Council of Medical Schemes propose amendments to 2019 Discovery Health contributions and benefits

Following the announcement of the 2019 Discovery Health Medical Scheme contribution increases and benefit changes in September 2018, the Council for Medical Schemes provided feedback on the proposed Rule changes for Discovery Health Medical Scheme early in November, and specifically requested that the merger of the two lowest income bands on KeyCare Plus and the Priority Plan threshold increases be reviewed.

After consideration of this feedback, and consultation between the Scheme and the Council for Medical Schemes, the Trustees have approved the following changes for 2019:

Priority Plans

The thresholds for the Above Threshold Benefits of the Priority plans will increase by 8.9% in 2019, and not by 10.9% as announced originally. Premiums and all other benefits remain unchanged.

The thresholds of the Priority plans for 2019 will now be as follows:

KeyCare Plans

It was originally proposed to merge the lowest and middle income bands on KeyCare Plus in order to address adverse selection and the negative impact that this could have on the KeyCare Plans in the long term; the impact of this would have been increases of up to 47% for affected members. While the introduction of KeyCare Start offers an alternative to mitigate the impact of this increase for members, this is not yet available nationally and hence the lowest income bands for KeyCare Plus and KeyCare Core in 2018 will be retained in 2019 for members earning less than R8 550 per month.

As a result of the retention of the lowest income bands in 2019, the contribution increases for KeyCare Plus and KeyCare Core have been revised, as follows:

Contributions for members on the lowest income band will increase by 9.9%, and not by 47% which would have been experienced by some members due to the merger with the middle income band as originally announced.

Contributions for the middle income band will increase by 9.9%, and not by 5% as originally announced.

The KeyCare contributions for 2019 will now be as follows:

Employees on the lowest income band of the KeyCare plans will have until 30 June 2019 to make plan changes without any underwriting requirements.

DHMS Network Enhancements 2019

We are pleased to announce the expansion of the Smart and Delta hospital networks in the following areas for 2019:

Discovery Health is concluding contractual network arrangements with hospitals in these areas, and we will confirm the specific hospital additions.