UCT Retirement Fund Seminar
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1 OPTIONS FOR HEALTHCARE IN RETIREMENT UCT Retirement Fund Seminar July 2016 Sue Zanninello CFP BR6
2 PSG Employee Benefits Financial Services Provider Accredited with: Financial Services Board Council for Medical Schemes All major medical schemes We hereby disclose that PSG Employee Benefits is a division of PSG Wealth an authorised Financial Services Provider that is registered with the Financial Services Board ( FSB ) and operating with license no Page 2
3 OVERVIEW WHAT COVER LEVEL DO YOU NEED? WHERE TO FROM HERE? PSG SERVICES IN RETIREMENT Page 3
4 OVERVIEW WHAT COVER LEVEL DO YOU NEED? WHERE TO FROM HERE? PSG SERVICES IN RETIREMENT Page 4
5 WHAT COVER LEVEL DO YOU NEED? PLAN YOUR SPEND Some people save enough for the later years, some won t have provided for the rising cost of medical expenses. Either way it is always best to PLAN your spend. Page 5
6 WHAT COVER LEVEL DO YOU NEED? IMPORTANT QUESTIONS TO ASK YOURSELF Do you understand your plan? what s best value how to maximise benefits what you are entitled to Do you know what your family have spent in the last few years? analyse your out of pocket spend differential between premium and requirement is your plan the correct level of cover for you? Do you know what your budget is? have you asked your financial planner to calculate the cost of your medical aid contribution into your retirement income monthly/ annually/long-term? Page 6
7 WHAT COVER LEVEL DO YOU NEED? PREMIUM FLEXIBILITY Hospital Cover : Scheme rate or 200% cover Hospital networks to reduce costs Delta specified hospitals countrywide Coastal best value for Coastal provinces Keycare specified lower cost hospital networks longer benefit exclusion list Chronic Cover: Comprehensive chronic or lower plans? What is the cost differential of the chronic medication vs premium from one level of cover to the other MedXpress and Formulary Medications save on co-payments HealthyCare via Clicks/Dischem Cash-back on purchases Page 7
8 WHAT COVER LEVEL DO YOU NEED? PREMIUM FLEXIBILITY For example have you considered that you may be paying a premium for something you do not need for eg. access to all hospitals countrywide for planned procedures. PRINCIPAL + SPOUSE CLASSIC SAVER COASTAL SAVER MONTHLY PREMIUM R4 190 pm R3 259 pm ANNUAL SAVINGS R R9 768 DIFFERENCE IN COVER 200% cover in-hospital 100% cover in-hospital DIFFERENCE IN PREMIUM less additional savings less Comprehensive GAP Real premium difference R931 pm -R233 pm -R180 pm =R518 pm Page 8
9 WHAT COVER LEVEL DO YOU NEED? PREMIUM FLEXIBILITY Day to day benefits Comprehensive/Priority plans Do you reach your Above Threshold benefit annually? How much do you spend once in the Above Threshold Benefit? Compared to your premium difference? Saver plans How much are you spending that is not submitted to the medical aid once the Medical Savings Account is exhausted? Is it worth your while to upgrade and save these out of pocket expenses? Page 9
10 WHAT COVER LEVEL DO YOU NEED? PREMIUM FLEXIBILITY For example have you considered the following: PRINCIPAL + SPOUSE CLASSIC PRIORITY COASTAL SAVER MONTHLY PREMIUM R4 825 pm R3 259 pm ANNUAL SAVINGS R R9 768 ANNUAL DIFF IN PREMIUM less additional savings cost of self payment gap value of limited ATB gap required on both Real premium difference R R R R neutral = R3 136 extra for Priority You are paying R3 136 per annum for access to all hospitals countrywide for planned procedures, for access to additional benefits you may never reach or spend, and Priority plans come with a number of procedures that attract upfront deductibles not found on Coastal Saver. Page 10
11 WHAT COVER LEVEL DO YOU NEED? PREMIUM FLEXIBILITY WHAT IS GAINED OR LOST : SAVER COMPREHENSIVE Oncology (unlimited on both) Comprehensive plans = R then 20% co-pay versus Saver plans = R then 20% co-pay Chronic Medication Benefit Comprehensive plan provides chronic cover for more diagnoses and more expensive medication Higher chronic drug amounts Biologics Centre for Diabetes and Endocrinology programme Above Threshold benefits Specialised Medicine and Technology benefit on Comprehensive plans Overseas Treatment benefit on Comprehensive plans Page 11 PROBABILITIES OF USING THESE BENEFITS MUST BE WEIGHED UP AGAINST THE ABILITY TO CHANGE ANNUALLY THE COST SAVINGS/INCREASE ANNUALLY
12 WHAT COVER LEVEL DO YOU NEED? PREMIUM FLEXIBILITY THINK YOU WON T BE ABLE TO AFFORD ANYTHING? The very cheapest plan is better than no plan. National Health Insurance is still years off KEYCARE UCT post-retirement subsidy covers almost full cost of the Keycare plans for those earning pension income of less than R7 550 per month * Member premium for principal + spouse ranges from R34.50 per month (income below 7550) to R per month (for incomes ) Unlimited access to private hospitalisation at selected private hospitals with certain benefit exclusions Unlimited access to GP s, radiology, pathology, medication, dental, optical etc via network of providers *Based on subsidy of 50% of Coastal Saver = R Page 12
13 OVERVIEW WHAT COVER LEVEL DO YOU NEED? WHERE TO FROM HERE? PSG SERVICES IN RETIREMENT Page 13
14 WHERE TO FROM HERE? CONSCIOUS CHOICE Consult with PSG Telephonic Face to face Letters of advice based on current utilisation levels Make a conscious decision about your cover levels Where possible plan your day to day care which is not conventional thinking UCT will subsidise your chosen option up to a maximum rand value which is currently equal to 50% of the Coastal Saver option, further dependant on years service will pay the full contribution and collect your portion via debit order Annual changes (upgrades or downgrades) can continue to be made with impunity Page 14 Year Dentistry Optical Hardware
15 OVERVIEW WHAT COVER LEVEL DO YOU NEED? WHERE TO FROM HERE? PSG SERVICES IN RETIREMENT Page 15
16 PSG SERVICES AFTER RETIREMENT Problem claims ONSITE : Dianne Wilson ELEVATED : Carol Creed Sue Zanninello Chronic registrations Benefit queries Year-end option choices Vitality benefits Addition or removal of dependants Wellness Day communication Page 16
17
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