Medical scheme contribution hikes for 2025: what’s driving the surge?
Contribution increases in 2025 are exceeding CPI, with some medical schemes aiming to rebuild reserves and ensure long-term sustainability.
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ConCourt clarifies when medical schemes can cancel membership for non-disclosure
Medical schemes cannot cancel membership based solely on the non-disclosure of a diagnostic procedure that does not lead to the diagnosis of a serious medical condition.
Bestmed’s 2025 contribution hike is the biggest of top five open schemes
Bestmed says that rand for rand its benefit options will remain competitive despite the proposed average increase of 12.75%.
Rise in complaints about medical schemes clawing back losses allegedly linked to fraud and waste
Schemes and healthcare professionals are at odds over whether these recoveries are justified, says the Council for Medical Schemes.
No proposed compromise on NHI is on the table, says Health Minister
The Hospital Association of SA’s proposal for mandatory health insurance aims to shift millions of formally employed citizens to private coverage.
Health Minister refuses to say how NHI will be funded
Motsoaledi insists that equalising healthcare shouldn’t be held back by funding concerns, and he challenges the assumptions behind the cost estimates.
Momentum’s NHI cost estimate is ‘mathematical hooliganism’, says Health Minister
Aaron Motsoaledi wants to engage with with stakeholders who are in favour of universal health coverage but have objections to the NHI Act.
Medical scheme placed under statutory management as reserves plummet
The deterioration in Sizwe Hosmed’s reserves is attributed to ‘benefit under-pricing and historically unreliable budgetary and forecasting processes’.
Ramaphosa and Steenhuisen say differences over NHI can be resolved
But statements by the Minister of Health indicate the ANC does not believe material changes to the NHI Act should be made.
Bonitas plans to ‘return’ up to R700m in reserves to members
The medical scheme says it will use its reserves to limit contribution increases, while possibly improving members’ benefits and reducing co-payments.
How NHI could cost employers and employees
It is expected that scrapping the medical scheme tax credit will be the first measure designed to raise revenue for NHI.
Costly battle: addressing absenteeism with corporate wellness programmes
Absenteeism costs South Africa R12bn to R16bn annually, with mental health-related ‘presenteeism’ adding an estimated R235bn a year.
CMS webinars for brokers, trustees, and medical scheme employees
The Council will provide a CPD-accredited training session for newly appointed healthcare brokers in August.
Medihelp’s solvency ratio drops below threshold amid high claims and rising costs
Medihelp submitted a CMS-approved three-year plan, requiring gradual contribution increases to restore its reserves to the statutory 25% level.
Discovery Health says Road Accident Fund is in breach of court order
In 2022, the High Court ruled that the fund could not withhold payments for past medical expenses covered by medical schemes.
Investigation calls into question the narratives used to support NHI
BHF-commissioned study identifies 11 assertions made about private healthcare and medical schemes that lack foundation.
Discovery’s enhanced screening benefit will be available to new members after 2024
DHMS provides an update on the impact of the WELLTH Fund and membership movements following the consolidation of the Comprehensive series.
