Medical aids again in deficit

05 December 2017 - 07:00 By Katharine Child
Most South African medical aid scheme premiums will again increase 2.5% to 4.5% above inflation next year, Alexander Forbes noted. File photo.
Most South African medical aid scheme premiums will again increase 2.5% to 4.5% above inflation next year, Alexander Forbes noted. File photo.
Image: Tyler Olson/ 123RF.com

A report by Alexander Forbes Health shows that most South African medical aid schemes are, for the third year, paying out more in claims than they earned in premiums.

Premiums will again increase 2.5% to 4.5% above inflation next year, Alexander Forbes noted.

The "diagnosis" report, released yesterday shows that last year the medical aid industry spent R2-billion more than it earned in monthly premiums.

The overall industry deficit was R2.39-billion, almost twice the R1.219-billion gap of 2015.

Roshan Bhana, head actuary of technical actuarial consulting solutions at Alexander Forbes Health, said the company's research team expected that this year's financial results would reflect an improvement over 2015 and 2016.

"This is in part due to the interventions that schemes have put in place to manage two years of unusually high claims," Bhana said.

"The industry as a whole also experienced its highest claims ratio since 2009," according to Alexander Forbes Health.

"The risk claims ratio for all medical schemes increased from 91.4% in 2015 to 92.1% in 2016."

Medical aid schemes are dipping into their investment income to cover claims.

"In 2016, 54 of 82 medical schemes (65.9%) failed to achieve an operating surplus and had to draw on their investments."

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