Launched as Old Mutual Health Solutions, employees and members now have access to primary care, gap cover, and related ancillary products.
As part of Old Mutual Health Solutions, these offerings are underwritten and administered by Genric, a licensed non-life insurer within the Old Mutual group of companies. Genric plays a vital role in ensuring that low-income earners have improved access to quality private healthcare. According to Prabashini Moodley, managing director of Old Mutual Corporate, research suggests that over 80% of South Africans don’t have access to affordable private healthcare.
Moodley said: “The biggest healthcare issue in the country is the lack of access. 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”.
To this end, Old Mutual aims to bridge the access gap with health-insurance products that provide more significant benefits.
“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. 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.”
In its primary-care range, Old Mutual Health Solutions offers a range of affordable options, including access to an extensive network of healthcare practitioners and private hospitals. The offering is designed for low-income workers across three plan levels; rates start from as little as R260 for a principal insured person (the entry-level plan) and increase to R400 and R440 for the rest of the options.
The gap-cover range is aimed at employees already in a medical-aid scheme, covering for shortfalls, co-payments, and excluded procedures. The ancillary range is acknowledgement that employees and employers see health as broader than just physical.
Humphrey Mkwebu, general manager of employee benefits solutions at Old Mutual Corporate, says old Mutual Health Solutions augments an already successful and integrated employee-benefits capability, allowing employers and groups to shield their members from the well-documented challenges of the public healthcare system.
Research shows that lower-income employees are more likely to report poorer health and that employees, in general, still trust and expect their employers to enable their access to healthcare.
The upside for employers is a reduction in absenteeism and improvement of the employee value proposition, and in staff retention and productivity.
Mkwebu emphasises Old Mutual Health Solutions’ offering is not medical aid. "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).
"This differs from health insurance, which is structured around more specific offerings. Health insurance is governed by long-term and short-term insurance laws, not medical-scheme legislation. 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. 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. We aim to bring innovative solutions, expertise, and our usual level of transparency and trust into this space,” Mkwebu concludes.
