Discovery delays 2026 contribution increase to April
Leading open medical schemes have announced increases above the CMS’s guidance, underscoring the tension between regulator calls for restraint and schemes’ funding needs.
#medicalschemes
Gender-neutral surname ruling shakes up families and institutions
Employers, banks, insurers, and other identity-verifying bodies must accept surname assumptions by any spouse and update onboarding and benefits procedures accordingly.
Decoding medical plans for your clients
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.
Provisional curator to advise on future of medical scheme
The curator will assess Sizwe Hosmed’s finances and recommend whether it should merge, be liquidated, or continue.
Medical scheme hikes: CMS calls for restraint, but will schemes listen?
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.
Competition Commission backs Fedhealth–Medshield merger
Fedhealth’s acquisition of Medshield comes after Sanlam named Fedhealth its exclusive open medical scheme partner.
Medical schemes call on Parliament to order RAF to settle claims
The Health Funders Association asks the Standing Committee on Public Accounts to direct the Fund to cease legal action relating to its directives.
Panel upholds findings of racial bias in medical scheme fraud investigations
Statistical analysis found that black healthcare professionals were multiple times more likely than their white peers to be investigated and found guilty of FWA.
BHF and Discovery challenge section 59 report’s conclusions
The Board of Healthcare Funders and Discovery Health say the panel’s final report on FWA investigations rests on flawed methodology and the misinterpretation of data.
Discovery members ‘make the Smart move’, while KeyCare loses ground
The decline in KeyCare Plus membership reflects a reduction in employer subsidies and fewer mandates for medical scheme membership, DHMS says.
Medihelp’s solvency dips again, but scheme says recovery plan is working
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.
Bestmed marks sixth year of membership growth
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.
CMS will issue a new circular on appointment of healthcare brokers
A significant ruling by the Appeal Board rendered the processes outlined in the circulars published in 2022 invalid.
HFA warns: NHI will slash healthcare, raise taxes, and drain the economy
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.
RAF loses another medical scheme member liability case
The High Court, endorsing the minority judgment’s view, rules the Fund must pay the medical expenses covered by Discovery Health.
Pandemic pricing pains catch up with medical schemes – higher contributions ahead
Three medical schemes fell below the 25% solvency threshold in 2023.
Medical expenses | Court grants leave to appeal in member’s dispute with RAF
The outcome of Discovery Health’s appeal before the SCA will affect the outcome of the member’s claim for R1.4 million.
