A year ago, Sizwe Hosmed was fighting for survival. Its solvency ratio had fallen below 7%, the scheme was under curatorship, and its future was being considered in terms that included a possible merger or liquidation.
Announcing its 2027 contribution increases, the scheme reported that its solvency had recovered to about 40% at the end of August, with reserves of R440 million. Claims are being paid weekly at about R14m and, since 1 September, Sizwe Hosmed has been running its own administration.
Under the new model, the scheme has direct responsibility for administration, with a focus on access, accountability, clinical communication, claims management, and issue resolution.
The scheme is still under curatorship. The current expectation is that this will end in September 2027, subject to the required regulatory and governance processes and engagement with the Council for Medical Schemes (CMS).
With self-administration now in place, key governance committees have been reinstated. Before the curatorship concludes, the curator team will appoint a new principal officer, after which members will elect a new board of trustees.
Sizwe Hosmed has launched its 2027 product portfolio, with benefits spanning maternity, childhood, adulthood, and senior care. The offering includes preventive and mental healthcare, doctors and specialists, chronic care, hospitalisation, and home, step-down, and frail care. Hospital at Home, home-based chronic support, and My Online Doctor extend care beyond traditional facilities, while wellness benefits include vaccinations, hearing tests, and health screenings.
Contributions increase by between 7.5% and 8.5%
Sizwe Hosmed’s 2027 contribution increases range from 7.5% to 8.5% for principal members.
The largest percentage increase is 8.5% on Essential Copper and Access Core, while Value Platinum has the lowest at 7.5%.
Essential Copper also has a new lower income band. Members earning up to R1 650 a month will pay R700 per member, adult, or child in 2027. Above R1 651, the contribution is R3 934 for a member or adult and R1 362 for a child.
The 2027 benefits and contributions are subject to approval by the Registrar of Medical Schemes.
What members will have access to in 2027
The 2027 portfolio runs from Essential Copper through to Titanium Executive, with cover across hospital and day-to-day care, chronic medicine, maternity, mental healthcare, wellness, and screening.
Members will have access to My Online Doctor, which provides consultations with doctors 24 hours a day, 365 days a year by video or telephone. The 2027 offering also includes services such as Hospital at Home and home-based chronic care.
Hospital cover has no overall annual limit for in-hospital services, subject to the relevant prescribed minimum benefit (PMB) requirements, clinical guidelines, and scheme rules. Titanium Executive covers major in-hospital surgical procedures at up to 300% of the scheme tariff. Access Core and Access Saver members face a 30% co-payment when they voluntarily use a non-preferred provider.
Mental healthcare is covered through a combined in- and out-of-hospital benefit of 21 days in hospital or 15 outpatient sessions per beneficiary per year. This includes psychiatrist consultations and six inpatient consultations with a clinical psychologist, subject to the applicable requirements.
The chronic benefit covers the 27 PMB chronic conditions across the options, with additional non-CDL chronic medicine benefits on the higher plans.
The maternity programme provides 10 antenatal visits per pregnancy: six with a GP or midwife and four with a specialist obstetrician. It also provides antenatal pathology screening, supplements, and ultrasound benefits, with the number and type of scans varying between options.
Wellness and screening benefits include blood pressure, blood sugar and cholesterol testing, diabetic eye and foot examinations, HIV testing, cancer screening, mammograms, Pap smears, and PSA testing. Children are covered for heart, hearing, and vision screening, immunisations, and HPV vaccination. The programme also includes specified vaccinations such as flu and pneumococcal vaccinations.
The options also include optical and dental benefits, with the level of cover depending on the plan.
Four options have medical savings accounts: Access Saver, Value Platinum Core, Value Platinum, and Titanium Executive. The 2027 annual MSA allocation ranges from R2 028 for a child on Access Saver to R29 964 for a principal member on Titanium Executive.
A long way from the position in 2025
Sizwe Hosmed was formed in 2021 when Sizwe Medical Fund and Hosmed Medical Scheme merged. The newly merged scheme reported a solvency ratio of 36.5%, but within a year that had fallen to 25.45%. By early 2023, it was below the statutory 25% minimum.
Things continued to deteriorate. Statutory management was imposed in July 2024, with Joe Seoloane appointed as statutory manager. When that did not turn the position around, the Registrar approached the High Court, which placed the scheme under provisional curatorship in September 2025. The curatorship was confirmed the following month.
Read: High Court confirms curatorship of medical scheme
By June 2025, the solvency ratio had fallen to 5.6%, edging up to 6.62% in July.
Lebogang Grace Mpakati was appointed curator in September 2025. Her first months were largely about getting the basics back on track: restoring access to healthcare providers, stabilising claims payments, tightening financial controls, and addressing governance and operational problems.
By December, provider access had been restored at major groups including Netcare, Life Healthcare, Lenmed, Busamed, Clinix, and National Hospital Network facilities. Claims payment runs had stabilised, while work continued on aged and disputed claims.
Read: Sizwe Hosmed making substantial progress, says curator
But the curatorship was not the end of the boardroom battle. In February 2026, the former board went back to court seeking to rescind the curatorship and remove Mpakati. The High Court rejected the attempt and replaced Mpakati with Ian Fleming, who took over as curator with immediate effect. Fleming had previously served as curator of Thebemed Medical Scheme.
Read: Sizwe Hosmed: High Court blocks board comeback, new curator installed
The court battle also brought allegations around duplicate claims payments, procurement, and other governance matters into the public domain. The parties concerned disputed the allegations.
Rebuilding an open scheme
The turnaround is not complete.
Sizwe Hosmed is an open, non-profit medical scheme. The scheme has 8 662 principal members and 17 394 beneficiaries. Its membership has historically included a significant public-sector and local-government component, but the scheme lost substantial membership during its financial difficulties.
The membership losses were closely linked to the scheme’s difficulties in the public-sector and local-government market. Sizwe Hosmed lost SALGA-linked members after the scheme failed to meet the relevant accreditation threshold.
An agreement between Sizwe Hosmed and KeyHealth Medical Scheme allowed affected SALGA-linked members to move to KeyHealth without underwriting or waiting periods. The move was voluntary, but members who remained with Sizwe Hosmed risked losing their employer medical scheme subsidies.
That membership base is substantially smaller than it was before the crisis, and the scheme is now looking to rebuild to between 12 000 and 15 000 principal members during the upcoming open period.
The scheme has also been working through outstanding member savings-account refunds. Refunds have reached R100m, while members whose banking details have not been updated still need to provide those details before the remaining balances can be paid. Sizwe Hosmed says it is working with brokers, employers, and unions to obtain the outstanding information.
