Old Mutual Corporate has announced the launch of a comprehensive health insurance product aimed at providing a private medical funding option for SA workers.
Old Mutual Health Solutions — an innovative employee benefits offering covering primary care, gap cover and related ancillary products — aims to provide high-quality healthcare solutions to employees via their employers and other work-related groups. The offerings will be underwritten and administered by GENRIC, a licensed non-life insurer that is owned by the Old Mutual group.
“The biggest healthcare issue in the country is the lack of access,” said Prabashini Moodley, MD of Old Mutual Corporate, adding that research had shown that more than 80% of South Africans do not have access to affordable private healthcare.
“A very small group of South Africans have comprehensive access to quality healthcare. The cost of full cover is prohibitive for most South Africans. Therefore, there is a need for an alternative option that can provide access to private healthcare at a price that meets the individual’s level of affordability.”
Old Mutual Health Solutions offers a range of affordable health insurance options, including access to an extensive network of healthcare practitioners and private hospitals through its primary care range. The gap cover range is aimed at employees already in a medical aid scheme that require additional cover for potential shortfalls, co-payments and excluded procedures.
“We must emphasise that our proposition is not a medical aid, and it in no way competes with medical aid schemes; it’s about creating access,” said Moodley. “The offering aims to extend private healthcare access to people with no chance or a very limited chance of belonging to a medical aid scheme. We believe that for the price point, there is significant value relative to other offerings we’ve seen in the market.”
Medical aid schemes provide more comprehensive cover and are governed by the Medical Schemes Act, which requires all schemes to pay for a basic level of care for 27 chronic conditions and 270 diseases — a set of conditions called prescribed minimum benefits (PMBs).
By contrast, health insurance is governed by long-term and short-term insurance laws, not medical scheme legislation and is structured around more specific offerings. This means it does not have to include treatment for certain conditions on the PMBs list, nor provide comprehensive cover.
“If you can afford medical aid and have more comprehensive healthcare needs, then objectively, you probably should consider medical aid — not a primary care offering,” said Humphrey Mkwebu, GM of employee benefits solutions at Old Mutual Corporate.
“If you can’t afford medical aid, but still feel access to a private GP and access to some form of in-hospital benefits if someone gets injured or ill is important, or still need access to acute or chronic medication, then this product may be for you.”
theunisseng@businesslive.co.za
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