
From spouses to parents: understanding medical scheme dependants
This edition of Cover to Cover explains medical scheme dependant rules, required documentation, and how advisers can help clients keep their families covered.

This edition of Cover to Cover explains medical scheme dependant rules, required documentation, and how advisers can help clients keep their families covered.

For single parents, a ‘one-family, one-premium’ gap policy turns unpredictable medical shortfalls into a fixed monthly cost, protecting household cashflow.

ASISA’s research shows formally employed South Africans face a major liquidity risk: R4 trillion in earnings versus only R1.1 trillion in critical illness cover.

South Africa now has a publicly available Climate Index, developed by actuaries and meteorologists, that tracks extreme weather events.

This edition of Cover to Cover explains waiting periods, helping advisers guide clients on when benefits start and strategies to avoid gaps in cover.

In a landscape defined by rising costs and digital disruption, brokers who embrace technology and tailor gap cover to individual life stages will lead the way.

The first edition of our new series unpacks the types of medical plan, who they suit, and why the cheapest option isn’t always the smartest choice.

The Council for Medical Schemes recommends capping 2026 contribution increases at 3.3% plus “reasonable utilisation estimates”, yet past trends show schemes often push far higher.

The annual benefit escalations for policies that fall under the Demarcation Regulations.

Medihelp says its recovery plan is on track, with strong cost controls, younger members, and CMS-approved funding measures set to restore financial stability by 2026.

Despite economic headwinds and high claims ratios, Bestmed grew net membership by 4.4% in 2024, bolstered by strong solvency and a R164.4m surplus.

Complaints about life-benefit payouts climbed to 36% of the Division’s cases, from 34% in 2023.

The Health Funders Association, which represents nearly half of SA’s private healthcare market, is the latest organisation to launch a legal challenge against the NHI Act.

Discovery Life’s claims data reveals rising risks, with increasing concerns about mental health and skin cancer.

Insurers are allowed to offer primary healthcare policies for an additional two years pending the finalisation of a framework for low-cost benefit options.

After months of speculation, Sanlam has officially partnered with Fedhealth as its exclusive open medical scheme provider.

The Board of Healthcare Funders questions the timing and content of the CMS’s report, claiming it ignores stakeholder input and the opposition to low-cost benefit options is politically motivated.