Liberty Medical Scheme: consistency is critical

Leadership talks to Andrew Edwards, Executive Principal Officer, Liberty Medical Scheme, and gets the lowdown on medical aid in South Africa


Please tell us a bit about Liberty Medical Scheme. When was it founded and what are its core services?

The Scheme was established in September 1998 as a self-administered medical scheme, then known as Provia Medical Scheme. In 2004 Provia outsourced its administration to Medscheme, and the name was changed to Liberty Medical Scheme, in order to align with the Liberty brand. In 2006, a further name change to Liberty Health Medical Scheme was effected in order to distinguish the Scheme as an offering from Liberty Health, a division of Liberty.

In October 2008 Liberty Health Medical Scheme moved its administration from Medscheme back to the Liberty Group based on Liberty’s re-commitment to Healthcare in South Africa. In January 2010, we amalgamated with Medicover Medical Scheme (“Medicover”) and re-branded as Liberty Medical Scheme (LMS). We are currently the eighth largest open medical scheme in South Africa with 56 379 principal members, as per the 2014/2015 CMS Annual Report. LMS is administered by V Medical Administrators, a subsidiary of Liberty Health Holdings, and has integral linkages to the greater Liberty Group, which assists the Scheme in growing its membership base through its extensive network.

The scheme offers a range of solutions including options that start with comprehensive cover right through to our network options. Through our extensive network of healthcare professionals and service providers, we are able to provide cover for significant medical expenses. Over and above our major medical cover and day-to-day benefits, our offering to our members includes our unique Extender Benefits, which includes; preventative care, casualty and crime trauma benefits, amongst others.

How many medical aid options do you offer? Please provide a few examples.

Liberty Medical Scheme provides one Scheme, with four options and 12 choices. Our four main options are Traditional, Complete, Hospital and Saver. Within each option, there are three different option choices with varying levels of benefits and cover. For example, Complete, Saver and Hospital offer Select, Standard and Plus options. The Select option choice contributions are approximately 15% lower than the Standard option choices as members choose to make use of the LMS Select Hospital Network, and when necessary to obtain their chronic medicines from the State. The Hospital option choices provide affordable entry-level cover with comprehensive major medical cover. Saver offers major medical cover, but also allows members to fund their day-to-day medical costs from a Medical Savings Facility. The Complete option choices provide even more day-to-day cover via an Above Threshold Benefit. In addition to the above options, Liberty Medical Scheme also offers solutions within a traditional benefit design, where there is a distinct benefit and limit for each type of treatment, for example, a GP visit benefit, a specialist benefit and an optical benefit.

How do clients determine the level of medical aid cover they require? What tools do you provide in this regard?

Choosing the right healthcare cover is an important part of everyone’s financial planning. Potential members can either contact their Financial Adviser who can arrange for a face-to-face interaction to explain the different option choices and to decide which one will suit their client the best. Alternatively, our Liberty Medical Scheme website,, has an LMS Recommendation Tool that potential members can use to identify the most appropriate option choice(s) for their needs. Alternatively, they can make use of the Compare Our Options facility also located on the LMS website. From there, clients are able to contact the Scheme or their Financial Adviser to complete the application process.

Please offer us a few comments on why it is so important to have a good medical aid? 

Put very simply, there are real life consequences of not having medical cover. The financial cost of a major medical event such as a motor accident, pre-mature birth or even a leg fracture can be astronomical. Without medical cover, individuals will either have to fund their healthcare costs from their own pocket or rely on State facilities. Having a good medical aid that suits your needs, ensures peace of mind knowing you can get access to the quality care you need, when you need it. This includes cover for major medical expenses such as hospitalisation, as well as those unforeseen costs such as an after-hours trip to casualty. All option choices provide day-to-day medical cover except the Hospital option choices, where you pay for your day-to-day medical costs from your own pocket. LMS believes in focusing on the core of the medical scheme offering – comprehensive major medical cover and adding additional benefit layers depending on each person’s unique medical needs.

Liberty Medical Scheme prides itself on providing the same level of commitment, care and high quality service to all its clients, no matter which medical aid option they choose. Please provide some examples of how you go about this?

We focus on healthcare options that are relevant to each life stage and in so doing help our members to insure for the unexpected and to plan for the expected. We are able to offer targeted cover to all from young and healthy members looking for an affordable hospital option, to individuals or families seeking competitive cover for their changing needs right through to members who need more comprehensive benefits. During 2015, LMS launched its Specialist Network, which gives members on certain option choices access to affordable specialist services within a reasonable distance of where they live. Our Preferred Provider Pharmacy Network (PPPN) includes the major name brand pharmacies, with whom the Scheme has negotiated preferred dispensing fees. LMS is dedicated to giving our members access to quality treatment and care. We want to give our members peace of mind about what benefits are available to them when they need them. With this in mind, we keep up to date with the latest medical technology so that we can provide members with optimal care and cover, which is in line with recognised treatments. We o­ffer members Extender Benefits or additional out-of-hospital benefits on all our option choices. These Benefits are designed to cover a variety of essential day-to-day medical costs from our member’s Major Medical Benefit rather than their Savings account, or from their own pocket.

How do you go about establishing the medical aid needs of individual clients?

We look at each person’s unique life stage as well as their medical needs. Our option choices are tailored to suit each life stage – for example, those who are young and healthy would only need major medical cover, so the Hospital option choices are likely to suit their needs. However, young families who need more day-to-day cover and benefits tailored to suit the needs of young children are more likely to choose the Saver option choices, whilst more mature families or people who want more comprehensive cover, would choose one of the Complete option choices. For clients looking for hassle free premium cover, LMS also offers the Traditional Ultimate option choice. For employer groups or individuals who want affordable cover and are willing to use a dedicated network of primary care providers, we offer the Traditional Standard or Traditional Basic option choices. That being said, we always encourage potential clients to speak to an accredited Financial Adviser. The Adviser will take their client through a detailed assessment to determine the most suitable option choice(s) for their life stage and unique medical needs. Our online LMS Recommendation Tool can also be used as a guide in identifying the most appropriate option choice(s) for their needs.

Liberty Wellbeing says it is a “Liberty Health offering that empowers you to understand your unique future risks and guides you towards positive and healthier outcomes.” In what ways do you achieve this? Please provide some information on Liberty Wellbeing? How does this initiative work?

LMS members can join Liberty Wellbeing and in so doing set goals to achieve a permanent change in lifestyle through a unique blend of motivation, inspiration, incentives, tips and tools. The programme offers a number of services including, information on health and wellbeing, a health risk assessment and a 24/7 health and psychosocial phone line which can offer assistance on psychosocial and trauma counselling, physical and medical counselling, financial assistance and legal information by qualified lawyers.

How would you sum up Liberty Medical Scheme’s mission and values?

Consistency is absolutely crucial to our brand; we strive to ensure our members can access the cover they planned for today, when they need it tomorrow by offering long-term value for our members and consistent design and structure within and across our option range. Stability and consistency, through maintaining benefit value and appropriate contribution adjustments, is also critical to us. Ultimately, we strive to provide a value-based offering that meets the real needs of our members and enables them to fully access their benefits.

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