2016
Chairman's year-end greetings
Looking back on 2016, I am pleased to report that, from a member perspective, we believe the Scheme has been able to deliver an excellent service over the year. It was the first time in several years that all our service providers continuously delivered on, or exceeded our very stringent service levels.
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FAQs from the annual member presentations
Anglo Medical Scheme is very fortunate to have members that actively participate in their Scheme. We would like to thank the members who attended our annual employee and pensioner presentations, where we discussed all benefits and contributions for 2017.
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Results of our 'pre-diabetes' or diabetes risk survey
We emailed all members a link to an online risk calculator in November, to determine if they are at risk of developing prediabetes or diabetes. If you have missed the opportunity to evaluate your risk, or if you have not provided the Scheme with your email address yet and would like to participate, visit Your Plan > Diabetes, where you will find the link to the one-minute questionnaire.
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Watch out for eye conditions and care!
Many of our members suffer from cataracts, which is the clouding of the lens in the eye. Cataracts can lead to a decrease in vision and can affect one or both eyes.
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Day Clinics
A more cost-effective alternative to hospitals for certain procedures. Value Care Plan members are already actively directed to the most cost-effective facilities on the Prime Cure network, including day clinics. Standard and Managed Care Plan members, so far, have not had the same guidance, which is why we would like to introduce the day clinic concept.
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Cost savings achieved by the Scheme
Each member can contribute towards reducing healthcare costs by using the right healthcare providers and by negotiating with them. The Scheme itself has many initiatives and programmes in place to reduce healthcare costs for all members. Over the last two years, AMS was able to participate in provider and tariff management initiatives facilitated by our administrator.
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Have you received your 2017 Benefit Guide?
We posted the 2017 Benefit Guide at the beginning of November. If you have not received your copy yet, please ensure we have your correct postal address.
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2017 Contribution increases
The good news is that benefits on all plans remain unchanged and our contribution increases are market related.
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Payment of your contributions
Contributions for membership of the Anglo Medical Scheme are due monthly in arrears. Some pensioners are responsible for their contribution payments (in part or in full). When Scheme members retire, they will receive a letter from the administrator, asking them to complete the relevant debit order forms to ensure monthly payment of the contributions.
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Incorrect claims payments
Some members had certain claims paid erroneously, which were not benefits covered by the Scheme. If you were affected you would have seen the following reason code on your statement: "We have paid your GP consultation fee from the Insured Network Benefit as you have run out of funds in your Medical Savings". You will not be held liable for this incorrect payment, but need to take note that this will not be covered in future.
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2017 Benefits and Contributions
As you might have heard in the news, rising healthcare costs have put South Africa's medical schemes under pressure. Consequently, medical schemes are anticipating contribution increases up to 14% for 2017 - in most cases higher than the increases in the past few years.
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Benefit and contribution presentations
Please diarise and attend the Scheme's year-end presentations to learn more about your benefits and contributions for 2017.
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Lodge a complaint
Anglo Medical Scheme is dedicated to executing good business practises and governance every day. We are lucky to have a membership that participates and communicates with the Scheme, and are pleased that most of the members are very happy with the service that they receive.
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Report fraud
Fraud is a real 'disease' in the South African healthcare industry. We make it our business to fight fraud in order to protect our members from the consequences, namely increased healthcare costs or contributions.
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Managed Care Plan – Medical Savings Account
Members who have positive medical savings carried over from 2015 might have, in some instances, noticed that these amounts, and the interest thereof, have not displayed correctly on their 2016 monthly claims statements.
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AGM Feedback
Our forty-seventh Annual General Meeting (AGM) took place in Johannesburg last month.
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App of the month
We recently sent you an SMS about the new mySOS app and would like to provide you with more detailed information. Our emergency evacuation partner, Netcare 911, has partnered with mySOS to offer our members fast and easy access to all emergency services in South Africa.
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No more cheques
In order to avoid cheque fraud, the Scheme has stopped issuing cheque refunds to members for claims payments they may have made. If you are one of the few members that has not yet provided us with your banking details, or if you just want to update your details, you will be happy to hear that we have simplified the process!
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Tax certificates
Your tax certificate will soon be on its way to you. Depending on your communication preferences, you will receive it either by post or email.
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Member survey results
Recently, you were invited to participate in the member survey and asked to provide feedback on the services, benefits and communication that you‘ve received from the Scheme. Within only a few days, 26% of members that communicate with us via email had already responded!
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AGM notice and proxy form
We look forward to seeing you on the 18 of May. If you can‘t make it this year, you can appoint a proxy to attend, speak and vote on your behalf by sending us the proxy form, printed at the back of the notice.
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Scheme Stakeholders – who plays which role?
We regularly receive questions about the relationship between Anglo Medical Scheme, its participating employers and our administrator Discovery Health. We explain the affiliation with these two stakeholders
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How to submit your claim
Our Call Centre team has noticed an increase in the number of questions around the claims submission process. Do you know which information to send and where to send it to?
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Call for nominations for the Disputes Committee
If you are interested in being a member of the disputes committee, or know of another member that would be a suitable candidate, please contact the Principal Officers Office.
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Admin checklist for an upcoming procedure
There is a lot to think about before having a procedure done. The following information describes the process with your Scheme prior to a procedure being done.
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Vaccines: The flu shot
Anglo Medical Scheme recommends a yearly flu vaccine, especially for high-risk persons, in order to decrease the risk of severe flu. The people who are at high risk of serious complications from flu include young children, pregnant women, people with chronic health conditions like asthma, diabetes or heart and lung disease, and people 65 years and older. Vaccination is also important for healthcare workers and other people who live with, or care for high-risk people.
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AGM – please save the date!
Our forty-seventh Annual General Meeting will take place at 10am on 18 May 2016 at the Auditorium, 18th floor, 55 Marshall Street, Johannesburg
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Participate in our member survey
We are conducting a member survey and invite you to participate. Your answers and feedback will enable us to further improve the Scheme‘s service to you.
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Fraud alert
You might be aware that fraud syndicates have managed to illegally deduct small amounts from bank accounts. Known as the “R99 debit order scam”, this scam essentially deducts small amounts of money from your account through debit order.
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A GP network for Managed Care Plan
In case you missed it in the 2016 Benefit Guide: Managed Care plan members can now make use of our administrator‘s GP network. Claims for consultations and selected procedures will be submitted directly to the Scheme and be paid directly from your MSA or by the Scheme if PMB.
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New Client Liason Officer for KZN
Noelene Dummer was appointed Client Liaison Officer for the KwaZulu-Natal region in 2002, and since then has truly embraced the Scheme‘s values of member and employer centric service. We are pleased to welcome Megan James as our new Client Liaison Officer for KwaZulu-Natal.
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Possible co-payments or an increase in co-payments for chronic medicine from 2016
The Scheme annually reviews all medicines approved for the treatment of chronic conditions. This is done to ensure that the most up-to-date and cost-effective medicines are available to members.
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New dedicated PO Box for Anglo Medical Scheme
Please address your post to our new AMS PO Box: Anglo Medical Scheme, PO Box 746, Rivonia, 2128
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