As a non-profit medical scheme in South Africa, Discovery Health Medical Scheme (DHMS or the Scheme) operates according to social solidarity principles, whereby the Scheme pools member contributions and manages these to fund member healthcare equitably.
Who We Are
Discovery Health Medical Scheme (DHMS) is the largest open medical scheme in South Africa, with an open market share of 56.7% (according to the Council for Medical Schemes Quarterly Report for the period ended 30 June 2019) and covering 2 808 106 beneficiaries at 31 December 2019.
DHMS is a non-profit entity governed by the Medical Schemes Act 131 of 1998, as amended, and regulated by the Council for Medical Schemes (CMS). It is a registered open medical scheme that any member of the public can join, subject to the Scheme rules.
The Scheme belongs to its members and an independent Board of Trustees (the Trustees or the Board) oversees its activities. The Scheme outsources its administration and managed care functions to Discovery Health (Pty) Ltd through a formal contractual arrangement.
Why Join DHMS?
Quality of care is key to our membership proposition
One of the Scheme’s strategic priorities is to drive value-based healthcare. Placing our members at the centre of care, this approach reimburses providers based on health outcomes and not only the volume of services they deliver. It gives our members access to programmes and providers that are committed to continuous improvement in quality care.
With Discovery Health, the Scheme strives to ensure that our members have access to the safest, most efficient and effective healthcare available in South Africa, through many quality of care initiatives and innovations, which are closely monitored by the Scheme on an ongoing basis. The Scheme also empowers our members with information relevant to their needs.
Our purpose is to care for our members’ health and wellness by engaging the brightest minds and innovative solutions to provide access to affordable, equitable and quality, value-based healthcare that meets their needs now and sustainably into the future.
Our vision is to be the best medical Scheme in the country. In the interests of our members we will always pursue excellence, leveraging the Vested® outsourcing model to lead healthcare innovation and create value. We will work closely with our regulator, our Administrator and Managed Care Provider, and the industry to shape an inclusive and complete healthcare system in South Africa.
The Scheme’s support of Discovery Health’s shared value model, which engages stakeholders in working together towards better healthcare access and affordability, also contributes to positive regulatory reform and extends the Scheme’s influence in driving beneficial change in our sector.
We’ll be here for you
Financial strength and sustainability are key factors to consider when selecting a medical scheme. Sound financial control and risk management enables the Scheme to maintain its required solvency reserve levels, which ensure its ability to pay claims even when they are unexpectedly high.
We make sure your investment in membership takes care of you
The Scheme’s income is derived only from member contributions and investment returns. The Scheme pools all contributions to fund members’ claims, and any surplus funds are transferred to Scheme reserves for the security and benefit of members.
In setting member contributions for each year, the Scheme aims to ensure sufficient contribution income to pay all claims, and to generate a modest surplus to meet regulated solvency requirements and maintain a cushion against unexpected cost increases. This accords with the fundamental operating principles of a non-profit organisation that must meet the claims needs of its members as well as maintaining a statutory level of reserves.
A portion of DHMS’s income (shown alongside) is used to fund activities that benefit our members and ensure the Scheme?s sustainability. These activities include administration, managed care, financial advisers and the daily operations of the Scheme.
Apart from the reserves and these activities, the Scheme’s entire income is used to fund claims.