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TopMed has announced an average weighted increase of 9.96% for 2012. This is coupled with an improved range of options that have been developed in direct response to requests from the medical scheme’s members.
Medical schemes have been under pressure to keep increases as low as possible; with the Registrar calling for an increase of between 4.3 and 5.3% at the same time that medical inflation has peaked above 9%.
“We are pleased to announce an increase which is under 10%,” said Jerry van Vuuren, Chairman of TopMed Medical Scheme.
“TopMed’s reserves are at 167, 1%, way above the legal minimum reserve of 25%. Our Board has wisely taken the long-term view to use the reserves to ensure our sustainability.”
Self payment gap done away
After listening to the requests from its members, the medical scheme will increase their medical savings to 25% on the renamed Professional option (previously Incentive Comprehensive) to do away with the self-payment gap between the savings account and threshold. At the same time, in a move that will reduce pressure on members’ day-to-day benefits even further, TopMed has widened the range of benefits that are paid from their risk fund.
The changes are option specific, but for TopMed Professional, maternity benefit, seven days Take Out Medications (TTOs) and 75% of the TopMed Tariff for dental treatment (Conservative and Specialised) will be paid from risk.
In addition, MRI and CT scans performed out of hospital now have the lowest co-payment in the industry at just R1000.
TopMed sights future leaders
Another major change for the Professional option is the removal of the 25% co-payment on non-CDL medications that are on the TopMed Chronic Disease List (CDL). This is a list of 31 diseases, over and above the 25 specified by the Registrar, which are recognised as chronic conditions by the medical scheme.
TopMed also has its sights on South Africa’s future leaders. A unique new feature on the TopMed Network option, which will be particularly attractive to future professionals (and their parents), is the inclusion of full time students into the lowest cost category. This means that all primary cover will be provided for a premium of just R558, regardless of whether it is the student or their parents who are paying the premium.
“We are confident that our brokers, members and potential members will be impressed by the changes we have made for the New Year,” van Vuuren said. “We are excited by the growth in membership that we have seen during 2011, and are looking forward to continuing our upward trajectory in the future.”
(Press release, October 2011)
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