A holistic view of healthcare coverage goes far beyond the bare essentials.

It’s that time of year again, when the frenzy to finalise projects masks the fatigue that so many employees are feeling. With incentives almost within reach – where companies have been fortunate enough to offer them—the engines are working overtime to finish 2023 on a high note.

As someone whose work, like yours, revolves around people, I am deeply familiar with the need to understand just what makes individuals tick. In my decades of experience in the medical schemes industry, nine times out of 10, the quintessential cornerstone of human drive stems from one indisputable source: family. This undeniable truth is rooted in the fundamental nature of healthcare, which is an indispensable pillar of human existence, akin to the very means by which we sustain our livelihoods.

While this is purely anecdotal, it bears further consideration given the pressure that so many family breadwinners find themselves under at this time. You may have taken note of the recent Q3 TransUnion 2023 Consumer Pulse Study, which reported a staggering 62% reduction in discretionary spending among respondents, with further cuts expected. And this is ahead of the holiday season.

As households nationwide adopt more conservative spending habits, the weight of insurance and medical plan premiums has become a significantly heavier financial burden for many. And yet, a hidden opportunity lies within this economic challenge, where informed healthcare choices can not only ease the burden of essential expenses but also result in significant cost savings and improved overall wellbeing.

Smart savings mechanisms

Benefit options specifically designed to maximise the value of each rand spent, such as Efficiency Discounted (ED) options, leverage partnerships with healthcare providers by securing pre-negotiated rates to deliver significant savings.

Significantly, these cost-effective healthcare options could translate to up to a 25% reduction in normal contribution rates for comparable plans. Such a difference can be the deciding factor for many in securing much-needed healthcare coverage, especially during times of uncertainty.

Such smart saving mechanisms should not come at the cost of reduced preventative and wellness benefits. For employers committed to safeguarding their families and employees’ well-being, the value of preventive care becomes even more pronounced.

It is therefore imperative that a medical scheme not only provides the same rich preventative benefits to members on all plans but also encourages members to utilise these benefits. This allows employees to take control of their health without financial barriers affecting day-to-day or savings benefits.

The heart of the matter

As a person becomes economically active and begins to achieve their life’s milestones, one of the primary considerations is safeguarding those achievements. Perhaps it is their first car, their most prized possessions, their home, or their life itself. Much as it pains us all to pay for it, insurance is simply a priority when protecting that which matters most to us.

Healthcare cover naturally works under the same premise, ensuring that employees and their loved ones have essential cover when needed and preventing their families from falling into financial hardship should a costly healthcare event occur. However, more than this, medical scheme cover is a living gift that can provide additional benefits for the entire family, unlike other types of insurance.

In particular, young parents putting in long hours and working to become financially established have much to gain from a healthcare partner that offers children’s benefits well above the market average, starting from birth and carrying your family throughout the early years and into the teens.

A world of options for employees with children

While childhood development may not be top of mind in a workplace environment, you can be sure that it is a priority for your people and having a healthcare partner who can deliver meaningful children’s wellness benefits brings a new dimension to employee support.

As is so often the case with medical scheme offerings, making the right choice comes down to the richness of benefits. Just as newborn screenings and paediatric consultations are traditionally aligned to early development milestones, the new generation medical scheme also provides for that all-important primary school readiness assessment and psychometric testing for adolescents.

As is widely upheld in the healthcare environment, children are not little adults, and these years are crucial in setting strong foundations for cognitive and emotional development. There is a need to recognise and support this from a healthcare perspective, an imperative that certain medical schemes have acknowledged for some time.

Physical development in children, by the same token, requires a particular and age-specific approach that helps children identify which physical activities work for them as individuals at an age when attention to this aspect of their development is sometimes overlooked.

Teens, whose bodies have grown significantly and who tend to engage more seriously in competitive sport, can benefit considerably from the opportunity to tailor their physical fitness programme in consultation with a healthcare professional.

This reasoning extends to dietary wellness, an evolving area of childhood development that requires ongoing attention. Here again, the nutrition that is needed in a young and growing body is very different from that of an adult, and while there is no doubt that every parent always does their best to provide a balanced diet, some professional guidance in this area can only help to take that development potential even further.

Partnering with skilled healthcare professionals such as biokineticists and dietitians to form well-entrenched relationships in the service of young members is one of the ways that such benefits can be paid directly from a scheme’s risk pool, leaving all other benefits of the member completely untouched.

The fact is that healthcare is costly, and no medical scheme member, no matter their age, should ever have to take the knock in their savings or other benefits simply to make use of preventative care that will ultimately benefit not only them but also their medical scheme in the future.

Likewise, benefits such as 24-hour access to a paediatric healthcare advice line and unlimited GP visits for children under the age of six, which answer to the very real needs of the young family, must therefore be made possible to deliver actual savings without compromising care.

Well-rounded value, for you and for them

It’s worth knowing that certain medical schemes offer members as much as R20,000 in value for annual wellness benefits, as a significant aspect of a complete toolkit for well-functioning employees. Not only do such benefits minimise potentially devastating healthcare risks but they also contribute towards the development of holistic employee wellness outside of the workplace.

Access to a scientifically-based Fitness Assessment and Exercise Prescription program with regular professional input and ongoing monitoring with a registered biokineticists at an accredited exercise facility provides individuals with a tailored approach to looking after their bodies.

Furthermore, wellness benefits covering injuries from adventure sports give an added layer of reassurance for those who enjoy playing outdoors. Such comprehensive healthcare support is a rarity but should be readily available to empower members to pursue their wellness goals freely.

Optimizing wellness through nutrition is made all the more possible by offering a nutritional assessment and healthy eating program that provides practical, powerful, and personalised nutrition insights during a consultation with a registered dietitian.

Getting into great shape and staying there also means being mentally fit and agile and having the support needed to perform at the highest possible level. A psychosocial benefit that provides round-the-clock access to counselling and face-to-face sessions when needed should be a non-negotiable for any employer wishing to anticipate their employee’s every possible healthcare need.

A holistic view of healthcare coverage goes far beyond the bare essentials, and getting to the heart of what matters most to people is what distinguishes leaders in their field—for medical schemes and employers alike.

Josua Joubert is the Chief Executive and Principal Officer of CompCare Medical Scheme in Johannesburg, South Africa.