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about medihelp

As one of the top open medical schemes in South Africa covering more than 200 487 lives, Medihelp makes it all about you! We believe everyone is unique, but we all have a need to ensure our well-being. 

For this reason, Medihelp follows an individualised approach to meeting your healthcare needs by –

  • offering 10 benefit options, each one priced and structured differently, to provide you with more value and suit every stage of your life, and
  • making a variety of service platforms available both online and offline, including our user-friendly app, a secured website and a dedicated call centre.

In order to make healthcare more affordable, we manage the escalating cost of healthcare provision by ensuring appropriate and quality healthcare through networks of providers.

Experienced

Medihelp has more than 112 years’ experience and a solid reputation, proving that we are able to adapt successfully to a challenging healthcare industry.  Medihelp has succeeded to offer sustainable healthcare coverage in a rapidly changing and highly regulated environment.

Big enough

Medihelp is one of the largest open medical schemes in the country, providing healthcare cover to close to 200 000 lives. 

A good investment in your health

Medihelp meets all the requirements of a good investment, with a solvency level which continues to exceed the industry requirement despite the worldwide economic decline which affects the South African economy in general and the healthcare sector in particular.


Solvency

Medihelp’s 29,56% solvency ratio far exceeds the statutory required level of 25% as prescribed in the Medical Schemes Act. This constant healthy performance means our clients can rest assured that there is more than sufficient provision for their claims payments.

Administration costs

You deserve to be part of a medical scheme where the largest portion of your investment goes toward paying for healthcare costs instead of non-healthcare expenses. At Medihelp we strive to keep our administration costs as low as possible, so you get more healthcare cover for every rand you contribute.

Claims payments

Medihelp again received an AA– rating in 2017 from Global Credit Rating for our claims-payment ability. This offers our clients the assurance that their claims will be paid. Medihelp processed 2 952 215 claims in 2017 and paid out R3 719 322 680 in benefits. Our efficient and regular claims payments ensure that healthcare providers have no hesitation in treating Medihelp members.

Product presentation and performance

We have designed our 10 products on offer to meet the diverse healthcare and financial needs of our existing as well as potential new members. We offer a range of options to suit individual needs, from an affordable hospital plan with additional insured benefits for preventive care and pooled day-to-day benefits, to savings account options with hospital and trauma cover, and comprehensive cover with chronic medicine benefits.

Our unique approach to network options ensures a stable risk pool and offers cover at network providers at a 20–22% price difference, while our non-network alternatives allow members to use the service providers of their choice.

Read more about our benefit options.

Client satisfaction

Medihelp follows an individualised engagement approach, and by focusing on the needs and expectations of our clients we have created a culture where our clients’ needs guide new service experiences we create. We constantly measure our clients’ expectations and we use the results of these measurements to get better insight into how we can enhance our service platforms. In 2017 Medihelp showed an improvement in service experience of 2,6% according to a SAcsi survey. 

Employee satisfaction

We believe that client satisfaction can be accomplished by ensuring employee satisfaction. Medihelp currently employs 532 highly trained – and satisfied – staff members who are skilled, well-equipped, and have a passion for excellence.

Our services
The following is a summary of how we meet our clients’ needs:

Customer care

  • Our Call Centre is staffed by 75 skilled consultants who handled almost 621 000 calls from members, service providers and advisers in 2017.
    Phone us on 086 0100 678 if you have an enquiry or need assistance.

Communication

  • Our communication with members covers all communication media, from printed letters and phone calls to electronic communication via email (newsletters and videos) and SMSs – in English and Afrikaans.
  • Visually impaired members receive special e-statements.
  • Medihelp’s presence on the major social media platforms encourages further engagement and interaction with all stakeholders.
  • Annual engagement events held in various regions across South Africa offer members the opportunity to engage in person with the Medihelp team and to get first-hand information and feedback.

Audit services

We are serious about good governance and preventing fraud and abuse – with the help of our team of internal auditors and forensic auditors.

Corporate clients

A relationship of mutual trust develops by following an approach focused on personal involvement. To accomplish this, we strive to offer tangible value for our clients who are part of corporate groups: 

  • Dedicated client relations consultants are trained in all aspects of our business and provide valuable assistance to HR departments, individual employees and appointed healthcare consultants.
  • Dedicated subscriptions recoveries staff assist with statements, reconciliations, enquiries about payments and membership changes.
  • Group profile reports contain vital statistics and information on employees’ membership, claims and health profiles, as well as service delivery feedback.
  • E-newsletters are sent to corporate groups regularly to keep them up to date with the latest news on Medihelp and the industry.
  • Medihelp sponsors wellness days for corporate groups as a fun way of making employees aware of the importance of a healthy lifestyle and possible health risks, and these events are very popular both with employees and employers.

Accredited advisers and the Sales team

A group of accredited financial advisers and our Sales team are ready to provide prospective clients with any information they might need. They also offer training in our benefit options. A safe, interactive website assists advisers through access to the Adviser Toolbox.

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