Medical scheme increases for 2027 range from 7.35% to 8.9%, as rising healthcare utilisation, ageing membership and expensive new treatments continue to push costs above inflation. Industry representatives say schemes must raise contributions to cover growing claims expenditure. According to the Council for Medical Schemes (CMS), healthcare costs can absorb up to R96 of every R100 contributed. Why Medical Scheme…
Tag: Discovery Health
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RAF Medical Expense Claims: SCA Blocks Scheme Deductions
RAF medical expense claims cannot be reduced because a medical scheme has paid or will pay treatment costs, the Supreme Court of Appeal (SCA) has ruled. Discovery Health welcomed the unanimous judgment, delivered on 16 October 2026, saying it protects members’ rights and supports medical schemes’ recoveries. The ruling follows litigation over RAF directives that sought to exclude expenses already…
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Medical Aid Contributions for 2027 from Discovery and Momentum
TWO of South Africa’s largest open medical schemes have unveiled their 2027 medical aid contribution increases. Discovery Health Medical Scheme (DHMS) is raising rates by an average weighted increase of 8.2%. Momentum Health is raising rates by 7.9%. Both framed the increases as a response to mounting medical inflation. Discovery: 8.2% on average DHMS contributions will rise between 7.4% and…
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Discovery earnings growth strengthens
Discovery earnings growth strengthened in its latest financial year as investments in banking, health and international operations increasingly translated into profit and cash generation. The group reported a 17% increase in normalised operating profit to R17.75 billion. Cash conversion reached 85%, while the full-year dividend increased 33% to 384 cents per share. Discovery’s share price has also reflected growing investor…
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Discovery Group Results: Profit Climbs 17% to R17.75bn
Discovery Group results for the year to 30 June 2026 show normalised profit from operations up 17% to R17.75bn. This growth was driven by its South African businesses and the international Vitality operations. The group also lifted its final ordinary dividend 36% to 273 cents per share. Headline earnings rose 34% and normalised headline earnings 21%. Meanwhile, normalised return on…
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Young adult mental health claims rise 80%
Young adult mental health is becoming an increasingly important driver of healthcare demand in South Africa. This is according to Discovery Health’s HealthTrend26 report. Among members aged 18 to 30, the prevalence of mental health claims has increased by 80% over the past decade. The report draws on more than 60 million life-years of clinical, lifestyle and behavioural data. It…
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Extensior Launch Cuts Ozempic Cost By 15%
Novo Nordisk will launch Extensior in South Africa on 31 July. The medicine contains the same active ingredient as Ozempic but will cost about 15% less. The lower price could reduce monthly expenses for patients who pay for semaglutide themselves. However, the discount is unlikely to persuade medical schemes to expand funding for the costly diabetes treatment. Extensior will be…
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Discovery Health Membership Growth and Challenges Ahead
Discovery Health Medical Scheme must recruit between 280,000 and 290,000 new members each year to maintain its current membership base. Discovery Health CEO Dr Ron Whelan disclosed the target at the scheme’s recent annual general meeting. He said the high recruitment requirement was necessary because of significant annual membership churn. DHMS is South Africa’s largest open medical scheme. At the…
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DHMS AI Prompts Drive Higher Screening Rates Among Members
Discovery Health Medical Scheme members who have opted into an AI-driven health guidance programme are significantly more likely to complete routine health checks and cancer screenings than members who have not enrolled. This is according to preliminary findings from Discovery Health. These results may be influenced by the effective use of DHMS AI Prompts within the programme. The results support…
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Discovery Health Claims Reversal follows member outcry
Discovery Health Medical Scheme (DHMS) has reversed its controversial decision regarding claims overpayments. The administrator will now cover the costs after sustained member outcry and mounting public pressure. This marks a significant shift in strategy. The provision protects members on the scheme’s high-end plans Impact of Discovery Health Claims Processing Errors The issue centres on a processing mistake. This error…
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Discovery Health Claims Error Triggers Outrage Over Oversight
A year-long administrative failure at Discovery Health Medical Scheme (DHMS) has sparked mounting frustration among members, as the scheme begins recovering erroneous payments from policyholders. The Discovery Health claims error, which went undetected for 12 months, has affected an estimated 16,000 members across five high-end plans. The administrator, Discovery Health, is now requesting repayment of substantial amounts, some exceeding R68,000.…
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GLP-1 Weight Loss Drugs Reshape Obesity Care In South Africa
South Africa’s fight against obesity has entered a decisive phase, driven by a surge in the medicalisation of treatment through GLP-1 weight loss drugs. In early 2026, two major medications, Mounjaro (tirzepatide) and Wegovy (semaglutide), have received key regulatory approvals, marking a new chapter in primary healthcare. With nearly 4.5 million South African adults living with obesity, the shift comes…