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GTC Medical Aid Survey 2017

Results reveal that small medical aids also offer good value, and highlights that consumers may be unaware of their own medical aid plans and the benefits contained therein.

Smaller medical schemes perform well by offering consumers value for money, but they have not been as successful as some of the larger schemes in attracting new members, and thereby ensuring continued value and ‘health’ for the scheme over the long term.

This is one of the significant conclusions from leading wealth and financial advisory firm GTC in its seventh annual Medical Aid Survey for 2017, according to Jill Larkan, the firm’s Head: Healthcare Consulting.

The Medical Aid Survey analyses and rates medical aid schemes and provides a standardised comparison and ranking of the choices available to consumers.

“This survey cuts through the notoriously complicated landscape of the medical aid industry and simplifies it according to the factors that matter most when consumers choose a medical aid scheme and option,” explains Larkan.

This year’s survey reviewed 23 open medical aid providers (Profmed is the only closed scheme reviewed this year), with a total of 144 plans, which were categorised into 11 areas according to benefits offered. The categories range from entry-level to traditional plans, and include hospital-only, saver and comprehensive options.

The Medical Aid Survey from GTC assigns every plan with a micro – indicating a plan’s competitiveness in relation to others in the same category – and macro rating – broadly a measure of a scheme’s ‘health’, and considers factors such as membership size and growth, average age and financial stability.

Smaller medical schemes score well yet again in GTC’s micro ratings

“Fedhealth is one of the schemes that has performed consistently well in the micro ratings, indicating that it is very competitively priced and can offer consumers good value for money,” she says.

With this year’s inclusion of multiple additional macro demographic areas in the GTC survey, along with the applied weightings on these, the more stable growing schemes have now scored considerably better in the macro rating. Discovery Health has topped these macro rankings in the 2017 survey.

GTC’s overall list of schemes for 2017 – ranked by “likelihood of support”

The full range of plans in this year’s Medical Aid Survey – from entry-level to comprehensive have been divided between network and non-network plans and been graded (micro, macro and combined) to simplify the choice and provide an easy way to compare options and cost.

The macro and micro rankings combine to create GTC’s overall list of schemes in the Medical Aid Survey for 2017 ranked by “likelihood of support”. This final analysis reflects a score which indicates the likelihood that a particular plan / scheme would receive GTC’s support (or not) through recommendations to clients.

NETWORK NON-NETWORK
Entry Level Comprehensive Student
Entry Level Hospital Only Discovery Keycare Core
Comprehensive Low State
(R3000 – R7000)
Makoti Primary
Comprehensive Low
(R3 000 – R7 000)
Makoti Primary Sizwe Gomomo Care
Comprehensive Mid
(R7 000- R10 000)
Student Market
Makoti Primary Sizwe Gomomo Care
Hospital Only Momentum Custom Genesis Private Choice
Saver Discovery Essential Delta Saver Topmed Active Saver
Saver Plus Resolution Millennium Discovery Essential Priority
Comprehensive Risk Momentum Extender Discovery Essential Comprehensive
Comprehensive Complete Discovery Classic Delta Comprehensive Discovery Executive

*table above only highlights the rankings for a family of four (Principal Member + Adult + 2 Children)

“No medical plan is going to suit all members equally, but our annual survey helps to ensure that an informed decision can be made based on these indicators, which will go a long way to easing member concerns regarding scheme performance relative to peers and their plan’s ‘health’ status,” Larkan concludes.

Click here to download the full MAS pdf.

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