Benefits and contributions for 2021

We are pleased to inform you that your Board of Trustees has agreed to keep the annual contribution increase as low as possible for 2021, while aiming to responsibly return to normal increases by 2022.

The 2021 increase is 3.9% which is approximately half a percent above the expected inflation rate and in line with the Council for Medical Schemes’ published recommendation. It is possibly the lowest increase in decades, which is in part due to the lower than expected 2020 claims, as members cancelled consultations and procedures or deferred them. Normal annual increases are around +3% above inflation, as members and healthcare providers claim more each year, namely around 7-10%.

The Scheme is highly sensitive to the economic pressures faced by employers, employees and pensioners alike and recognises their plight in this unusual time. The 2021 increase has been kept low, despite the investment losses suffered through the equity market fall during the first half of this year and the expected increased member healthcare catch-up spend next year.

The Board believes that the Scheme will be able to absorb this lower-than-normal increase and the higher claims without undermining the reserves in the longer term. In times like these, we are grateful for the wisdom and foresight of our former Trustees and employers in ensuring the sustainability and reserving security of the Scheme.

Due to the continued uncertainty surrounding the COVID-19 pandemic, minimal changes have been made to the benefits for 2021. Co-payments have been maintained at the 2020 rates to reduce the impact on members’ out-of-pocket expenses. The additional COVID-19 tests and provider protection equipment will be covered by the Scheme according to legislation and where reasonable and appropriate. We are pleased to re-introduce the non-PMB chronic condition, Benign Prostatic Hyperplasia for 2021, paid from the non-PMB Chronic medication benefit on the Standard Care Plan and Managed Care Plan, following an increase in member need. We have also added a new papilloma virus test for cervical cancer, according to the latest clinical guidelines.

An unexpected lesson learnt from the pandemic has been that we have an abundance of electronic tools available to improve our efficiencies and direct funds back into members’ pockets. Virtual communication and technology-driven solutions have strengthened at an exponential rate — your participation in our AGM and use of the virtual healthcare services bears testimony to this — and we have demonstrated our adaptability in a fast-changing environment.

We will expand these services into 2021. Through these solutions, we believe that a certain amount of wastage can be avoided. We will continue to implement similar solutions in a bid to help keep contributions low in future years.

We thank you all for being careful and compliant while also playing your part in containing COVID-19. While nobody ‘escaped’ the pandemic, AMS was fortunate in that we have not yet had to  cope with unmanageable numbers of cases and were able to provide the much-needed additional support to those less fortunate who succumbed to the virus. Our deepest condolences to those who have lost loved ones during this time.

More detailed information about all benefits and contributions for 2021 will be made available in the year-end presentations, as communicated last month, in the Benefit Guide and Scheme Rules (once approved by the Council for Medical Schemes).

All 2021 benefits and contributions are subject to the approval of the Council for Medical Schemes.