An extraordinary medicine price increase could add R1bn to medical schemes’ costs in 2027, after schemes submitted their budgets. The Health Department announced the additional 2.88% single exit price (SEP) adjustment on 30 September, effective from 1 October. It cited cost pressures for pharmaceutical manufacturers, including geopolitical tensions. The adjustment follows an earlier 1.47% increase in 2026. Although annual increases…
Tag: GEMS
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Mental Healthcare Access: A Rising Challenge Today
Depression costs at GEMS rose 198% since 2019, and experts say mental healthcare must be easier to access and integrated into primary care. Rising demand for mental healthcare is driving sharp cost increases, with the Government Employees Medical Scheme (GEMS) paying R2.75bn for depression treatment in 2025. That is a 198% increase on the R923.9m it paid in 2019. Metropolitan…
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GEMS principal officer suspended
The Government Employees Medical Scheme (GEMS) has placed its principal officer, Stan Moloabi, on precautionary suspension while it completes an internal administrative process. GEMS confirmed the decision on Tuesday but did not disclose the nature of the process. Moloabi also confirmed his suspension. The scheme has appointed its chief operating officer, Dr Vuyo Gqola, as acting principal officer. Meanwhile, the…
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Parmed Medical Aid Reform Bill Moves Through Parliament
The National Assembly is considering legislation that could end compulsory membership of the Parmed Medical Aid Scheme for MPs, judges and other public office-bearers. ActionSA MP Dr Kgosi Letlape introduced the private member’s bill. It proposes amending the Parliamentary and Provincial Medical Aid Scheme Act of 1975. Under the amendment, eligible officials would be allowed to remain with Parmed, move…
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GEMS Contribution Increase Sparks Union Backlash
Public sector unions have criticised the Government Employees Medical Scheme after it failed to secure approval for a lower increase in member contributions. GEMS asked the Council for Medical Schemes to reduce its average increase to 7.5% from July 2026. However, the regulator rejected the proposal. The decision means members will continue paying contributions based on the approved average increase…
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Netcare Growth Expectations Cut After GEMS Benefit Changes
Private hospital group Netcare has trimmed its full-year outlook. This decision follows sudden benefit adjustments by the Government Employees Medical Scheme (GEMS). South Africa’s largest medical scheme for public sector workers introduced strict cost-cutting measures. These alterations will inevitably impact patient volumes across the private hospital sector. Why Netcare Growth Expectations Were Revised Downwards The scheme’s popular Tanzanite One option…
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Rising Medical Aid Premiums Ignite Unions Over Healthcare Costs
South Africa’s two major union federations, Cosatu and Fedusa, have escalated their warning that the country’s healthcare funding model is pricing workers out of cover. They argue that the current approach is “unsustainable, too expensive and failing workers”. Health Minister Aaron Motsoaledi has acknowledged the scale of the problem. He agrees that the model is inappropriate and that medical aid…
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GEMS Medical Aid Increases: Scheme Battles Record Claims
The Government Employees Medical Scheme (GEMS) is facing a significant financial crossroads. It has recently paid out in a single year what some of South Africa’s largest private insurers distributed over a quarter of a century. This unprecedented surge in claims has triggered mandatory increases to GEMS Medical Aid for members, effective from 1 April. Rising Costs Amid Financial Pressure…
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GEMS Contribution Increases Spark Talks With Unions
GEMS is currently the largest restricted medical scheme in South Africa. It serves nearly 2.45 million beneficiaries. Membership is strictly limited to public servants and their dependants. To encourage membership, government departments provide subsidies of up to two-thirds of the monthly cost. However, this benefit is only available to those who remain with GEMS. The current conflict stems from GEMS’…
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GEMS Contribution Increase Sparks Union Backlash
Trade unions in the Public Service Co-ordinating Bargaining Council (PSCBC) have rejected the Government Employees Medical Scheme’s (GEMS) decision to raise member contributions in 2026. The scheme implemented a 9.8% increase from January 2026. It will then apply a revised 9.5% increase from 1 April 2026. Unions say the hikes are economically unjustifiable and socially regressive. They argue the increases…
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GEMS Tariff Intervention Underway Amid Affordability Concerns
The South African government has stepped into the controversy surrounding sharp increases in contributions to the Government Employees Medical Scheme (GEMS). Public Service and Administration Minister Mzamo Buthelezi told Parliament that officials will engage with GEMS trustees regarding what he called “unaffordable tariffs.” This follows a 9.8% hike in GEMS member contributions this year, on top of a 13.4% increase…