Your benefits of belonging to the Anglo Medical Scheme

AMS, as you are aware, is a restricted membership scheme, open exclusively to employees and retirees of participating employers, as well as their continuation members. Membership is granted 'by appointment only' (by virtue of your permanent employment contract with a participating employer), and this exclusivity brings numerous advantages and benefits worth exploring.

Our employers' interest in employee well-being

Our participating employers, by offering access to a restricted membership scheme, aim to provide peace of mind for both the employer and the employee. The primary focus is on ensuring that employees can concentrate on their jobs without the worry of healthcare funding for themselves and their families. This is essential for managing the financial burden of potential catastrophic medical costs during emergencies or significant health issues. Research shows that employees with sufficient medical cover tend to be more productive, with reduced stress and absenteeism.

Employers' long-term interest in the Scheme

While employers initially have a short-term interest in ensuring employee well-being, participating employers in AMS have an exceptional long-term commitment to the Scheme's sustainability which, in the current economic and healthcare landscape, is particularly valuable.

Tailored benefits for your unique needs

Restricted membership schemes like AMS can tailor benefits to the unique needs of their members. Knowing our membership intimately enables us to craft benefits that align with specific requirements. This customisation results in more comprehensive benefits, a healthier membership, better risk management, reduced membership costs and enhanced sustainability, compared to open medical schemes. As a result, employees can access medical scheme cover at a more affordable rate compared to similar cover available in the market, a fact substantiated by a recent independent benchmarking exercise which we presented in our annual year-end presentations.

Efficient contribution collection and lower administration costs

Restricted, employer-based schemes can streamline member contribution collections, dealing with fewer employers and healthcare providers. This efficiency minimises administrative efforts and costs, leading to more cost-effective contributions compared to open medical schemes.

Cost savings for marketing and brokerage

As permanent employment is a condition to belong to AMS, marketing and broker fees are eliminated which results in cost savings. These savings are used for member claims instead of advertising or commission. Restricted schemes in South Africa allocate nearly 6% more of income towards healthcare costs compared to open schemes.

Role of employer-appointed Trustees

Our employer-appointed Trustees play a crucial role in representing both the employers' needs and ensuring the protection of all members' interests. Their personal knowledge of employees or at least their understanding of workplace dynamics allows them to advocate for members effectively. The presence of skilled Trustees contributes to informed decision-making on benefits and annual contribution increases, balancing market relevance and competitiveness.

Dedicated Scheme Head Office

AMS stands out with a dedicated Head Office that goes beyond legal requirements. The team supports the Principal Officer and Trustees by overseeing administrator services, negotiating for favourable prices, monitoring industry trends, and ensuring service providers offer optimal tools and solutions. The Head Office maintains a focus on quality and service levels, fostering meaningful relationships with members and employers to provide the best possible attention and member experience.

Network quality control and care coordination

Restricted medical schemes like AMS can carefully select their network of healthcare providers, leading to better quality control and assurance. With a tailored and limited network of healthcare providers, it is easier to coordinate and manage patient care, leading to more streamlined communication among healthcare professionals, improving the overall quality and efficiency of healthcare delivery.

Reduced fraud and abuse

Compared to open medical schemes, restricted schemes are exposed to less anti-selection by members. Anti-selection occurs when individuals with a higher risk or likelihood of using healthcare services are more likely to join a medical scheme, resulting in a higher risk pool of members and increased costs for the scheme. This ultimately results in the need for the scheme to increase contributions by more than if anti-selection does not occur. Therefore, due to a restricted scheme's structural features that limit the enrolment criteria, anti-selection is reduced, resulting in better risk profiles and more affordable resultant contributions.

Enhanced member engagement and faster access to care

AMS is able and proud to provide more personalised and attentive service to its members than bigger, open schemes. This can be particularly beneficial in urgent or emergency situations. Not only do our call centre and service teams exceed agreed service levels the whole year through, we also continuously receive the biggest compliments and praise for the team from our members. Moreso, members that deal with the Scheme regularly, often build great relationships with the service agents allocated to them. This level of personal engagement would not be possible in a bigger, open scheme.

Dedicated Client Liaison Officers

As an employee, you have access to our AMS Call Centre and digital tools for answers and solutions to your claims or membership queries, and to the AMS Client Liaison Officers. They come to your workplace to assist you with advice, information, and more complex issues that are better resolved through face-to-face discussions.

What does this mean for you as a member of the AMS?

In summary, you enjoy significant benefits being a member of a restricted membership scheme, particularly the Anglo Medical Scheme. These benefits stem from AMS' commitment to providing tailored and sustainable solutions with its exceptional health care interventions, dedicated service, efficient administration, and financial advantages for members, realised through the unique structural features of AMS. There are many more reasons why you can be reassured being an AMS member. We will continue to explain the benefits of your membership during this year.

Published February 2024