Unveiling the value of your benefits and contributions
At Anglo Medical Scheme, we are committed to providing you with great service and good value in terms of your benefits. Each year, we undertake an assessment of our plans to ensure we offer relevant benefits at the right contribution levels. Our goal is to provide valuable benefits relative to market norms that cater to your healthcare needs at every stage of life, in a cost-effective manner.
Earlier this year, our Board once again commissioned our independent actuaries to critically evaluate our offerings against a selection of comparable schemes and plans. This in-depth analysis considered our specific member segmentation, profile dynamics, and member needs. We analysed claims behaviour per plan to identify benefit priorities for our member groups. The results of this exercise guide our Trustees in making future decisions regarding benefits and contributions.
As with last year's analysis, a Benefit Value Index (BVI) was calculated for each plan, which represents the value for money your benefits offer, meaning the rands you get back in claims for each rand of your contribution spent. We are pleased to share some key findings from this assessment with you:
Value Care Plan (VCP): Our actuaries have confirmed that the VCP offers particularly affordable contributions compared to its private network competitor options. Notably, VCP's benefits in areas such as oncology, psychiatric hospital admissions, specialised radiology, internal prosthesis, pharmacy advised medicine, and specialised dentistry are generally richer than what comparable options can offer. On a BVI Index, VCP scores 98% compared to the average across competing options of 91%. This means that VCP offers a higher value for money than most of its competitor options.
Standard Care Plan (SCP): SCP's contributions are also very low relative to the benefit value that you get. SCP's benefits compared favourably in benefit categories such as oncology, specialised radiology, internal prosthesis, additional chronic conditions, optometry and overall day-to-day limits. Overall SCP offers good value to members with a BVI score of 98% compared to the average across competing options of 87%. This means that SCP offers a higher value for money than most of its competitor options.
Managed Care Plan (MCP): You can be reassured that MCP's contributions are also among the most affordable in its category. MCP's benefits in categories such as in-hospital specialist reimbursement rate, oncology, organ transplants, basic and specialised radiology, internal prosthesis, additional chronic conditions, overall day-to-day limits, optometry, and pathology services are better than what competing schemes and plans offer. In terms of the BVI Index, MCP scored 124% relative to the average on competing options of 103%. This means that MCP offers a higher value for money than most of its competitor options.
We recognise that we are not market leaders in all benefit categories. These categories remain on our Trustees' radar. That being said, the areas of AMS benefits noted as being superior relative to industry comparisons generally also cater for acute and critical health needs, which speaks to the Scheme's approach of providing support and benefits to members at the time of greatest need and vulnerability. As explained above, the benefits AMS offers need to be relevant to what our membership needs and is willing to pay for.
You can rest assured that AMS is dedicated to continually delivering competitive benefits at affordable contributions for you, our members, and your families.
Published August 2024