
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.

Medihelp says it will challenge the judgment while the cost of Elaprase awaits a final decision by the CMS Appeal Board.

New benefits, flexibility, and holistic well-being support strengthen Medihelp’s role as a healthcare partner, not just a funder.

Leading open medical schemes have announced increases above the CMS’s guidance, underscoring the tension between regulator calls for restraint and schemes’ funding needs.

The curator will assess Sizwe Hosmed’s finances and recommend whether it should merge, be liquidated, or continue.

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.

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.

The deterioration in Sizwe Hosmed’s reserves is attributed to ‘benefit under-pricing and historically unreliable budgetary and forecasting processes’.

The medical scheme says it will use its reserves to limit contribution increases, while possibly improving members’ benefits and reducing co-payments.

Medihelp submitted a CMS-approved three-year plan, requiring gradual contribution increases to restore its reserves to the statutory 25% level.

And the solvency ratio of the restricted Transmed Medical Fund continued to fall in 2022.