Discovery Health Medical Scheme launches Active Smart: affordable healthcare for new entrants and young professionals

[disclaimer] This press statement is issued by Discovery Health (Pty) Ltd, registration number 1997/013480/07, an authorised financial services provider and accredited administrator of medical schemes on behalf of Discovery Health Medical Scheme, registration number 1125, which it administers.

Key highlights:

• Launch date: Subject to the approval by the Council for Medical Schemes (CMS), and their subsequent registration of the plan, the Active Smart plan will be available from 1 January 2025 as part of Discovery Health Medical Scheme’s expanding Smart Series.
• Affordability: The plan would be the most affordable offering in the open medical scheme industry, specifically tailored to new entrants and young professionals starting their careers.
• Valuable benefits: Active Smart provides a range of day-to-day benefits that are highly valued by young professionals, while also ensuring protection against medical emergencies leveraging digital tools and efficient healthcare networks.
• Lifestyle alignment: Young professionals tend to prioritise medical scheme plans that align with their healthcare needs, lifestyle and income-level. The Active Smart plan delivers on these needs, offering flexibility, affordability and coverage that balances day-to-day healthcare benefits with financial protection for medical emergencies.

12 November 2024, Johannesburg, South Africa – Discovery Health Medical Scheme (DHMS) is seeking to introduce a new medical scheme plan, Active Smart (subject to approval and registration by the Council for Medical Scheme), aimed at addressing the healthcare needs of new entrants and young professionals. With an intended launch date of 1 January 2025, Active Smart will be the most affordable medical scheme option in the open medical scheme market, offering a tailored benefit package for individuals starting out in their careers.

Dr Ron Whelan, CEO of Discovery Health, the administrator and managed care provider for DHMS, emphasises the importance of catering to the unique healthcare requirements of young adults. “Young professionals have distinctive healthcare needs, and they often invest time researching affordable plans that provide benefits they need most,” Dr Whelan explains. “The Active Smart plan delivers a tailored solution, meeting these needs at an affordable price.”

Priced at just R1,350 per principal member per month, the Active Smart plan will offer the lowest entry point in the open medical scheme industry. Dr Whelan adds, “This monthly contribution enables Discovery Health Medical Scheme to expand access to medical scheme cover for new entrants and young professionals who may have otherwise foregone medical scheme cover due to cost constraints.”

Key features of the Active Smart plan:

• Hospital Coverage: Full coverage for emergencies in any private hospital. In addition members will have access to planned hospital admission in the Dynamic Smart Hospital Network, subject to a fixed deductible per admission. Dr Whelan highlights that young adults face a 36% higher risk of trauma events compared to older adults, making private hospital cover for accidents and emergencies a crucial component of their healthcare.
• Day-to-Day Benefits: Unlimited virtual and in-person consultations with a Smart GP, a dental check-up, an eye test, and over-the-counter medication. “A Discovery Health survey of young adults in South Africa shows that access to day-to-day benefits including GP, dental and optometry consultation, and over-the-counter and prescription medicine is highly valued,” notes Dr Whelan.
• Personal Health Fund: Active Smart plan members can accumulate up to R1,000 per adult in addition to the day-to-day benefits set out above, based on their engagement in their Personal Health Pathway, which is a feature that delivers specific healthcare actions based on individual needs. The Personal Health Fund, which is subject to approval by the Council for Medical Scheme, can then be used for a variety of medical expenses, including prescription medicines, physiotherapy, and contraceptives.
• Digital access: The Active Smart plan offers members access to the Dynamic Smart Hospital Network, underpinned by sophisticated technology that advises members on high-quality healthcare providers and Smart network hospitals in their preferred region.

Addressing coverage gaps for young professionals

Most young people who start out in their careers often have limited disposable income available and this results in them delaying joining a medical scheme.

Research conducted by Discovery Health (Pty) Ltd highlights the financial barriers faced by young adults when considering medical aid coverage. “Medical scheme contributions consume a larger share of younger people’s disposable income,” says Dr Whelan. “Discovery Health data analysis shows that for members aged 20-29, approximately 7% of their income goes toward medical scheme contributions, whereas for older working adults approximately 4% or lower of their monthly income goes toward medical scheme contributions.”

He adds, “Discovery Health research estimates that 109,000 uncovered young professionals would take up medical scheme cover if there was an affordable option and where contributions amount to roughly 5% of their income. The Active Smart plan is designed to carefully balance needs of new entrants and affordability, thereby enabling greater access to private healthcare for young professionals.”

A plan built to meet the needs of new entrants and young professionals

The Active Smart plan addresses five core healthcare priorities identified as being most important to new entrants and young professionals:

1. Preventive care: Coverage for routine health check-ups, pap smears, and annual flu vaccinations for at-risk members through the plan’s Screening and Prevention Benefit, as well as the Personal Health Fund. Discovery Health Medical Scheme has seen a 23% increase in the prevalence of hypertension among younger members since 2019, underscoring the importance of preventive care.
2. Mental health support: Access to the Discovery Health Medical Scheme Mental Health Care Programme, which includes consultations with a Premier Plus GP, anti-depressant medications, psychotherapy, and online Cognitive Behavioural Therapy and gives members access to tools and benefits to monitor and manage their condition. Claims for mental health conditions have increased, with one in seven young adults now claiming for such conditions, compared to one in 20 in 2013.
3. Emergency cover: Full coverage for emergencies in any private hospital, and unlimited access for planned (i.e. non-emergency) admissions to the Dynamic Smart Hospital Network, subject to a fixed deductible.
4. Dental and eye care: The plan offers an annual eye test with a network optometrist for R125 and an annual dental check-up for R190.
5. Over-the-counter medicines: Members can obtain over-the-counter medication and contraceptives through the pharmacy network. Members can also utilise their Personal Health Fund to supplement their day-to-day medical expenses.

Addressing the needs of the next generation

With the launch of the Active Smart plan, Discovery Health Medical Scheme will offer a solution designed to support the next generation of professionals as they navigate the unique challenges of early career life. "Built on a deep understanding of the unique health and wellness needs of young professionals, the Active Smart plan will provide a tailor-made solution at a very affordable price” Dr Whelan concludes.