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…
Tag: Medical Inflation
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Employer Health Insurance Costs To Rise For US Workers In 2027
US workers are likely to pay more for employer-sponsored health insurance in 2027. Large companies are preparing to pass more healthcare costs on to staff. This follows another year of rising medical inflation and prescription drug costs. A Mercer survey of companies with at least 500 employees found that two-thirds of large employers expect to raise monthly health insurance premiums…
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GEMS Solvency Ratio Projected To Fall Below Legal Limit
The Government Employees Medical Scheme (GEMS) expects its financial reserves to be severely strained over the next 18 months. According to newly updated internal projections, the GEMS Solvency Ratio is highly likely to plunge below the statutory minimum requirement of 25%. This may occur by the end of 2026. This looming regulatory non-compliance comes after the scheme’s management capitulated to…
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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 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…
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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…