Symphony Health is an open/private medical aid scheme registered as a Trust and started operating on the 1stMay 2013. The Scheme is administered by Symphonic (Pty) Ltd. Symphony is said to be the first medical aid scheme to offer“new generation” medical aid products in Botswana.Speaking at the fully packed launch of the new entrant at Lansmore Hotel last week,Rose Tatedi, Managing Director of Symphonic(Pty) Ltd, the Administrators of Symphony Health, said that the introduction of new generation medical aid schemes will have a positive effect on the medical aid industry.
She explained that, “the introduction of our product offering and the different way of doing things should motivate other medical aid schemes to be more innovative and responsive to their members’ needs and consequently provide members with better benefits and more options. We will all be given more choice and more control, which can only be a good thing.”Industry experience and feedback along with detailed actuarial analysis were used when establishing the Scheme, ensuring that Symphony Health offers the most competitive products on the market. Tatedi said that she truly believes that Symphony Health gives the market what they want, “a true alternative that gives members more control over their money and better benefits.”The first component of a new generation medical aid scheme is the “Risk Pool”, that covers the costs that the member cannot control, such as hospital stays.
These uncontrollable costs are paid up to specified limits of the Scheme, as is the case with traditional medical aid schemes. A fixed portion of the member’s monthly premium goes towards this component and in the case of Symphony Health, it’s 75 percent.The second component is the “Medical Savings Account (MSA)” which covers the healthcare costs that the member can control such as General Practitioners’ visit sand medication. For example, a member could buy generic medication, instead of branded medication for a relatively low price but still get the same efficacy from the medication. Another example is with regard to optical benefits where if a member’ s prescription stays the same, they could keep the glasses for another year instead of buying a new pair.
The money that a member saves is theirs and can be used when there is real need for it to be used. In the event that all or any portion of the MSA is not used in a financial year,that amount is carried forward into the next financial year.One guest who attended the launch and preferred anonymity told Gazette Business that the coming in of Symphony will supplement the already existing players such as Pula medical Aid and BOMaid amongst others. In this day and age, he said it is important that everyone has healthcare coverage.“Without a healthcare plan of some sort,you are forced to have your expenses taken care of by state operated facilities, or to pay for the care that you receive out of pocket.If you decide to obtain private care, then you will be expected to pay for a wider majority of the services that have been rendered out of pocket,” said the source.