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Putting control back into members hands

In a first for the medical scheme industry, Fedhealth has announced its 2019 benefit options which features a revolutionary new approach to benefits that gives consumers more flexibility, choice and control.

Jeremy Yatt profile pictureOver the last six months we have carried out extensive research with our member base and the overriding message is that members want to be in control of their medical aid. They want flexibility and they want choice,” explains Jeremy Yatt, Principal Officer of Fedhealth Medical Scheme.

There are four different benefit packages within Fedhealth’s new FlexiFED range each featuring a core benefit bundle and day-to-day cover, but the most innovative feature of the FlexiFED range is the way members are able to choose to pay for day-to-day benefits.

Traditionally, up to 25% of the members’ monthly contributions has been placed in a medical savings account which was used to pay for day-to-day benefits. For the first time ever, Fedhealth has turned this model around. FlexiFED allows members to begin paying for day-to-day benefits only when they need them. They then have the flexibility to pay back that amount over 12 months, interest free.

At a time when most consumers are struggling to make ends meet, this can make a meaningful difference to their financial position. This is a significant departure from how other medical schemes in South Africa manage their medical aid savings accounts. Traditionally members have been charged for day-to-day benefits from the beginning of the year regardless of whether they have seen a doctor or purchased medicine or not.

Fedhealth is also now the only medical aid to offer members a significantly reduced monthly rate by introducing the MediVault and Wallet.

“Based on their unique profile and the core benefit bundle they select, a pre-approved amount is placed in the member’s individual MediVault at the beginning of the year. This amount is not pro-rated and works the same as a traditional savings account, except that members only pay for it once they use it.

“When the member needs to pay for day-to-day expenses, they simply transfer the funds they need from their MediVault into their Wallet and only then start paying back those funds, without having to pay interest,” explains Yatt.

But that is not where the revolution ends. “When it comes to medical aid, we know price is one of the most important considerations for members,” says Yatt. “We worked hard to find innovative ways to save members money and provide them with the benefit of added choice. Our solution has been to offer four core benefit bundles, specifically tailored to different lifestyle requirements and which can be personalised even further to suit individual needs.”

For example, the flexiFED 1 is perfect for healthy, young single people looking for affordable, quality cover. Personalised benefits like trauma treatment, unlimited accident and emergency treatment and female contraception have been added here for example. FlexiFED 2 is  more suited to young families starting out and this option is now rich in maternity benefits and some great lifestyle and childhood benefits.   FlexiFED 3 has been tailored to young families making their way up in the world and also includes rich maternity, lifestyle and childhood benefits for families who are still growing. Finally flexiFED 4 has been designed for more mature families looking for all-inclusive cover. Personalised benefits like specialised radiology, child rates up to the age of 27, unlimited network GP consults from core benefit bundle and unlimited private hospital cover for planned procedures etc are just some of the key features offered under this bundle.

All core benefit bundles come pre-packed with value-added benefits covered from Risk, not from the MediVault and Wallet.

Fedhealth has also introduced a Benefit Maximizer to boost the above benefits. On flexiFED 1, 2 and 3 it covers unlimited network GP visits and dentistry benefits even after a member’s MediVault and Wallet has been depleted. On flexiFED 4, claims can be submitted to accumulate to a pre-determined threshold level, whereafter they will be paid from the Benefit Maximizer with a 20% co-payment on all claims.

The final unique benefit for members is that they have the flexibilty to now choose to control their own rates. Once they have selected their core benefit bundle they can personalise their option and create the package of  benefits they need at a price they can afford.

“Members save 11% of their contribution by selecting the Network Hospital Option (GRID) or they can save 25% by limiting themselves to a smaller hospital network or just by paying an R11 500 excess for planned procedures at a hospital of their choice.  The important thing for members to remember is that in the event of an emergency or accident they can still use the private hospital of their choice.”

Yatt points out that there has been little innovation in medical aid benefit design for decades and limited differentiation between schemes. “While many claim that benefits can be personalised, the reality is that members only have the choice of options that suit a generic life-stage category. There is little transparency and members have limited control over how their money is allocated,” he says.

“FlexiFED represents a completely new approach. We believe it is going to transform the industry and change the way medical aid benefits are structured in the future,” concludes Yatt.