital plan for the big events. Then a next chunk is set aside for chronic but if you are lucky enough not to need chronic medication, that unused allocation disappears into a black hole.
They are designing wrong approaches into their rules imho. If I track what is going on and my clever watch tells me that hey boy, maybe having a heart rate range 38 to 190 in a day is concerning, and I book a cardiologist to have a look : wham goes all my allocations for the year. If instead of that route I go to hospital and say not feeling so lekker, hospital admits me from an abundance of caution, specialists and 20 tests are covered. That is plain dumb system.
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Agree ! If I could change medical aids, I would but obligated to stay because of employment. But Discovery is honestly a massive rip off.
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I am not pro medical aid, but we forget that we get old or severely sick sometimes.
Some of my clients (I don’t provide their medical aids I send them to an independent 3rd party) claim hundreds of thousands above what they contribute later in life.
The one lady had 4 operations in the last 3 years, neck and brain, expensive stuff. She had total co-payments of R20 000. Each operation around R100k to R400k.
Another client has multiple sclerosis, his meds, R11k per month but he only needs to contribute his normal medical aid contribution nothing more.
Two sides to every coin. I think if we approach medical aid as an “insurance” of some sorts that only benefits us when we need it and fast, then it justifies the payments.
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Discovery paid – without a blink all the costs of a heart operation, spinal cord fusion and knee replacement!!!!
A great company in my opinion and I only have a hospital plan.
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That is sort of what I mean, but not explaining well.
Say premium is R1000pm
A chunk maybe R500 is day-day so have annual R6000 in day-to-day cover and when that is consumed, you pay. In effect a savings account.
A bit is chronic maybe R100, but if you have no chronic, that R1200 is not topped into your exhausted day-to-day.
Then the actual “insurance” bit is R400pm for hospitalization and this where risk and reward is shared by all million members. You are grateful if never use that R400 and happy to pay that R400 into pool for somebody that did need it.
Somewhere in the mix is PMB but heaven knows how you access that. I had TB in 2021 luckily not pulmonary but unluckily drug-resistant. The medicine is anyway provided by state clinics but the extra private blood work and MRI that are DIRECTLY related to the TB came out of my day to day and not covered by PMB. If TB is not a PMB, not sure what is. It kills eleven times as many people as road deaths.
We’ll have the wrong outcome. If I was 20-something I’d have a very good hospital plan and put the difference between that and medical aid into unit trusts every month, or my bond, and be frugal about what really need a doctor for.
Discovery introduction of Vitality is one of the best ideas introduced to the Health Insurance sector, however their entire system is so complex that it is impossible to compare Discovery with anything else.
On their own, none of their products would survive in a competitive market but somehow through the dark art of reward marketing, points multipliers, cash back, discounts people think they might be getting a good deal. And quite honestly it is impossible to prove them wrong.
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