169. Personal Health Pathways, Explained

What if your medical scheme could spot your risks early, guide your next best step, and reward you for taking it? We sit down with Aldu, an actuary from Discovery Health, to unpack Personal Health Pathways — a built‑in DHMS benefit designed to turn preventive care into simple weekly actions with real‑world rewards. No Vitality membership required, no extra cost to activate, just clear guidance via the Discovery Health app or WhatsApp and a smart way to turn healthy habits into Discovery Miles and a usable wallet for care.

We break down the two action streams at the heart of the programme. On the exercise side, you get targets that match your current fitness, from steps to heart‑rate‑based sessions, plus a game board that pays out miles you can spend with Vitality partners. On the healthcare side, it starts with a fully funded wellness assessment to capture blood pressure, glucose, cholesterol, BMI, and smoking status. From there, the app suggests practical next steps like a digital mental wellness assessment or nominating your primary care provider, so your care stays coordinated and nothing falls through the cracks.

The conversation goes deep on money matters too. We explain the Personal Health Fund you build by completing actions, how claims are paid in a member‑friendly order, and why funds don’t roll over. You’ll also hear about a thoughtful boost: meet simple engagement criteria — activate Pathways, do your wellness check, enable sleep and exercise tracking — and you start the next year with R1,000 in your Personal Health Fund. It’s a timely kickstart when many of us book checkups in January.

If you’ve wondered how data‑driven healthcare, preventive screenings, and behavioural rewards can work together, this is your field guide. Subscribe, share with someone who keeps postponing their checkup, and leave a review to tell us the first action you’re taking today.

Transcript

SPEAKER_00 0:12

Hello everybody, welcome to Know Your Money. I'm Brandwin Wayner.

What Personal Health Pathways Is

SPEAKER_02 0:16

And I'm Craig Finch, and we are from Growth Financial Planning. We hope you enjoy our podcast. Hello everybody, Elder, welcome back to the studio from Discovery Health. You're an actuary there, and thank you so much for your time and explaining personal health pathways. Eldo, what is that? Can you tell our listeners more about that, please?

Data-Driven Risk Insights

How To Activate And Access

SPEAKER_01 0:36

Personal Health Pathways is a new program that we launched at Discovery Health Medical Scheme. At the beginning of 2025, it got launched and made available to all of our members. Personal health pathways in a nutshell is almost your personal pathway to better health. When we put together this program, and important to note that it's available to all DHMS members, this is a benefit that we built into the medical scheme. It's independent of having vitality or any of those types of ancillary products. You as a Discovery Health Medical Scheme member have access to it and it's across all of the plants. Just important to flag that because we get a lot of confusion about that. So just if you think about like all of the data that we have at Discovery Health Medical Scheme and at Discovery Health in general, in terms of like individuals' health metrics, but also in terms of their lifestyle, how they exercise, how they make choices in terms of like food purchases and things like that. So we have a lot of data, so we're in a very good space to give recommendations in terms of saying that like you haven't been to the GP for long. Based on our actual data, we actually see that you're at a high risk of developing, for example, diabetes or one of those chronic conditions. So we as an administrator can see all of these very unique insights of individuals that they may not be aware of. And it's important to go for these actions if you think about like preventing someone from developing diabetes or just like almost like intervening as soon as possible if you think that they could have this chronic condition already. So what personal health pathways does is it basically encourages these members to go for these actions. For example, every single member gets so every single member have a set of actions that we surface to them on their Discovery Health app.

SPEAKER_02 2:23

Well, you need to join the personal health pathways, right?

SPEAKER_01 2:26

Somehow, is that correct? Yes, yeah, correct. Yeah. So either on WhatsApp or on your Discovery Health app, it's a very seamless activation. It's literally just like a click of a button that you can go to, just like say that you want to activate it.

SPEAKER_02 2:38

And then will it say that you need to go to the whatever the pharmacy or the doctor or get a checkup based on your claims history or whatever use matrix behind the per per individual. Exactly, yes, yeah.

Rewards And Game Board Miles

SPEAKER_00 2:53

And then if you do do those actions, what benefit does the person get?

SPEAKER_01 2:58

Yeah, so we've built in rewards for these members for completing these actions because we understand there's one point of telling someone to do something, but it's difficult to actually like get them to do it.

SPEAKER_02 3:08

If you go and do this personal pathways, you you you uh uh you connect to it and then you you get the benefit of knowing that you need to go for certain checkups of what what what is it? What what will they tell me?

SPEAKER_01 3:25

What kind of checkups will they come into the picture? That's a good question. So, in terms of the recommended actions that we give our members, we have two sets at the moment. One's exercise actions, where we actually encourage our members to do more exercise. So, depending on where you are on your fitness journey, we'll give you a recommendation, for example, to like reach a certain number of steps or to go for a run or things like that and have like a target level heart rate. So that's like almost like the one set of actions. So every single member has a personalized set of exercise actions.

SPEAKER_02 3:57

Okay.

SPEAKER_01 3:57

If they do complete their exercise actions in the week, um then they'll get a reward. So they'll, for example, like get a play on our game board, um, which is just like a game board, but you can earn discovery miles, for example.

SPEAKER_02 4:09

But those miles can convert into purchases or stores or flying or whatever, right?

Exercise Actions And Targets

SPEAKER_01 4:16

Correct, yes, yeah. So you can like stack up the miles and use them as you see fit within like our vitality ecosystem on all of the partners that we have. So that's the set of exercise actions. But then we also have healthcare actions, and that's what you were asking about in terms of like what are those recommended type of like healthcare actions that we give our members. So, similar to the exercise actions, we also reward you in our healthcare actions as well. Um, yeah, we also give, for example, the discovery miles benefits. Um, if you complete a certain set of those healthcare actions, we coin it if you close your ring, um, which may just mean like completing like one or two um healthcare actions, for example, then you unlock the discovery miles benefit, but then you can also unlock a personal health fund benefit, which I think we can maybe touch on in a separate episode as well. Yeah. So, what are those actions? So the actions vary. Um, so typically the first action that we surface to new members would be, for example, to go for a vitality health check or a wellness assessment. Okay. And this is basically to understand like the baseline health point that the member is. So understanding like what is their blood glucose level, what is their um blood pressure, um, their cholesterol, their um BMI, like all of these, like understanding like what their smoking status is. So almost like assessing like the baseline level of that member. So you're bringing in vitality without vitality, is that right? We refer to these wellness assessments as vitality health checks, but it's a scheme benefit. It's almost just a wellness assessment.

SPEAKER_02 5:45

So you don't have to be on vitality to do this. No, not as you're on the pathway plan or you've signed up for that, then you go to the you're getting other benefits of being a healthy vitality member, is that correct? Yes, yeah, completely yeah. Yeah.

SPEAKER_00 6:00

So these are people that don't have vitality don't go for those vitality health checks. So what you're trying to do is get your other members that don't have vitality to do these checks, but then still get a reward for going and doing that.

Healthcare Actions And Closing Rings

Baseline Wellness Checks Explained

SPEAKER_01 6:13

Yeah, we're definitely trying to increase that. So right now on Vitality, we have those incentive structures built in to almost like drive those members through the vitality point structure to get more of those like wellness checks done. But on the medical scheme side, um, historically we had, for example, the wealth funds to almost like drive vitality health checks, um, and that resulted in a significant pickup. Um, and the insights that you gain through these vitality health checks, and also just like from a member perspective, for them to understand their health better, there's so many benefits to get individuals to do them. So, this is definitely like a way that we actually manage members, manage more members to go for these health checks. Do you have to pay for this benefit? Not at all, no. So the health checks, every member has access to one health check during the year. It's completely funded by the scheme. You don't need to pay for it at all. And the personal pathways when you sign up for that, do you pay for that as well? Not at all. It's built into your contribution. So you don't pay anything extra. And the rewards that you can get through it, it is amazing. Um, and the actions really aren't hard either. So typically we go like for the vitality health check, like as the baseline type of like action, just to understand. But then there's also a lot of um actions that's digital. For example, completing a mental wellness assessment that you can literally just sit at home in the comfort, um, complete an online assessment, um, and you'll get rewarded for that. Um, things like nominating your primary care provider, um, which is actually a very important action. Why is that important? If you think about like if you have like one primary care provider, it almost means you have like that designated um doctor that takes care and understands you as a pa as a patient realistically. Can it be my current doctor? Yes, yeah, yeah.

SPEAKER_00 7:57

It should be, yeah. Okay.

SPEAKER_02 7:58

Yeah, ideally, yes, yeah. So it's not you saying to me, I must go to another doctor. I'll just say that is my doctor, and you know that all my info goes to that guy. Yes, yeah.

SPEAKER_01 8:08

On network plans, it's slightly different. Um, where you should nominate one of your networks. It's just in the interest of the member to get like the full benefit as well. Okay. But yes, yeah.

SPEAKER_00 8:18

I think you can maybe explain. Um, so if they finish those actions, they can either get it in miles, or you said they can get it in medical aid premiums. Maybe you can explain it in this episode.

SPEAKER_01 8:31

Yeah, so not medical aid premiums.

SPEAKER_00 8:33

I mean not premiums.

SPEAKER_01 8:34

What is the the personal health fund?

SPEAKER_00 8:36

Yes.

SPEAKER_01 8:37

As members complete their health care actions and their exercise actions, they can also accumulate money inside a personal health fund. So, what the personal health fund is in essence is if you think about a medical savings account, it's money of the member. It's almost like this discretionary fund that you can choose where you want to spend it on. Is it shown separately to your MSA? Yes, yeah, you can track it on your app to see what your personal health fund balance is. And you say consumer. How do you use that? Yeah.

Vitality Vs Scheme Benefits

SPEAKER_00 9:07

So like how do you choose that instead of using your medical savings?

SPEAKER_01 9:12

So it goes by default. So if we pay the claims, we first check like, do you have like medical scheme benefits that make you entitled, which we call risk benefits? If you don't have those benefits, then we check, are there personal health funds available? And could they overlap? Oh yes, yeah. So if there's like a co-payment or things like that.

SPEAKER_02 9:34

And does that that that money go year by year? Can you accumulate it?

SPEAKER_01 9:38

So you can't accumulate your personal health fund money, no. But what we need to spend that in the year. Yes, yeah. Okay. But what we did create this year, and it's quite a nice addition. We got a lot of good feedback for this benefit. It's a very useful new addition that we made to the personal health fund. It's basically to say that if members participate in their health during the year, so if you go for a vitality health check or your wellness check, if you activate your personal health pathways, and if you enable sleep and exercise tracking, um if you do that during this year, you'll actually start your next year with a thousand rand inside your personal health fund already. So almost like giving the member an advance. Um because we do understand that at the beginning of the year, typically like a lot of members want to go to the doctor as well. So that's almost like a kickstart or just like an advance in their personal health fund. Um so it doesn't accumulate, but we do have that advance benefit um that you can use. Yeah. Although thanks so much.

No Extra Cost To Members

SPEAKER_02 10:37

The personal health pathways, let's all sign up for that. Yes, please. Doesn't cost your wall, it doesn't cost anything. But you you touch on sleep, and I think the next episode I'd like to hear more about that. Yes, yeah, definitely. Thank you so much. Thank you for listening. If you have enjoyed this podcast, would like to subscribe, please visit our website www.growth.fp.co.za. The information we have provided in this podcast is our personal opinion. For more detailed information, please discuss your financial association with a financial planner.