Not just inflation: the demographic shift driving medical scheme hikes
Shrinking younger membership is intensifying an ageing risk pool, pushing contributions higher even when hospital use is flat.
#medicalschemes
Bonitas: administrator change is part of a wider repositioning
The scheme says continuity of care remains the priority as it moves administration to Momentum Health and managed care to PHA on 1 June.
Bonitas move: Momentum Health sets out the operational playbook
From broker commissions to digital channels and claims processing, Momentum Health has set out what stakeholders can expect when Bonitas changes administrators.
PHA lays out its case as Bonitas managed-care handover nears
Private Health Administrators outlines how provider contracts, managed-care operations, and service commitments will work from 1 June.
RAF liability for expenses paid by medical schemes ‘is settled law’ in W. Cape Division
The judgment criticises the Fund’s continued resistance to medical-expense claims already addressed in earlier Western Cape rulings.
NHI case hinges on one question: was the public truly heard?
The Constitutional Court must decide whether Parliament’s NHI process met constitutional standards – or whether the law must go back for a redo.
3Sixty wins lifeline in accreditation dispute with CMS
The High Court finds the Council must disclose the material it relies on before taking a decision that affects the provider’s ability to operate.
Medscheme secures Sisonke administration mandate
The appointment strengthens Medscheme’s foothold in the employer-based healthcare sector.
SARS says poor employer data is disrupting auto-assessments
As third-party submissions open, SARS urges employers to file early and accurately or risk triggering errors, delays and taxpayer verifications.
Bonitas transition proceeds as administrators outline plans amid legal uncertainty
Sanlam and Momentum outline how they are managing workforce, operations, and risk as the Bonitas transition proceeds despite an unresolved court challenge.
Parliament flags slow progress on Health Market Inquiry reforms
The CMS cites statutory constraints, while the Portfolio Committee on Health calls for a clear roadmap to implement the Inquiry’s recommendations.
Sanlam links health and wealth in advice model shift
The group plans to combine healthcare and financial data to refine risk assessment and product pricing.
CMS moves to rein in how medical schemes investigate fraud
Circular 10 introduces interim rules to standardise audits, investigations, and clawbacks as broader reforms are developed.
Bonitas-Medscheme court battle stalls as application removed from urgent roll
Medscheme’s bid to halt Bonitas’ administration transition has been delayed after procedural lapses and unresolved interlocutory issues forced the matter off the urgent roll.
Medical scheme vs medical insurance: the risk conversation advisers can’t avoid
In this edition of Cover to Cover, we unpack the structural, regulatory, and underwriting differences that advisers must clarify before recommending either healthcare funding option.
Tensions rise as Bonitas and Medscheme clash ahead of court showdown
Bonitas, Medscheme, and PHA trade accusations as court papers, whistleblower claims, and a CMS probe intensify the battle over medical scheme contracts.
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.
