In a notice signed by MASM Chief Executive Officer (CEO), Sydney Chikoti, dated 12 July, the medical aid provider this week this week announced price increases to their schemes. This is the result of the pressure on its resources and sustainability brought about by the revision of the benefit package at the beginning of the year 2017.
“As you are aware, decisions to go the ‘no-short-fall way,’ were a result of member expectations from a survey that was conducted. The revision of the benefits package, however, brought over some unexpected behavioral shifts and actions from members, who are impacting the Society significantly. This is because a large number of our members have moved from their traditional service providers like CHAM facilities or nominated General Practitioners where MASM has favourably-negotiated tariffs, to more expensive private hospitals and facilities,” said Chikoti.
Chikoti said this affected the first half of the year resulting into claims that far exceed the contributions being collected consistently on a month to month. This impacts on the Society’s ability to settle claims that arise from service providers in a timely manner.
“This scenario cannot be sustained any further without reverting to the membership. In order to correct the situation, the Society has been and will continue to tighten controls and firm up on already existing scheme rules, which have over the time been eroded,” he added in the statement.
He further said moderate co-payments will be re-introduced for certain high-user benefits so that the larger membership is not made to pay for a few.
With the two increments, VIP Scheme members will pay K21,000 from K16,800; while dependants will pay K18,000 up from K14,400.
EXE Scheme members’ fee has risen from K9,000 to K11,250, while dependants will move from K 8,400 to K10,500; Econo-plan Scheme currently at K 3,000 moves K3,750; EXO Scheme from K16,800 to K21,000; and VIO Scheme from K22,200 to K27,750 according to the notice. These figures indicate a 25 percent increase.