A Smarter Healthcare System

Transcription

1 LAUNCH SEPTEMBER DISCOVERER THE Financial Adviser Publication, September 2015 A Smarter Healthcare System In 2016, Discovery Health will continue to strengthen the healthcare system through smarter healthcare delivery, ensuring better health, better healthcare and lower costs for Discovery Health Medical Scheme (DHMS) members. Smart networks Digital technology powered by smart algorithms and smart use of data are transforming the healthcare system. Combining Discovery Health s digital capability with smarter networks and risk management techniques, Discovery Health Medical Scheme members will have the most convenient access to quality healthcare at the lowest cost per unit of benefit. Smarter Healthcare System for members Better health Science-based wellness interventions Personalised medicine Better healthcare Clinical and risk management assets The significant advances in genomic research, and reductions in the cost of DNA sequencing, are making genetic testing more accessible. Healthcare professionals can use the results to enhance the precision of diagnosis, and tailor treatment to the unique genetic profile of the patient, with better healthcare outcomes. Healthcare delivery assets Intuitive and accessible Lower costs Product range Enhancement of benefits Discovery Health Medical Scheme continues to offer the most comprehensive benefits for all members, young and old. Amongst the 2016 enhancements are extensive benefits tailored for children, while introducing the Advanced Illness Benefit to improve quality of care for members during the last stages of cancer. Maintaining lower costs Discovery Health s risk management capabilities and system efficiencies ensure that Discovery Health Medical Scheme members will enjoy contributions that are on average 14.8% lower than competitors contributions in The weighted average contribution increase for Discovery Health Medical Scheme is 8.6%. P02 The Smart Plan P06 Personalised Medicine P08 Healthy Kids P09 Additional product updates for 2016 P10 Discovery Health Medical Scheme performance P11 Contribution increases P12 Contribution table This brochure is intended for financial advisers only, and is presented by Discovery Health (Pty) Ltd, registration number 1997/013480/07, an authorised financial services provider, which is the administrator of the Discovery Health Medical Scheme, in terms of its contractual arrangements. This brochure is only a summary of the key benefits and features of the Discovery Health Medical Scheme plans, awaiting formal approval from the Council for Medical Schemes. For detailed information on all Discovery Health Medical Scheme plan options, please visit for access to plan brochures as well as a full copy of the proposed 2016 Scheme Rules. Vitality is not part of the Discovery Health Medical Scheme. Vitality is a separate product sold and administered by Discovery Vitality (Pty) Ltd. Registration number 1999/007736/07, an authorised financial services provider.

2 Introducing the Smart Plan In 2016 the latest in digital technology meets the best in healthcare as Discovery Health Medical Scheme provides members with new access points into the healthcare system. The Smart Plan will be a fully digital experience, where members will be guided intuitively to the most appropriate healthcare providers, ensuring better healthcare journeys at the lowest possible cost. The Smart Plan is the ultimate manifestation of a more effective Discovery Health System, which provides members with: 01 Intuitive and accessible healthcare journeys The Discovery app will guide Smart Plan members through their healthcare journeys, from choosing a healthcare provider to accessing and booking an appointment, or having a video call consultation with participating doctors. 02 Smarter networks Health Tech Discovery has partnered with healthcare professionals who, like Smart Plan members, engage with Discovery Health Medical Scheme on the many digital platforms made available to them. These providers will facilitate a smooth transition through the healthcare system for Smart Plan members. 03 Lowest cost per unit of benefit available in the market As a result of the use of digital technology to guide members through smart networks in the healthcare system, healthcare costs are significantly reduced. This allows the Smart Plan to offer unique and comprehensive benefits at the lowest cost per unit of benefit in the industry. 04 Unique and comprehensive benefits The Smart Plan combines comprehensive cover for in-hospital costs with unique cover for essential day-to-day medical expenses, such as unlimited GP consultations and unlimited acute medicine paid by the Scheme from the first rand spent on these healthcare services. P G 2

3 Benefits of the Smart Plan Comprehensive hospital cover Full cover for chronic medicine Screening and prevention benefits Maternity benefits Smart Plan members have full cover for hospital admissions in the Smart Plan Hospital Network, with no overall limit on hospital cover. There are 32 private hospitals on the Smart Plan Hospital Network. Admissions outside the Smart Plan Hospital Network are subject to a R7 500 upfront co-payment. Specialists who treat Smart Plan members in hospital are covered in full if they are on a DHMS payment arrangement. Specialists who are not on a payment arrangement, are covered up to 200% of the Discovery Health Rate. The Smart Plan provides full cover for all Chronic Disease List conditions as per the prescribed formulary list when using MedXpress, Clicks or Dis-Chem. Members and their children enjoy extensive screening and prevention benefits when done at any of our wellness providers. Screenings for adults include preventive tests, screenings and a seasonal flu vaccine (for members registered for certain chronic conditions and members older than 65 years). Screenings for children cover growth assessment as well as health and milestone tracking. The Smart Plan pays for three days and two nights hospitalisation for a normal delivery, and four days and three nights for a delivery by caesarean section. Healthy mothers who agree to be discharged one day early with their healthy baby will have access to Discovery HomeCare s postnatal home care nursing service. Postnatal care includes three day nurse visits, or one day nurse visit and two night caregiver visits, within a six-week period. We have payment arrangements with over 90% of specialists who operate in the Smart Plan Hospital Networks. Unlimited GP consultations Extra benefits Members will have access to The Smart Plan provides members with unlimited GP consultations at a GP in the Smart Plan network. A R50 co-payment applies for each visit and the balance of the consultation fee will be covered up to the Discovery Health Rate. Any other healthcare services will be for the member s account. The Smart GP Network ensures that more than 90% of Smart Plan members in major metropolitan areas live within 5km of a network GP. Video call GP consultations Members enjoy full cover for video call consultations with participating GPs in the Smart Plan network through the Discovery app. There are no co-payments applicable for video call consultations. Unlimited acute medicine cover Members enjoy full cover for a defined list of acute medicine prescribed by a Smart Plan network GP, subject to a co-payment of R10 per item on the prescription. Prescription medicine must be dispensed at the member s selected network pharmacy Clicks or Dis-Chem. additional benefits that enhance their cover: International second opinion services from Cleveland Clinic (50% of cost funded) Trauma Recovery Extender Benefit Cover for medical emergencies when travelling outside of South Africa 3 P G

4 Discovery app functionality to support the Smart Plan The Smart Plan embraces the dynamic world of digital technology that empowers members to manage their health plan and navigate the healthcare system through our sophisticated technology platforms. The Discovery app, a personalised self-service tool, puts members in complete control of their Smart Plan, 24/7. Access your digital membership card Find a provider View your health plan cover Have a video call consultation with a GP Book an online doctor appointment Rate your provider Order medicine for delivery or collection Submit a claim View your claims history 1 View your full health record View your interactions with us Request important documents P G 4

5 Cost-effectiveness of the Smart Plan The Smart Plan offers the best value-for-money in the South African open medical scheme market due to its use of digital technology and smart networks to significantly reduce healthcare costs. At R1 397 a month for the main member, Smart Plan s contributions are 23% lower than the average contributions of health plans in the core and saver market segment. When compared with other plans paying up to 200% of tariff for healthcare professionals in hospital, the Smart Plan is 32% cheaper on average. The graph below illustrates the competitiveness of the Smart Plan s main member contribution compared to comparable plans from the four largest open medical schemes. For plans without day-to-day benefits, contributions have been adjusted to include the average cost for GP visits and the resulting medicine. Comparable plan contributions R3 000 R2 000 The Smart Plan is 25% cheaper than the only other plan that offers day-to-day benefits and 200% of tariff for healthcare professionals in hospital Smart Plan has the lowest cost per unit of benefit Average (excl. Smart Plan) 23% lower R Plans paying up to 200% for healthcare professionals in hospital This plan has no day-to-day benefits and does not pay healthcare professionals in hospital up to 200% of tariff Plans that include day-to-day benefits Smart Plan Hospital Network There are 32 private hospitals on the Smart Plan Hospital Network, which was designed to ensure that over 80% of Smart Plan members in major metropolitan areas live within 10km of a Smart Plan Network hospital. Gauteng Mediclinic Morningside Wits Donald Gordon Medical Centre Netcare Clinton Hospital Life Roseacres Clinic Netcare Waterfall City Hospital Life The Glynnwood Life Wilgeheuwel Hospital Netcare Krugersdorp Hospital Clinix Lesedi Private Hospital Mediclinic Vereeniging Mediclinic Medforum Netcare Park Lane Hospital Mediclinic Legae Mediclinic Midstream Clinix Botshelong - Empilweni Private Hospital Life Genesis Clinic Life Fourways Hospital Life Little Company Of Mary Hospital Free State Mediclinic Bloemfontein KwaZulu-Natal Mediclinic Pietermaritzburg Netcare St Augustine s Hospital JMH Isipingo Clinic Life Westville Hospital Netcare Umhlanga Hospital Western Cape Mediclinic Panorama Mediclinic Constantiaberg Melomed Gatesville Mediclinic Cape Town Mediclinic Stellenbosch Melomed Mitchells Plain Mediclinic Milnerton Eastern Cape Netcare Greenacres Hospital 5 P G

6 Introducing Personalised Medicine Gearing the Discovery Health System towards the future of personalised healthcare In 2016, DHMS members can access new benefits and tools designed to take advantage of advances in the use of genomics in healthcare, including benefits for genetic testing and the Family History Tool. Genetic testing completes a member s risk profile The significant advances in genomic research, and reductions in the cost of DNA sequencing, are making genetic testing more accessible to healthcare professionals and their patients. Healthcare professionals can use the results of genetic testing to enhance the precision of diagnosis, and tailor treatment to the unique genetic profile of the patient, with better healthcare outcomes. 01 Health history Discovery has significant data on the member s health history, which also informs treatment pathways for the patient and their doctor 03 Genetic information 01 Health history 03 Genetic information 02 Wellness data 02 Wellness data The member s risk of disease is not only described by their genetic information and health history a big residual risk remains which is linked to their lifestyle Human cells contain 46 chromosomes that provide the genetic instructions for a body to live, grow, and develop. This collection of chromosomes forms the genome. Errors in the genome can cause disease. By sequencing this genome, or specific parts of it, genes that may cause disease, or affect the risk of disease, can be identified. This information can assist a member and their healthcare professionals to take a more proactive and preventive approach to the management of the member s health. Discovery Health Medical Scheme benefits for genetic testing Whole-exome screening Non-invasive prenatal testing Newborn screening DHMS members can access whole-exome screening at the world s lowest price. The process involves the collection of a DNA sample from the member, sequencing by a contracted genetics laboratory, and customised interpretation and reporting of the exome screening results. Benefit: 50% of the cost will be paid by the Scheme from MSA, with 50% accumulation towards the member s threshold, where applicable. Booking: Members will be able to book their whole-exome screening by logging on to from 1 January 2016; or they can discuss the option with their doctor. The non-invasive prenatal screening test is a low-risk screening that tests for chromosome abnormalities, including Down Syndrome in babies before they are born. Benefit: For women facing a high-risk pregnancy, the cost of the test will be paid by the Scheme from MSA and ATB, with accumulation for high-risk pregnancies. Booking: The member s gynaecologist will need to refer her for this test. The sample will be taken at the gynaecologist. Newborn screening provides members with the opportunity to test their infants for genetic, metabolic and endocrine disorders. Benefit: The cost of the test will be paid by the Scheme from available MSA, without accumulation. Booking: A paediatrician will refer the member for this test. The sample will be taken in hospital after the baby s birth. Genetic counselling DHMS members can access genetic counselling in addition to the genetic testing benefits. This counselling is provided by qualified genetic counsellors, who are healthcare professionals with specialised training in the areas of medical genetics and counselling. The genetic counselling sessions can be provided before and after genetic testing to help members make informed decisions about genetic information. They can also explain genetic results and answer questions the member may have about genetics. Genetic counsellors: Explain genetic testing options Educate about genetic conditions and inheritance patterns Identify potential genetic health risks Provide resources and support All counselling is paid from available MSA with accumulation. P G 6

7 Why should members consider having a genetic test done? 01 Members with a prior diagnosis of a hereditary condition If a member has a particular health condition or disease, genetic testing may help determine what medicine and dosage will be most effective and beneficial in the treatment of the condition. 02 Members who are at risk of developing certain conditions due to a high prevalence in their family If a member has a family history of a genetic condition, undergoing genetic testing before they have symptoms may show if they re at risk of developing that condition. 03 Genetic testing can assist healthcare professionals in diagnosing certain conditions If a member has symptoms of a disease that may be caused by genetic alterations, genetic testing can reveal if they have the suspected disorder. 04 If a member is pregnant and her baby has an increased risk of chromosome abnormalities Genetic tests are available that can detect some types of abnormalities in a baby s genes. 05 If a member would like to test a newborn baby for certain genetic, metabolic and endocrine disorders This is used to detect rare genetic diseases in infants. If results show the presence of certain disorders, appropriate care and treatment can start right away. More information on whole-exome screening What is the human exome? The human genome consists of 3 billion letters of DNA. The exome, which consists of only 1.5% of these letters, is translated into proteins, which are the functional players in the body. About 85% of known disease-causing variants occur within the exome. Surveying just this portion of the genome is an efficient and powerful clinical diagnostic tool for patients and healthcare professionals. Whole-exome screening enables personalised medicine Genomics will increasingly enable personalised, precise, proactive medicine. Personalised medicine means tailoring treatment for common and rare diseases to the unique genetic and biological makeup of each individual. For example, there are over 150 drugs whose actions in the body are now known to be affected by an individual s DNA. This information can help determine precisely which treatment is most appropriate for the individual, thereby reducing the risks of side effects and improving the likelihood of successful treatment. Better understanding of an individual s risk for certain serious diseases can lead to better proactive, preventive measures. Where appropriate, lifestyle modifications or medicine can be prescribed. While genomic testing remains at an early stage, it is progressing extremely quickly with new conclusions being published almost daily. The link to life insurance If a member takes out a life insurance product, as part of the underwriting process, the life insurer may ask whether they ve had a genetic test done in their lifetime. If so, they may be required to make the results of the genetic test available to the life insurer. Digital tools The Discovery Health Family History Tool Expert partnerships Human Longevity, Inc (HLI) Discovery Health developed the Family History Tool to allow DHMS members to capture their family health history, which is a critical component of personalised medicine. The European Journal of Human Genetics states that obtaining a medical and family history is the gold standard in the initial assessment for the presence of a heritable cancer syndrome. Members will be able to access the Family History Tool by logging on to from 1 March DHMS members who are on Vitality can earn points for completing the Family History Tool. Discovery Health has partnered with HLI, a world leader in genome sequencing and interpretation. Human Longevity, Inc. (HLI) founder, Dr. J. Craig Venter, led the team that was responsible for decoding the first human genome in The partnership will allow Discovery Health to provide members with the latest developments in genetic testing and enable them to benefit from the best possible personalized healthcare available. HealthID With the member s consent, genetic test results and family health history can be shared with doctors through HealthID. This additional clinical information can assist doctors in formulating appropriate diagnostic and treatment options. The Discovery Health Genetics Advisory Panel Discovery Health has appointed an advisory panel comprising of international and local experts in the field of genetics. This panel will help Personalised Medicine focus not only on exploring new knowledge, and delivering better care, but doing so safely, ethically and responsibly. 7 P G

8 Healthy Kids 2016 Ensuring good health for their children is a primary focus for all parents. That s why providing a complete solution for better health and better healthcare for children is important to us. The following benefits will be introduced in 2016, ensuring that the Scheme provides benefits and products tailored for children: Kid s emergency assistance benefit Kid s video call consultations benefit Kid s screening benefit Kid s electronic health record 01 Kid s emergency assistance benefit 04 Kid s electronic health record Children younger than 10 years will have cover from available day-to-day benefits and additional cover through the Insured Network Benefit (INB) for GP casualty consultations. Each child will have access to two visits a year from the Insured Network Benefit The hospital facility fee and any consumables will be covered as part of the GP consultation This benefit applies to Classic and Executive plans (excluding Classic Core). 02 Kid s video call consultations benefit Children younger than 10 years will have cover for afterhours video call consultations with participating network paediatricians. Parents often need to refer back to particular health information when submitting a school application or for medical emergencies when specific dates and treatment details are required. An electronic health record is a trusted source of health and wellness information, spanning the child s entire life. It will include records of doctor s visits, vaccinations, hospitalisations, medicine and lifestyle activities over time. The electronic health record will incorporate a child s Health and Vitality information which will provide a complete and comprehensive health and physical activity overview of the child. Having access to a digitally stored record will provide healthcare professionals with a valuable source of consolidated data. Members who complete their child s health record will be able to view and track: These consultations will be paid from the member s available day-to-day benefits When a member has used up their MSA, video call consultations will be paid from the INB, provided the member uses a network paediatrician This benefit applies to Classic and Executive plans (excluding Classic Core). 03 Kid s screening benefit The screening and prevention benefits will be enhanced to accommodate children. This programme will offer age-based screening tests at our wellness providers. Growth assessment tests covered will include height, weight, head circumference, health and milestone tracking. This benefit is applicable to all DHMS plans and is paid from risk. Developmental milestones Self-capture of milestones allows a parent to keep a lifelong digital record of when important milestones were reached. Growth chart The growth chart will include the weight, length and head circumference of the child, which will be recorded at clinic visits or at visits to the healthcare professional. Paediatricians use the chart to detect potential areas of developmental concerns. Lifestyle This data will include information that has been captured from the Vitality Child Health Assessment and will provide parents with useful tools and advice based on these results. For DHMS members who have Vitality, refer to page 7 of the Vitality Discoverer for further enhancements. P G 8

9 Additional updates for 2016 Increasing the quality of life for members with cancer during the advanced stage of their illness The existing Compassionate Care Benefit provides members, in their final months of life, with access to a defined basket of services such as pain, hydration, general nursing care and supportive care up to an overall benefit limit. To ensure that members benefit from optimal palliative care, the current benefit structure will be enhanced for all members with cancer in The implementation of the initial phase includes those members who will derive the most value clinically and the best possible care from the Advanced Illness Benefit. Members can discuss their options with their treating doctor or oncologist. The Advanced Illness Benefit provides members with access to: GPs specialising in end-of-life care who will assist in coordinating and improving the care of DHMS members on the Advanced Illness Benefit a The healthcare provider will facilitate the care through HealthID by use of a Care Plan tailored for the member b All medicine, oxygen and surgical requirements prescribed will be delivered via MedXpress when required Personalised high-touch experience and a defined home-based care programme through Discovery HomeCare a Access to personalised care services such as oxygen, wound care, home nursing and pain management for the member b Access to counselling services for member and family A dedicated care coordinator who will: a Remain with the member and the family throughout b Manage the relationship between the member and the multi-disciplinary team on an ongoing basis ensuring the member receives the best of care KeyCare Series changes for 2016 Preferred suppliers for spinal surgery devices 2016 Enhancing cover for out-of-network GP visits The current benefit structure provides for one out-of-network GP visit a person each year. This will increase to four visits per person per year from Introducing a preauthorisation threshold for KeyCare GP consultations from 2016 Members on KeyCare Access and KeyCare Plus have cover for unlimited KeyCare Network GP consultations. After 15 visits for a member, preauthorisation will be required to access further benefits. In 2016, Discovery Health Medical Scheme members will have unlimited cover for devices used in spinal surgery by making use of a list of preferred providers. If members choose to use a provider not on the list, their devices will be covered up to a defined limit. Aligning the dental benefits on the Executive Plan Currently all in-hospital dental treatment accumulates to the overall dentistry limit on the Executive Plan. To ensure that the dental benefit on the Executive Plan is more aligned to the Comprehensive Series benefit, the cost of the hospital account will no longer accumulate to the overall dentistry limit in Cover for treatment and surgery related to knees and shoulders All non-prescribed Minimum Benefit surgery and treatment related to knees and shoulders will not be covered on KeyCare from Keycare income bands Keycare income band thresholds will increase by CPI + 2% PrimaryCare changes for 2016 As from 1 January 2016, the standard PrimaryCare contract fee will increase by 5% to R209 for each employee a month, excluding VAT. In addition, the dentistry and optometry buy-up benefits will be included in the PrimaryCare contract as standard, with no additional charges. For current PrimaryCare contracts that include dentistry and optometry, the rate will be adjusted to that of the standard contract, with effect from 1 January Annual changes to limits, co-payments, deductibles and thresholds For 2016, all benefit limits, co-payments and deductibles will be increased by the contribution increase, except: 01 Scopes are increased in line with the hospital tariff increase. 02 MRI/CT scans are increased in line with the professional tariff increase. 03 Internal prosthesis, external medical appliances and devices limits will be increased by surgical inflation. The annual thresholds and threshold limits, where applicable, will be increased by the plan contribution increase except on the Comprehensive Series which will be increased by 9.9%. The threshold for oncology will remain the same for Currently over 99% of members are funded in full within these thresholds. 9 P G

10 Discovery Health Medical Scheme: Sustained excellence across all performance measures The Scheme s excellent performance and ranking among the top 3 health insurers globally, illustrate the tale of two cities within South Africa s challenging medical scheme market. In contrast, other open medical schemes are struggling to grow their membership, while their solvency is reducing and the management of their healthcare costs continues to be a major challenge. Top 3 global ranking 1st DHMS global ranking between 2006 and 2013 The latest benchmarking by Deloitte Consulting places Discovery Health Medical Scheme amongst the top healthcare funders internationally. 2nd 3rd 4th 5th 6th DHMS The study benchmarked the top 20 funders globally including DHMS, plus the next four South African open medical schemes. 7th 8th 9th 10th 11th 12th Next four SA open schemes 13th 14th Sustainable growth DHMS has achieved sustained positive membership growth year-on-year, and covered more lives in 2014 than all other open medical schemes combined. This high growth and low lapse rates increased DHMS s market share of open medical schemes from 15.4% in 2000 to 53.8% in Net growth in lives covered ( ) 1.9m DHMS All other open medical schemes - 1.6m Better management of claims costs DHMS manages to contain claims costs significantly better than other schemes. The differential in claims cost increase is illustrated by the cumulative increases in risk claims per average beneficiary per month, between 2005 and 2014 for hospitals Cumulative increase in hospital claims cost 2007 All other schemes DHMS % 03 Stable net healthcare results Net healthcare result (Rm) The financial performance for DHMS has been exceptional compared to other schemes in an industry struggling to contain healthcare costs. The next five largest open medical schemes experienced net healthcare deficits in recent years. The sustained healthcare surplus of DHMS ensures its financial stability, and has improved the Scheme s reserves and solvency DHMS Next 5 largest open medical schemes Reserves Despite the significant growth of DHMS in recent years, the exceptional performance of the Scheme meant that reserve levels are now in excess of R11bn, increasing solvency to 25.8% in ,6 DHMS 3,1 Reserves (R bn) at December ,4 1,0 1,0 1,0 1,0 0,9 0,6 0,4 0,1 The next 10 largest open medical schemes Solvency DHMS solvency increased to 25.8% in Due to DHMS Solvency Ratio 25,8% sustainable performance, the Scheme s reserves grew by R6.3bn between ,3% and In comparison, all 23,4% other open medical schemes only added R3.8bn to their combined reserves over the same period P G 10

11 Discovery Health Medical Scheme 2016 Contribution increases Contribution increases linked to healthcare inflation Medical inflation in the industry is driven by three factors: 5.5% 1% 2% 2% 4% 1% 2% 9.5% 13.5% Tariffs that are correlated with CPI Demand-side factors that reflect changing demographics, adverse selection and increased burden of disease Supply-side factors due to advances in medical technology and fragmentation of care CPI Tariffs Demand-side pressure Supply-side pressure Unmanaged medical inflation Maintaining lower costs for Discovery Health Medical Scheme members 8.6% weighted average Discovery Health Medical Scheme headline increase in 2016 DHMS contribution increases continue to be lower than the level of unmanaged medical inflation. The increase for all plans will be 8.9%, with the exception of Essential and Classic plans in the Saver and Core Series, which have a 7.9% increase. The contribution increases for 2016 are set such that DHMS enhances benefits, while strengthening the Scheme s competitive position and maintaining solvency while growing membership. All plans will experience an increase of 7.9% or 8.9% 13.5% Unmanaged medical inflation 9.5% 8.9% 7.9% Executive Classic Comp Zero MSA Essential Comp Classic Priority Essential Priority Classic Saver Essential Saver Coastal Saver Classic Core Essential Core Coastal Core KeyCare Plus KeyCare Access KeyCare Core Lower than average contributions are maintained in 2016 The 2016 contribution increase reinforces the competitive advantage DHMS has built over time through contribution increases that have been consistently lower than competitors. This advantage is illustrated through the DHMS Inflation Differential, shown below. Annualised increases since 2007 relative to CPI The sustained lower contribution increases for DHMS over time have resulted in contributions that are, on average, 14.8% lower than the rest of the industry. Lower average contributions for DHMS members (family of four) 6% 5% 4% 3% 2% 1% 0% R5 000 R4 500 R4 000 R3 500 R3 000 R2 500 R2 000 R1 500 Next 10* largest open schemes 14,8% Discovery Health Medical Scheme Next 10* largest open schemes DHMS Target at CPI + 3% * Assuming historic contribution increases relative to CPI for competitors in P G

12 Contributions 2016 Discovery Health Medical Scheme 2016 contributions Average contribution increase per family for 2016 Series Plan Contributions Contributions to Medical Savings Account Total contributions Main member Adult Child* Main member Adult Child* Main member Adult Child* Main member Main member + adult Main member + adult + 1 child Main member + adult + 2 children Main member + adult + 3 children Executive Executive Plan % 8.9% 8.9% 9.0% 9.0% Classic Comprehensive % 8.9% 8.9% 8.9% 8.9% Classic Delta Comprehensive % 9.0% 8.9% 8.9% 8.9% Comprehensive Classic Comprehensive Zero MSA No Medical Savings Account % 9.0% 8.9% 8.9% 8.9% Essential Comprehensive % 8.9% 8.9% 8.9% 8.9% Essential Delta Comprehensive % 8.9% 8.9% 8.9% 8.9% Priority Classic Priority % 9.0% 8.9% 8.9% 8.9% Essential Priority % 9.0% 8.9% 8.9% 8.9% Classic Saver % 7.9% 7.9% 7.9% 7.9% Classic Delta Saver % 7.9% 7.9% 7.9% 7.9% Saver Essential Saver % 7.9% 8.0% 8.0% 8.0% Essential Delta Saver % 7.9% 7.9% 7.9% 7.9% Coastal Saver % 8.9% 8.9% 9.0% 9.0% Smart Smart Plan No Medical Savings Account New plan Classic Core % 7.9% 7.9% 8.0% 8.0% Classic Delta Core % 8.0% 7.9% 7.9% 7.9% Core No Medical Essential Core % 7.9% 7.9% 7.9% 7.9% Savings Account Essential Delta Core % 8.0% 8.0% 7.9% 7.9% Coastal Core % 8.9% 8.9% 8.9% 8.9% KeyCare Plus % -12.1% -12.1% -12.1% -12.1% KeyCare Plus % 8.9% 8.9% 8.9% 9.0% KeyCare Plus % 9.0% 8.9% 8.9% 8.9% KeyCare Plus % 8.9% 8.9% 8.9% 8.9% KeyCare Access % 8.9% 8.9% 8.9% 8.9% KeyCare ** KeyCare Access No Medical % 8.9% 8.9% 8.9% 8.9% Savings Account KeyCare Access % 9.0% 8.9% 8.9% 8.9% KeyCare Access % 8.9% 8.9% 9.0% 9.0% KeyCare Core % 8.8% 8.9% 9.0% 9.0% KeyCare Core % 8.9% 8.9% 9.0% 9.0% KeyCare Core % 8.9% 8.9% 9.0% 9.0% * We count a maximum of three children when we work out the monthly contribution, Annual Medical Savings Account, Annual Threshold and Above Threshold Benefit limit. This excludes KeyCare Series. ** Income verification will be conducted for the lower income bands. Income is considered as: The higher of the main member or member beneficiaries earnings, commission and rewards from employment; interest from investments; income from leasing of assets or property; distributions received from a trust, pension and/or provident fund; receipt of any form of financial assistance received directly or indirectly from any source; and income from any statutory social assistance programme. P G 12 GM_34354DHM_15/09/15_V10