Deferred increase: relief for members

• Scheme strives to meet the holistic health care and financial needs of companies and individuals

There is no question the pandemic has had a debilitating financial impact on many medical scheme members.

Cognisant of this, Momentum Medical Scheme has deferred its contribution increase to later in the year. The weighted average, 6% increase that will be introduced in September 2022 equates to a net increase of 2% over the year, one of the lowest increases announced for the year ahead.

What made the scheme able to defer the contribution increase to later in the year was its robust performance throughout the pandemic and stable financials, reveals Damian McHugh, executive at Momentum Health Solutions, the scheme’s administrator.

“Although medical inflation continues to rise, and new medical procedures are adding health care costs that we have not previously had to make

provision for, we believe we are in a position to delay the increase in contribution required to ensure the scheme’s long-term sustainability until September next year.

“As consumers bounce back from reduced income — or even loss of income in many cases — this relief could benefit many of our members.”

In Momentum Medical Scheme’s favour is the fact its members are, on average, well below the industry average age. This means, explains McHugh, the scheme’s long-term claims forecast is more favourable than most other schemes.

“When you factor in a pandemic like Covid-19, the impact of a favourable member profile becomes even more important. The reality is there is a higher cost associated to treating an older Covid-19 patient, especially if they end up in hospital and on a ventilator, compared to a younger patient being treated at home.”

While the scheme has made provision for unexpected future pandemic-related costs, McHugh acknowledges there remain many unknowns around Covid, as well as pentup demand as members delayed checks such as mammograms, it has been able to focus more on helping members retain their medical scheme cover while battling through these tough economic conditions, says McHugh.

Momentum Medical Scheme is an open medical scheme that has more than doubled its membership over the past decade. It is currently ranked as the third largest open medical scheme in SA and, for the past few years, has consistently implemented the lowest increases in the industry. While the scheme lost some members during the pandemic primarily foreign students and corporate members as a result of job losses and retrenchments

these losses have largely been mitigated by the addition of new corporate clients.

Members have access to a range of options including complementary products offered by Momentum such as HealthSaver+ and HealthReturns+, the latter which is a one-of-a-kind programme to reward members with up to R36,000 per family per year for being active.

A vaccine reward benefit in the form of monthly wins has been introduced via the HealthReturns+ programme. Members who have been fully vaccinated and achieved certain milestones during the month receive an additional R100 to spend at participating partners or swipe into their HealthSaver+ account to further boost their

HealthReturns+ earned.

“Momentum’s view is not to force anyone to get vaccinated but rather to educate and encourage members to do the right thing,” says McHugh. “We’re strongly in favour of vaccinating as many individuals as possible everyone’s

choices and actions have consequences and the more people who choose to protect themselves and those around them the better for our country’s long-term economic and health care outlook.”

Rewards for health activities are based on the premise that more active people tend to have lower health care costs.

The scheme, he adds, is committed to mutual respect and open, honest engagement in its approach to beating the pandemic.

Momentum Medical Scheme members also have access to complementary products available from Momentum.

Digital health care is one of the areas where Momentum has focused on innovating. The extent of the scheme’s capacity to afford members world class health care from the safety and convenience of their homes now includes an expansion of its Hello Doctor offering with 24/7 access to consultations with qualified doctors, who can now also prescribe medication; the ability to do a virtual health assessment at home; the option to complete an online fitness assessment; and extensive wellness support through the scheme’s comprehensive Coach in your Pocket app.

INSURANCE PRODUCTS

Momentum also offers health care insurance products which essentially offer private health care solutions based on insurance methodology, and these products have seen phenomenal growth in the past year, says McHugh.

One of its most popular products is Health4Me, a lowcost, affordable solution with good day-to-day cover and benefits, but no hospital cover.

Health care insurance products are exempted from offering prescribed minimum benefits as they don’t fall under the ambit of the Council for Medical Schemes. That will change in due course once the Council for Medical Schemes creates a legal framework for insurance products.

“We’re focused on innovation and problem solving. Ultimately, we’re striving to meet the holistic health care and financial needs of companies and individuals across the spectrum through a safe, affordable and seamless lifejourney for our clients,” he says.

REWARDS FOR HEALTH ACTIVITIES ARE BASED ON THE PREMISE THAT MORE ACTIVE PEOPLE TEND TO HAVE LOWER HEALTH CARE COSTS