Discovery Health Medical Scheme (DHMS) is pleased with the notable increase in the number of annual Health Checks as well as the uptake of the Scheme’s additional screening and prevention benefits covered by the WELLTH Fund.

Since the introduction of the WELLTH Fund in January 2023, more than 485,000 beneficiaries of Discovery Health Medical Scheme have activated and claimed from the benefit. The once-off benefit will be available until 31 December 2024.

To-date, over R600 million has been paid out to providers and members from the WELLTH Fund. Members have predominantly used their WELLTH Fund to access dentists, GPs, physiotherapists, optometrists, obstetricians and gynaecologists.

“The WELLTH Fund has had a powerful impact in encouraging people to complete their annual Health Checks and reinforced the value of preventive care in increasing the lifespan and health span of members of Discovery Health Medical Scheme,” says Dr Ron Whelan, CEO of Discovery Health.

Discovery Health Medical Scheme (DHMS) claims data shows that during January to December 2020, the first year of the COVID-19 pandemic, annual Health Checks carried out by members dropped by 52%, compared to the same time period in 2019.

“With the introduction of the WELLTH Fund in January 2023, we are pleased to note that the health checks rate has not only returned to pre-Covid levels but exceeded expectations. In 2023, we saw more than double the number of Health Checks compared to 2021. In comparison to 2022, there was a 47% increase in health checks in 2023.”

“If members keep up with their annual Health Check – which typically takes 15 to 20 minutes to complete – they have a regular update on their blood pressure, blood glucose, cholesterol, and waist-adjusted Body Mass Index (BMI), enabling effective management of their health and early-detection of the main health risks impacting lifespan and health span,” says Dr Whelan.

How does the WELLTH Fund work?

The WELLTH Fund is activated once all beneficiaries on a medical aid plan have completed their Health Checks. For adults, this is the annual Health Check (funded from the existing Discovery Health Medical Scheme Screening and Prevention Benefit), and for children (two years and older), the annual online Kids Health Review.

• The Health Check available to DHMS adult members involves tests for blood pressure, blood glucose, cholesterol, and waist-adjusted Body Mass Index (BMI). The assessment also includes a voluntary non-smoker’s declaration and HIV screening.
• Health Checks can be completed in-person at a Discovery Store, an accredited pharmacy, a GP’s rooms in the Discovery Health Wellness Network or at an employer’s Wellness Day.

Once the WELLTH Fund is activated, each adult beneficiary is allocated R2,500 and children between the ages of two and 18 years of age are allocated R1,250 each – up to a limit of R10,000 per family. Children under the age of two have full access to the fund once a primary member has activated the benefit, without first having to complete any health check.

The WELLTH Fund gives members access to six broad categories of preventative health services. These include:

• General health screenings including screenings for visual, hearing, dental and skin conditions.
• Physical health screening at a dietician, chiropractor, biokineticist and/or physiotherapist.
• Mental health wellness check-ups.
• Women and men’s specific health screening such as gynaecological, prostate and/or heart consultations with a doctor and bone density checks.
• Children’s specific health screening in the form of a child wellness visit which includes growth and developmental milestone assessments with an occupational therapist, speech therapist and/or physiotherapist.
• Medical monitoring devices for personal monitoring of key health metrics including blood pressure, cholesterol, blood sugar management and respiratory. Find out more about the WELLTH Fund on https://www.discovery.co.za/medical-aid/wellth-fund.

Increase in chronic disease prevalence

The increasing prevalence of chronic disease in South Africa is impacting the clinical outcomes for members across medical schemes. From 2018 to 2023, the prevalence (the number of people who have a condition at a specific point in time) of diabetes increased by 29%, hypertension increased by 22% and hypercholesterolaemia increased by 35%.

“Many chronic illnesses have no symptoms – people typically don’t feel unwell until the chronic disease is well-advanced. For instance, diabetes will often only be detected for the first time following a heart attack, a non-healing foot sore, diminished eyesight. Similarly, hypertension is often only detected for the first time following an acute cardiac event such as a stroke or heart attack.”

With early detection of a chronic condition through health checks, Discovery Health offers specialised healthcare programmes (CardioCare, DiabetesCare, KidneyCare) for specific conditions to help members (diagnosed with hypertension, diabetes or kidney disease) and their doctors actively manage and navigate care for specific conditions. Discovery Health’s Care Maintenance Organisation (CMO) currently coordinates and manages delivery of specialised and multi-disciplinary diabetes and cardiometabolic care for more than 248 000 Discovery Health Medical Scheme members.

“We strongly encourage members of Discovery Health Medical Scheme to make an annual Health Check a priority in 2024, and every year. We also encourage members who have not yet unlocked and accessed their WELLTH Fund benefit to do so soon, and before the WELLTH Fund comes to an end of 2024,” concludes Whelan.