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Health insurance
Sunday, February 1, 2004
More for your money

Mapp Healthcare has introduced MedishieldPlus, ‘an easy-to-understand medical aid product range’, which it says addresses two key issues:

• The high cost of health cover; and,
• The need for prompt and direct payment in respect of medical services and broker commissions.

MedishieldPlus comes together with a range of lifestyle insurance product options, collectively marketed as iChoices (individual choices).
Explains John Sherratt, MD of Mapp Healthcare, “On the medical aid side we are looking to provide comprehensive cover priced at up to 15% less than comparable schemes, with healthcare providers paid within a targeted 14 days; and offering brokers an opportunity to generate revenues over and above the normal commission rates as capped by government.”
For example, he estimates a family of four can save about R600 a month for the same cover as many other schemes while, at the same time, having “total choice and flexibility in what they opt for.”
He points out that central to helping individuals take responsibility for their healthcare needs — a big issue these days — is their ability to make choices about their lifestyle requirements and to optimise cover to meet affordability and specific needs.
MedishieldPlus comprises three basic products:
• Network Cover, based on the company’s networked healthcare facilities called PrimeCure, and is designed as an entry-level product suitable for those earning R4 000 per month or less. It carries various limits, including up to Prescribed Minimum Benefits;
• Healthstyle Cover, which allows members to use their chosen healthcare provider including doctor and dentist. Many features are unlimited, or have high limits in terms of the Board of Healthcare Funders’ rates;
• Extended Cover, which additionally provides a higher level of out-of-hospital expenses through the provision of threshold cover.

Each product offers out-of-hospital, in-hospital and chronic illness cover with a number of different options within different plans, and an optional savings plan. Monthly premium examples for a family of four are: R1 108 (Network); R1 213 (Healthstyle); and R1 871 (Extended). For parents and three children the current rates are R1 267, R1 417 and R2 136 respectively.
The product range is supported by the company’s single point of contact centre, intended to develop a long term relationship between iChoices and the member for all his medical cover and long term health lifestyle needs. It includes confirmation messaging via SMS and e-mail.
iChoice brokers are equipped with Palm Pilot computers through which they can capture client data, download relevant details electronically, and enable membership cards to be despatched within 48 hours.
There is also a ‘Benefits Calculator’, which can be accessed over the Internet, whereby individuals and brokers can determine their cover needs based on, amongst other things, family profile, the number of expected medical consultations in a given year, chronic care needs and other requirements such as dentistry and optometry. There’s a Medical Aid dictionary that will help dispel confusion about all the jargon being used in the industry today.
Says Clinton Alley, the company’s marketing and sales director, “The aim of the calculator is to involve the spouse at home in the medical cover decisions, rather than allow the working partner to make all the choices. Typically, it is the wife who will take the children to the doctor, so she may better know what cover is needed.”
  Mapp also wants to avoid situations where the breadwinner selects cover without appreciating the real needs of the family, drawn as much by the offer of free movie tickets or discounted gym contracts, than competitively priced appropriate products.
Commissions on new membership for medical aid is currently capped at 3%, or a maximum of R50 per policy. iChoice brokers, however, can earn further commissions through the sale of ‘a range of value added products’ currently comprising: Top-up (which covers additional hospital costs up to R1m); Gap (to cover the difference between the medical aid rate and the doctor’s private rate); AIDS cover (for the costs of testing and treatment within 72 hours of infection); Recovery (after hospital costs of recovering from illness or injury); Debility (loss of bodily functions); and Group Life.
Mapp’s existing public sector products are now re-branded MedishieldClassic. The products are administered by Sovereign Health Administrators.

Copyright © Insurance Times and Investments® Vol:17.1 1st February, 2004
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