South Africa: Liberty Medical Scheme
….Containing Costs Through Innovation – In line with Government’s objective to make healthcare more accessible and affordable for all South Africans, Liberty Medical Scheme (LMS), through various innovative initiatives and measures, as well as prudent managed care, consistently works towards driving down costs to the benefit of its members.
Liberty Medical Scheme Executive Principal Officer, Andrew Edwards
“Contrary to what many consumers believe, medical schemes are not in this business to make a profit. As custodians of our members’ contributions, it is our duty to facilitate the best quality healthcare possible, taking their financial means into account. All profits go to the members in the form of reserves or to keep contribution increases as low as possible.”
“LMS statistics prove that in many instances we are becoming increasingly successful in containing costs. Administration costs, for example, are not only on par with the industry average, but for the past two years administration fees, have increased at a rate below CPI,” says LMS’ Executive Principal Officer, Andrew Edwards.
To ensure that LMS options remain affordable and relevant to members’ needs at their specific life stage, options are shaped accordingly. “This means there is a more effective focus on members’ needs, therefore offering them value for money and affordability,” says Edwards.
Another exciting and innovative development is the approval by the Council of Medical Schemes of LMS’ new Select options in which members who don’t have chronic needs or obtain these from the State, receive a discount on their contributions.
He adds that LMS options are designed in such a way that a number of preventative care benefits are paid from risk rather than from the members medical savings accounts. “A preventative benefit is only a benefit if a member doesn’t have to pay for it, therefore, it should be included in the risk pool, which makes your savings last longer,” Edwards stresses.
Moreover, in specific options, on LMS, a number of additional benefits such as crime trauma support, ultrasound during pregnancy and MRI/CT scans, are also paid from risk. “Again, we wholeheartedly agree with Government on the importance of preventative care to contain costs, which may well be incurred further downstream because of extensive curative care.”
LMS offers members a host of option specific benefits such as cover for professional sports and hazardous pursuits, basic and advanced dentistry, cover for chronic medicines and immunisations, unlimited oncology benefits, and unlimited casualty/emergency room visits. In addition, LMS charges only for the first three child dependants, while full-time students up to the age of 26 pay children’s rates. “Going forward, LMS will continue to develop innovative new products to meet members’ needs, emotionally, physically and financially, thus rising to the challenge of spreading their funds in the most equitable way possible,” Edwards concludes.
