A regulatory dispute could ensnare thousands of South African health insurance policyholders following a Council for Medical Schemes (CMS) finding that Dis-Chem’s branding breached the Medical Schemes Act. Davizro | iStock/695273346 The CMS ruled that Centriq Insurance Company’s decision to market its MyHealth Core and MyHealth Vital products under the Dis-Chem name amounted to an unauthorised name change. In the…
Tag: Health Insurance
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Discovery and Google partner for Personalised Healthcare
Health and life insurer Discovery has announced a global partnership with Google, harnessing artificial intelligence to transform preventative healthcare. The initiative aims to provide individuals with highly personalised recommendations to improve their health, simultaneously helping to drive down the rising cost of insurance cover. The new platform, dubbed Vitality AI, combines the insurer’s extensive behavioural change expertise with Google Cloud’s…
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‘Mega Gap Claims’ Explode by 512% as Medical Aid Shortfalls Soar
South African medical scheme members are facing an unprecedented financial crisis, as new data reveals that “mega” out-of-pocket gap claims have exploded by 512% in just four years. This alarming trend highlights the soaring medical aid shortfalls patients are forced to pay, driven by specialists charging up to 500% of scheme rates and medical aids systematically reducing benefits. The data,…
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Medical Aid Premiums to Continue Outpacing Inflation
Multiple sources are warning South African consumers to brace for continued high increases in their medical aid premiums. Experts expect costs to keep rising significantly faster than general inflation. The caution comes from Adrian Gore, CEO of Discovery, the country’s largest medical scheme administrator. He suggests that the underlying drivers of medical inflation continue to be a persistent challenge for…
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Weight-Loss Drug Costs Fuel US Employer Healthcare Cuts
More than half of large employers in the United States are planning to reduce their healthcare benefits in 2026. This decision comes as the skyrocketing cost of new weight-loss and specialty medicines puts unprecedented pressure on budgets. The soaring costs of weight-loss drugs are a key concern, according to a new survey. The report, released on Wednesday by consulting firm…
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Medicaid Coverage slashed by US Bill
Leading healthcare organisations have strongly condemned the passage of a major tax-cut and spending bill in the United States, due to proposed Medicaid cuts that directly impact Medicaid coverage. They warn that drastic changes to the nation’s healthcare safety net will cause widespread harm, leaving millions of Americans without medical coverage. Republicans passed a controversial bill late last week focused…
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Medical Scheme Solvency Issues Impacting Members
Three medical aid schemes – Medihelp, Sizwe Hosmed Medical Scheme, and Transmed Medical Fund – did not maintain their medical scheme solvency ratios at or above the statutory minimum of 25% in 2023. This was a key finding in the Council for Medical Schemes (CMS) Financial Performance Industry Report 2023, released last week. While the total number of medical aid…
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Low-Cost Benefit Options Extended Until 2027
The medical schemes regulator has extended low-cost benefit options (LCBOs) for health insurance companies until March 31, 2027. This enables affordable coverage for lower-income households while a formal regulatory framework is still pending. The medical schemes regulator has granted health insurance companies a two-year extension until March 31, 2027. This allows them to operate under a framework that permits low-cost…
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Discovery reports a 34% increase in first-half earnings
Discovery has revealed a robust 34% increase in its first-half headline earnings, showcasing its strong growth trajectory. This surge is primarily attributed to the exceptional performance of its South African health insurance division and the globally recognised Vitality programme. Key Financial Highlights: Headline Earnings: Increased by 34% to R4.35 billion (£234 million) for the six months ending December, rising from…