Full Bench adds weight to challenges against RAF medical expense directives
Internal directives cannot displace court orders or long-standing principles governing compensation, says the Western Cape High Court.
#medicalschemes
Sizwe Hosmed: High Court blocks board comeback, new curator installed
The CMS frames the judgment as necessary to protect members, emphasising the scheme is compliant, operational and under close oversight.
Bonitas-Medscheme split: what the CMS probe means for members
The scheme and the regulator say a narrowly focused investigation will not halt the transition – but members should brace for some operational changes.
Stretch your medical savings: smart strategies for the year ahead
This edition of Cover to Cover looks at how members can plan, track, and optimise their medical savings to reduce out-of-pocket costs and get the most from their benefits.
Bonitas’ dispute with Medscheme heads to court
Bonitas’ decision to change administrators comes amid a CMS investigation and High Court proceedings involving its former service provider.
CMS says GEMS cannot cut 25% reserve requirement
The comment comes amid a growing standoff between organised labour and GEMS after the scheme announced a 9.8% contribution increase for 2026.
MediCheck claims win as Discovery Health writes off up to R170m in ATB recoveries
Discovery Health has abandoned recovery action against more than 16 500 members, agreeing to absorb up to R170 million in overpaid ATB claims after sustained pressure from MediCheck,
CMS steps in as Discovery Health begins recovering pharmacy overpayments
Discovery Health is engaging affected members individually after a processing error led to some pharmacy claims being paid beyond Above Threshold Benefit limits during 2025.
Transitional delegations under the FSRA pushed to 2028/29
New end-dates extend the temporary allocation of certain supervisory duties to the FSCA and PA while regulatory frameworks are finalised.
‘Medical schemes face structural strain as claims growth outpaces contributions’
The 2024 Industry Report highlights rising utilisation, ageing membership, and persistent under-pricing as the key forces reshaping medical scheme sustainability.
Eleven schemes account for nearly 90% of broker fees
Broker service fees made up 17.65% of medical schemes’ directly attributable insurance service expenditure in 2024.
Sizwe Hosmed making substantial progress, says curator
An accelerated 19% contribution increase is designed to correct historic under-pricing and shore up reserves.
Co-payments unpacked: the real drivers behind member shortfalls
A practical guide to why co-payments arise, how schemes set them, and how advisers can help clients manage the risk.
Bonitas commits to co-operating with CMS investigation
After concluding its section 43 inquiry into Bonitas, the CMS has determined that the allegations merit a further forensic investigation.
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.
Medihelp to appeal contempt judgment in Elaprase case
Medihelp says it will challenge the judgment while the cost of Elaprase awaits a final decision by the CMS Appeal Board.
Family-wide gap cover: a budget lifeline for single-income households
For single parents, a ‘one-family, one-premium’ gap policy turns unpredictable medical shortfalls into a fixed monthly cost, protecting household cashflow.
