Time to review your medical aid option

Spotlight on 2019 Healthcare Industry

South Africans eagerly, albeit with bated breath, await the proposed full implementation of NHI in 2026.

The debate on NHI, its roll-out and what relief this will bring to the cost and cover of healthcare for South Africans continues fiercely amongst stakeholders.

Those covered under private healthcare continue to experience premium increases well above inflation year-on-year.

The Council for Medical Schemes’ annual report has been released and their statistics mirror the findings of the Competition Commission’s Healthcare Market Inquiry, reflecting rising cost and expenditure in the private healthcare industry.

Statistics from the annual CMS report 2017/2018

• In 2018, the number of medical schemes declined to 79, comprising 21 open schemes and 58 restricted medical schemes.
• The report notes that there has been an increase of 0.18% in the number of beneficiaries between 2017 and 2018 on open medical schemes.
• The total healthcare expenditure on benefits paid in 2018 amounted to R173.3 billion, an increase of 8.0% from the 2017 amount reported.
• Out-of-pocket expenditure amounted to R32.9 billion in 2018, which represents 19% of the total benefits paid.

Reviewing your medical option as part of your budget

At this point in time, medical schemes will continue to operate as normal, which means that a review of your benefits and cover versus the cost is still a crucial component of your budgeting process.

Members automatically consider downgrading options when faced with premium increases.

This may be appropriate for some, but carefully consider if you are not merely decreasing contributions in lieu of restrictions not suited to medical needs and larger out-of-pocket expenses.

Questions to consider

• Are you comfortable with hospital restrictions for planned admissions?
• Do you have a Gap cover product?
• What is the total out-of-hospital expenses for everyone on the membership? Tip: use an average of the last three years.
• What chronic conditions do you require cover for?
• What routine checks and tests do you have done?
• Are there any upcoming expected treatments that you and your family require in the next twelve months?
• Can you afford to pay day-to-day expenses out of your own pocket?

Important Documents

To assist you with your review, you can request these documents from your provider:

• Claims Transaction History Statement
• Self-Payment Gap reconciliation report (if your plan has this component)
• Chronic Benefits Guidelines
• Screening Benefits Guidelines
• Plan Brochures

The most effective way to review your medical aid plan is to compare your plan option and benefits on a like-for-like basis against potential alternatives. Make sure you factor in your specific healthcare needs in a comprehensive review with your financial advisor.

You are welcome to contact us at Chartered Employee Benefits with any queries.

Paramesh Dayaram is a Senior Healthcare Consultant at Chartered Employee Benefits.

At our Retirement and Risk benefit education workshops, we emphasise the importance of having an up-to-date Will. A concern frequently raised by attendees is the rights of couples living together or of their common law spouse, often referred to as a cohabitant. Chartered Employee Benefits Director, Andrew Craze, provides clarity in this article.

Most members believe cohabitation is a legal relationship, similar to marriage, customary marriage or civil unions. In fact, there is no legal status. This month we look at some of the aspects cohabiting partners should consider.

Cohabitation is not a recognised legal relationship in South African law

Co-habiting or common-law partners are not without rights; however, it is difficult to enforce these rights as there is little case law dealing with cohabitation relationships.

Some areas of law are applicable to co-habiting partners. On Medical schemes, a cohabiting partner can be recognised as a financial dependant; partners can nominate each other as beneficiaries on life policies; a partner can be recognised as a nominee under the retirement fund rules; a partner is covered by the Domestic Violence Act, and by the Maintenance Act to provide for children.

We have found that these are the most misunderstood areas of financial risk facing couples:

• The death of a partner: When a partner dies without a will (intestate), the surviving partner has no right of inheritance in terms of the Intestate Succession Act. They also cannot claim in terms of the provisions of the Maintenance of Surviving Spouse Act as they have no enforceable right to claim spousal maintenance.
• The dissolution of the relationship: Neither party has much recourse in terms of the divisions of assets.

Proposed Domestic Partnership Bill

Since more couples are choosing to live together without entering into a legally recognised marital regime, legal changes have been considered resulting in the draft Domestic Partnership Bill, tabled in 2008, though not yet law.

The Bill proposes that couples register their relationship as a domestic partnership and, in so doing, have the same rights and responsibilities as marriage partners.

Cohabitation Agreement

The Cohabitation Agreement is a binding contract between two parties cohabiting or intending to cohabit. The various aspects of their relationship are formalised in an agreement, giving substantial protection to both parties.

The Agreement must be entered any time before the relationship has come to an end. It is preferable to sign the agreement before the cohabitation relationship starts to ensure absolute certainty at the commencement of the relationship.

The Agreement should deal with, among other things:

• The assets and liabilities of the respective parties, including joint purchase of immovable property.
• The managing of living expenses of the common household and the apportionment thereof.
• Agreement that they will nominate each other as beneficiaries on their various insurance policies and retirement funds.
• How the dissolution of the relationship will take place, should it end.

Draft a Will

Another important way to protect yourself and your cohabitation partner is to ensure that your Will is current.

Bear in mind that cohabiting parties do not have a right to any assets in their respective partner’s deceased estates if the said partner passes away without leaving a Will.

On the other hand, a person may make any bequest in a Will, and in this way the cohabiting parties may ensure that their partner is looked after in the event of their passing away.

Conclusion

It is important that both parties in this type of relationship do the necessary work and prepare the necessary documents to protect both their rights during the cohabitation relationship.

Senior Healthcare Consultant at Chartered Employee Benefits, Paramesh Dayaram, looks at what the outcome of our country’s recent elections means for us, and encourages us to be part of the change.

The World Happiness Report was released earlier this year by the United Nations.  South Africa ranked 105th place out of 156 countries.

The country has dropped four spots since last year’s report.

GDP per capita, social support, healthy life expectancy, social freedom, generosity, and the absence of corruption were the criteria used by the UN to explain the variation of happiness across countries.

For interest’s sake, Finland has been named as the happiest country, while Burundi ranked last on the report.

Winston Churchill stated that the pessimist sees difficulty in every opportunity whilst the optimist sees the opportunity in every difficulty.

So, please bear with me as I don my rose-tinted glasses and explore how we can improve that “happiness ranking”.

First, face reality
A CNBC Africa talk show host and prominent Asset Manager facilitates an annual informal road running event aptly named “The Growler”. I made my debut at this event in early December.

In short, in excess of 100 Jo’burgers congregate opposite King Edward VII school and proceed to run through some of the perceived “poor or rough no-go zones” in Hillbrow, Betrams, Yeoville and Lorentzville and finish back at KES after climbing Monroe Drive.

The state of the streets – which abound with pot holes, litter and derelict homes – left me in a state of shock.

Second, see the upside

So, what is the upside?

The whole experience heightened each participant’s awareness of how tough conditions are for a large section of our fellow Jozi citizens. This fresh insight resulted in the provision of generous donations at the conclusion of the run to a home for abused women and children in Bertrams (www.bethanyhome.co.za).

The sense of caring and community among the participants was obvious.

The mantra of Chartered Employee Benefits is “Bridging the Gap”.

As we enter the festive season (and having had a brief glimpse of the other “gaps” in our society), we hope that our advice to our clients helps meet their needs: firstly, how best to bridge a funding gap by making provision towards a successful retirement; and, secondly, how to meet the immediate need for an adequate healthcare plan for them and their families.

Perhaps this can contribute in some small way towards improving that happiness rating.

We wish you and your families well over this festive period and look forward to working with you in 2019.

Health Minister, Dr Aaron Motsoaledi announced radical changes to the Medical Schemes Amendment Bill, to align it with the National Health Insurance Bill, in a media briefing on Friday (21 June 2018).  These developments promise to revolutionise the healthcare industry, and strongly indicate that you and I will be members of NHI by 2022.

The gazetted bills will be open for public comment for a period of three months.

On the National Health Insurance Bill, Dr Motsoaledi claimed that the implementation of NHI will solve two pressing issues currently facing the South African consumer:

• The exorbitant costs of private healthcare, and
• the inferior quality of care in the public system.

Whilst NHI is being phased in, the Health Minister envisages that the proposed amendments to the Medical Schemes Bill will provide financial relief to medical scheme members, allow for a smooth alignment with NHI and little or no disruption to the accessibility of healthcare.

The ten key proposed amendments discussed include:

Cessation of co-payment 
Dr Motsoaledi stated that ‘every cent charged’ to a member of medical scheme must be funded by the medical scheme, a proposal he wishes to assure ‘was well thought out’.

An end to the practice of using ‘brokers’ within the industry
Dr Motsoaledi questioned the need for brokers, given that members often don’t even know who their brokers are, and few make use of their services.

PMBs to be replaced by comprehensive service benefits 
Comprehensive service benefits will include Primary Health Care (PHC) like family planning, vaccination, screening and wellness services.

Restricting schemes from implementing scheme options 
These options will be restricted unless approved by the Registrar of the Council for Medical schemes.

Businesses not registered as medical schemes
Dr Motsoaledi will be clamping down on unregistered businesses carrying on the business of medical schemes, such as hospital cash-back plans.

A central beneficiary register 
A database will be created for identifying trends and assessing risks within medical schemes, to counteract the reluctance of medical schemes to share information with Government.

Income cross-subsidisation model
Based on the same approach as the NHI model, the rich should subsidise the poor. No further information on how this will be implemented has been provided yet.

Members benefit from savings
Dr Motsoaledi used the example of scheme requesting members to use designated service providers and stated that this saving should be passed back to members in the form of premium reductions.

Cancelled membership and waiting periods
The application of this amendment has various scenarios, most notably, medical schemes will not be able to impose any waiting periods in respect of any child.

Governance of medical schemes
This refers to minimum educational qualifications and expertise for Medical Aid Scheme CEOs and members of a Board of Trustees.

In addition, Dr Motsoaledi acknowledged the amount of money held in reserves as part of the statutory 25% solvency requirement for medical schemes. This is currently being reviewed by the Council for Medical Schemes with the view to having excess funds ‘released for the care of patients.’ The Minister also mentioned the publication of the Healthcare Market Inquiry provisional findings and recommendation report on 28 June 2018.

The overarching goal would seem to be to save the public money.

Abolishing co-payments was a dramatic and ostensibly positive opening statement, but consider income cross subsidisation, and we have to ask what the actual outcome is for a member of a medical scheme.

Whilst we can all agree that the cost of private healthcare needs to be reviewed, we also need to consider changing the industry responsibly and with careful consideration.

To drive down the cost of healthcare in South Africa successfully, the public and private sectors need to combine their intellectual resources and work together to provide workable solutions for all South Africans.

To access the full Medical Schemes amendment Bill and NHI Bill please visit www.gpwonline.co.za. You are welcome to contact us should you wish to clarify any of the changes or their implications.

Carol Lenzi, from Chartered Employee Benefits’ Retirement Consulting team, and a Certified Financial Planner®, delves into the costs of saving for retirement.

The costs of providing for retirement has been subject to much scrutiny in the financial industry, and rightfully so.

It is important for you to know what fees you pay, how you are paying these fees and what they are for, when you save for your retirement.  That way, you can ensure that you are not paying more than you should, and that your costs are not eroding the growth that a good investment will offer you.

Types of fees
These are the types of fees that you could pay and how they can be levied:

Administration fees:
These fees are paid to the administrator of the retirement fund for the administration services they provide.  These can be levied as a percentage of salary or as a fixed Rand amount per member per month.

Some administrators who both provide the administration platform and manage the investments may charge no administration fee and only an asset management fee.

Contingency reserve account levies:  This fee is used to pay for the running of a retirement fund (operational expenses), such as FSB levies, Trustee fidelity insurance, actuarial services, audit expenses, independent Trustee expenses, and member communication.

These fees may be levied in various ways:  Either as a percentage of the assets under manager in the portfolio, or as a flat rate per member per month, which is then deducted from the share of fund (or retirement fund value) by way of a sale of units.

Investment consulting and / or employee benefits consulting fees: These fees are paid to the advisors who provide their expertise, support and assistance. These can be levied either as a flat Rand amount per month or as a percentage of your salary or contribution.

Asset manager fees: 
These fees are paid to the investment managers who manage the investment portfolios.  As these fees are intrinsic, they are deducted before the investment performance is applied.

Performance fees:  
Performance fees can be paid to asset managers who outperform a predefined benchmark.  These fees have come under a lot of scrutiny in the industry, and some asset managers have chosen not to levy performance fees on their portfolios.

Your role
Once you have identified all the fees, you need to understand whether these fees are annual fees (that may be levied monthly), and whether they include VAT or are non-vatable.

If the fees are expressed as a percentage, are they levied on the total assets under management, on the salaries or on the contributions paid to the retirement fund, and then deducted from the contributions before they are invested?

A question you could ask is: Who pays for some of these fees? For example, in your employer’s pension or provident fund, do the service providers (administrator or consultant, for instance), issue an invoice to the employer for their services on a monthly basis (who then pays these fees for you), or are they deducted from your salary or the contribution that you make?

To do a proper comparison, it is best to convert all the fees into Rands to enable you to quantify them. You could calculate the ‘Total Expense Ratio’ or ‘TER’, which is a measure of the total cost associated with managing and operating your investment and can be calculated by dividing the total cost of your fund by the total assets under management.

This may seem like a daunting task to do on your own, and it is preferable to seek counselling from a CERTIFIED FINANCIAL PLANNER^®.

And bear in mind that we at Chartered Employee Benefits are always on hand to assist and to guide.

Our Chartered Employee Benefits Healthcare Specialist, Paramesh Dayaram, updates us on the current healthcare inquiry, initiated by the Competition Commission, and what it means for the consumer.

In 2014, the Competition Commission began its inquiry into Private Healthcare.  Its mandate was to determine the barriers to competition and to consumer access.  As such, it aimed to “implement measures to increase market transparency”. The Commission initiated the inquiry in the belief that there were features of the sector that “prevent, distort or restrict competition”.

The proposed date for the draft report was August 2016, but it was only in December 2017 that the Commission published a series of analytical reports, with 15 December 2017 being the proposed publication date for the Final HMI report and recommendations.  Now, the final report and recommendations have been scheduled for later this year. March 2018 has been earmarked for seminars covering proposed regulatory interventions for the licensing of healthcare facilities.

Why is it important to you, the consumer?
With the concern about the quality of care offered by the public sector healthcare providers, consumers are increasingly turning to private healthcare providers; however, this sector is not as regulated as it should be – hence, this Healthcare Market Inquiry initiated by the Commission.

There is no doubt that private medical care has a place, but the industry is riddled with complexities and jargon.  So, can this sector be more transparent?  Can moves be implemented to regulate it? Are private hospitals driving up healthcare costs, thereby being responsible for a significant portion of the above-inflation increases in expenditure reported by medical schemes?

Important for consumers is the debate about cost:  should there be a limit to what one has to pay for the best treatment? In fact, what constitutes the ‘best’ treatment?

The ideal must surely be reaching a point where the average consumer is fully educated on the total package he or she has purchased: service and product.

Focus on industry, not individual companies

Advocate Clint Oellermann, Director of the Healthcare Market Inquiry, says, “Firstly, it must be understood that a market inquiry is a general investigation into the state, nature and form of competition in a market, rather than a narrow investigation of specific conduct by any particular firm.”

Oellermann’s comment speaks to the scope and magnitude of this investigation which has been, and continues to be, a consultative process with the many stakeholders within the sector.

Looking forward … 

We at Chartered Employee Benefits are awaiting the final report and will provide comment when it appears.

For now, when those poolside conversations spout words such as “shortfalls”, “co-payments”, “deductibles”, “PMBs” and “wrong procedure codes”, be assured that there are processes underway to simplify the concepts and make the jargon more understandable … all towards a more effective industry and a more satisfied client.

Other articles of interest:

Is Gap Cover for you?  Click here.

Know what your investments cost.  Click here.

Each year, Chartered Employee Benefits’ CEO, John Campbell, provides comment on the annual Budget Speech, highlighting those aspects of particular relevance to us as South African consumers.  You will find his insights a useful reference point in your personal financial planning … and, as always, you are welcome to contact us for advice or with any queries.

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Your Quick Guide to the toughest budget in years

We’re not even two months into the year and we’ve already seen some game-changing political events.

Our new President was sworn in on Thursday, 15 February – almost 18 months sooner than expected – and we wish Mr. Cyril Ramaphosa every success in returning South Africa to an all-important economic growth path. A growing economy makes our lives that much easier in that it improves the outlook for investment returns and reduces the pressure on government to raise income tax. And that brings me to the topic of today’s communication: the 2018 Budget Speech.

There has been so much political noise over the past two months that we were left wondering whether the Budget Speech would even take place today – and as recently as yesterday we weren’t even sure whether the current Minister of Finance, Mr. Malusi Gigaba, would take to the podium. But sanity prevailed, and the speech went ahead at 2pm as planned.
 
Budget day is an important ‘marker’ in the financial planning year. It is held near the tax year-end of 28 February and is a great time for you to focus on getting your tax planning right and to take advantage of any ‘tools’ to save tax efficiently, in line with your holistic financial plan, of course.
 
What did we expect from the Budget?
 
Most analysts quoted in the media in the past two weeks predicted a tough budget. You need only look at some of the key issues to appreciate National Treasury’s problem … They are struggling with slow economic growth; a R50.8bn shortfall in revenue collection for the current tax year; and rising expenses due to the funding demands of free education and National Health Insurance. These projects are consistent with Government’s focus on socioeconomic transformation as they strive to overcome the inequalities and divisions so apparent in our society.

What did the Budget Speech reveal?
 
At the outset I should say that the 2018 Budget Speech is one of the toughest that we’ve seen in many years, but this wasn’t unexpected. Chartered Employee Benefits predicted that the 2018 Budget would be extremely tough on High Net Worth (HNW) clients, difficult for the middle class and largely neutral for the rest. And we had it spot on!
 
Our expectations were confirmed early in the speech. An additional R36 billion is being raised through a combination of tax increase, mainly through a higher VAT rate and below-inflation adjustments to personal income tax brackets. 

We summarise the main tax proposals as follows:

• An increase in VAT from 14% to 15%;
• A below inflation increase in the personal income tax rebates and brackets, with greater relief for those in the lower income tax brackets;
• An increase in the ad-valorem (proportional) excise duty rate on luxury goods from 7% to 9%;
• Estate Duty will be levied on the dutiable value of an estate at a rate of 20% on the first R30 million, and at a rate of 25% on the value above R30 million;
• A 52c per litre increase in the levies on fuel (22c for the general fuel levy and 30c for the Road Accident Fund); and
• Increases in the alcohol and tobacco excise duties of between 6% and 10%.

There were no changes to the marginal rates of individual income tax, the rate of tax on trusts (45%) or the rate of tax on companies (28%). Transfer duties on the sale of properties remained unchanged too, with a 13% tax on the portion of the transaction exceeding R10 million.
 
The feared removal of medical-schemes tax credits did not materialise either; but the increases were minimal – from R303.00 to R310.00 for the main member and first dependent, and from R204.00 to R209.00 for each additional beneficiary. Other good news is that there were no changes to the tax treatment of retirement fund lump sum benefits or severance benefits.
 
What does it mean for you?
 
The range of announced tax changes will significantly impact the household budgets of high and mid-income families. We suggest that you take a close look at your income and expenses post-budget and review the impact of an expected reduction in post-tax income against your financial plan.
 
It is also good practice for those saving toward retirement to consider lump-sum top up payments to your retirement annuities as well as making the maximum allowable contribution to Tax Free Savings (TFS) accounts, if this suits your circumstances.
 
We were a bit disappointed on two fronts:  firstly, the R500,000 tax-free portion of the retirement lump-sum benefit was not increased); and secondly, there was no increase in the maximum contribution in either Retirement Annuities or Tax-Free Savings, being 27.5% of Retirement Annuity contributions capped to R350,000 and R33,000 for Tax-Free Savings contributions per annum respectively. Nevertheless, we recommend that you continue to take advantage of the tax efficiencies associated with retirement funds and Tax-Free Savings accounts.
 
The changes in Estate Duty apply to estates worth more than R30 million and will affect High Net Worth individuals who will have to review their financial plans and estate plans accordingly. We note that the basic deduction allowed under this tax heading was left unchanged, at R3.5 million.
 
What happens next …
 
You should not make hasty financial decisions based on the changes announced in today’s Budget Speech. Your best approach is to stick to your holistic financial plan and make considered changes to your portfolio over time based on the advice of your financial planner, thus continuing your journey towards a secure retirement based on your lifetime goals and dreams.
 
We invite you to contact us if you have any concerns about the Budget Speech and what the various changes to taxation rates mean to you.

Warm regards

John 

The festive season usually instils a sense of joy and almost relief as we approach the end of the year. For most of us, just a brief respite from the relentless demands of our routines is most welcome.

In these tough economic times, however, we can also have an equal sense of dread as we wait for January pay day after a lengthy and expensive gap between salary cheques.

So, this edition of the Xpress Newsletter cites worthwhile tips from our strategic partner, Interface Employee Financial Solutions, on how to get our bucks in a row as we head into 2018.

• Stay Motivated: Think back to your January financial resolutions and goals, and perhaps remind yourself of the goal. Don’t allow the festive season to distract you from your bigger financial picture.
• Budget Better: It is vital to create a holiday budget even if you are not travelling. Often we think we will have a staycation and experience being “a tourist” in our home town. Remember if you are not working chances are you are spending. So create a budget and then stick to it!
• “The best gifts don’t come in boxes” – a saying so true. Think carefully before you spend on gifts. One of the best financial gifts in life is the feeling of financial freedom, and knowing that you are financially secure. Set expectations with your loved ones and don’t buy unnecessary gifts out of guilt or fear, swiping your card and then spending months paying it off.
• Plan Ahead: Before you know it December will be a distant memory and we will be into January 2018. Many people feel that January is the longest month of the year as we usually get paid on the 16th of December and it is a whopping 40 days to wait until we receive our January salaries on the 25th. January is also a month where additional items hit the budget, and this is especially if you have children: you may have to fork out for new clothes, books and school fees. So plan ahead in December, keeping a secret stash of cash for the costs that you need to budget for in January.
• Yes you can: Having a “can-do” positive attitude is vital to financial success. Don’t feel overwhelmed or allow yourself to think that there is no way you will be able to manage your finances. The saying, “if you think you can, you can” is very true. Remind yourself of your abilities and tell yourself that you can be money savvy and you can succeed.

From me, Trevor and the CEB team, we wish you a stress-free approach to the festive season with much planning to keep your financial peace of mind.

Spring is a great time for reflection and renewal. CEB’s Healthcare Consultant, Paramesh Dayaram, helps clients take stock of their medical aid option in this practical article.

Reviewing your medical aid option is an important part of your budgeting process, but what do you need to consider? 

Many South Africans are cutting back on costs in their budget in an effort to keep expenses down. Medical aid benefits are often one expense that gets ‘trimmed’.

Medical schemes have been launching their 2018 benefits and enhancements, and as usual, prices are increasing year-on-year above inflation. So, it’s wise to assess if the price you are paying matches the benefit you are receiving. There are three possible outcomes: remain on your current option, or downgrade to a lower option or upgrade to higher plan option.

The following list will help you review your medical aid option:

Key Benefits

Hospitalisation

The fundamental reason members join medical aid is to ensure cover for hospitalisation. Consumers know that the cost for private care hospitalisation can be exorbitant and often financially crippling without the right level of cover.

Most schemes offer unlimited cover for hospitalisation. There are still a few options with overall annual hospitalisation limits that are aimed at providing some level of cover for lower income earners as opposed to no cover at all.

Schemes also provide options that impose restrictions on what hospitals members may use for a planned admission. This allows them to charge a lower contribution. So, if this is your option, make sure that you are familiar with the hospitals on the list. 

Day-to-Day

The new generation plans offer a Medical savings account that cater for day-to-day expenses, subject to available funds. There a few traditional model options on the market; however, they are generally highly priced. Hybrid options offer a mix of benefits funded from medical savings and risk pools.

The extent of day-to-day cover is where most of the variation occurs in terms of options available, and can affect the overall contributions substantially.

Scheme Rate

This refers to the medical scheme’s rate of reimbursement for related accounts. Schemes can cover from 1 times, up to 3 times the medical rate depending on the plan option.

Questions to consider

• Are you comfortable with hospital restrictions for planned admissions?
• Do you have a Gap cover product? (To read our article on Gap Cover, click here.)
• What are the total out-of-hospital expenses for everyone on the membership?

Tip: Use an average of the last three years.

• What chronic conditions do we require cover for?
• What routine checks and tests do we have done?
• Are there any upcoming expected treatments that my family and I require in the next twelve months?
• Can I afford to pay day-to-day expenses out of my own pocket?

Important Documents

To assist you with your review, you can request these documents from your provider:

• Claims Transaction History Statement
• Self-Payment Gap reconciliation report (if your plan has this component)
• Chronic Benefits Guidelines
• Screening Benefits Guidelines
• Plan Brochures

The most effective way to review your medical aid plan is to compare your plan option and benefits on a like-for-like basis, factoring in your specific healthcare needs in a comprehensive review with your financial adviser.