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Medical aid amalgamations look set to continue in the year ahead as medical schemes deal with higher costs and regulations. South Africa's medical schemes now total double digit figures -95 at last count - and 2013 is likely to be another year of reductions in the number of schemes. This is according to Alan Fritz, executive manager: Branding, Communications and Marketing Distribution at Bestmed. Fritz says that long term, - the introduction of an NHI could well see a lot fewer schemes - possibly five big schemes existing alongside NHI. But that is a long way into the future and in the interim schemes, advisers and members have to deal with high costs, demanding members and demanding PMB (prescribed minimum benefits) regulations. This makes it a difficult environment for smaller schemes. The high cost of healthcare is one of the reasons why so many of us purchase a medical aid - we want the best care possible. The best care is also often very expensive. "There is a perception," says Fritz, "that a medical aid should be everything:'

Everything might just not be financially sustainable in the long run, and Fritz says there is an education gap that needs to be filled to make members more aware of the costs of medical care. In general, he notes that members want more for less, but in South Africa, "private healthcare is expensive:' In many cases medical aid is second in cost to a bond - a big family expense. Can this cost be contained? Elnarie Hendriks of Bestmed says that one way a member can lower their contribution is to opt for a capitation product when choosing an option - where the user is restricted to certain providers. Hendriks says this option is becoming more popular - and they do offer good benefits at an affordable rate. However there is still a perception among lower income users that it is a 'boxing-in' option where benefits are limited. For many more this is likely to be the affordable route - and these products have evolved over the last few years to offer good value. Fritz and Hendriks agree that more people are recognizing this value - particularly the more aware and educated member. As costs continue to Fewer schemes, greater member responsibility As costs continue to increase it is likely that many more medical aid products will have designated service providers with whom they have negotiated good rates and members wanting to move outside of these will pay substantially more increase it is likely that many more medical aid products will have designated service providers with whom they have negotiated good rates and members wanting to move outside of these will pay substantially more. Hendriks says that when a medical aid option is considered - while looking at usual factors like health of the medical scheme, claims payout ratios (above 86% is a warning sign) and benefits - also consider your past claims experience as the claims factor of an individual often stays the same. And if you are going to buy down at any stage - know what benefits you will no longer have access to and know where and potential costs of co-payments. Given the chunk of money taken up by medical aid it is also crucial to manage medical costs responsibly. For Fritz this involves the member and the scheme. On the member's side you need them to be aware of the costs and use the benefits when they are really needed and not just because they are there. For the scheme - it involves education and Fritz says Bestmed has a focused strategy for members and advisers dealing with this issue.