Fear of public hospitals, high medical bills and family responsibilities are often the underlying motives for those who become medical aid members. Furthermore, there is real need among consumers for easy, accessible information to compare healthcare providers.

These findings emerged from a Healthcare Consumer Survey that was conducted by the Health Market Inquiry (HMI) in 2016. The focus was on consumers’ experience in buying medical aid cover and using private healthcare services.

Players in the health industry should take note; consumers would value reliable and understandable information about how providers measure up to one another. At present, in the absence of any objective criteria or data, they rely on word-of-mouth information from providers, family and schemes on which services to use.

The general feeling among respondents was that information should be available in a simpler form – specifically regarding credentials and details of doctors, experiences at hospitals as well as costs of services.

According to the research, there is a sense that “any information relating to all of this should be readily available, for instance an app or online website like Hippo or TripAdvisor for private healthcare”.

Choosing schemes

Cost and the variety of medical scheme options are the primary factors that influence scheme choices.

Cost was the determining factor for the younger group of respondents (age 18-34), while range of options were more important for older people (age 35-59).

Belonging to a scheme is also motivated by other factors. Participants in the survey’s focus groups stated that their choice of medical scheme was based on their fear of public hospitals, high medical bills and family responsibilities.

Age-related factors, health scares like a stroke, and other heart-related diseases were also mentioned.

Choosing a specific benefit plan on the medical aid is, however, not easy. Many respondents felt that the information made available by medical schemes was complicated.

They also stated that they got confused at times because not only were the scheme plans complex, but the plans also kept changing. One participant said: “You always need to check if you are covered for something. It changes all the time.”

Most respondents (50%) had selected their medical schemes through their employer. Only 18% had selected the scheme on their own and 12% used a broker.

Reasons for leaving a medical aid

Affordability seemed to be the main factor for members leaving schemes. Forty-one percent of respondents who were no longer members left because it became unaffordable. This was followed by 13% who were members through an employer, but contributions became unaffordable after changing employment.

Other reasons for leaving medical schemes included a change of job (11.6%), unemployment (11.2%), lack of value for money (5.6%), and exclusion due to health status (0.4%).

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