Medical aid remains central to accessing private healthcare in South Africa, but members can no longer assume it will cover the full cost of treatment. In 2026, increases in medical scheme contributions have continued to put household budgets under pressure. Healthcare cost inflation is also running well above consumer inflation, while many scheme options have introduced more co-payments, sub-limits and…
Tag: Medical Schemes
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Health Insurance Growth Reshapes Private Healthcare Market
Health insurance is now the fastest-growing segment of South Africa’s private healthcare market, driven by consumers seeking more affordable options than traditional medical aid. Momentum Health estimates the health insurance market is growing by 14% to 16% annually, significantly outpacing the largely stagnant medical scheme sector. Over 1.2 million principal members now hold health insurance policies, covering nearly 2 million…
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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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Shingrix launch in South Africa Raises Access Concerns
A more effective shingles vaccine is expected to become available in South Africa by the end of June 2026. However, its price and planned private-sector launch could place it beyond the reach of many patients. Shingrix is manufactured by pharmaceutical company GlaxoSmithKline, or GSK. The South African Health Products Regulatory Authority recently registered the vaccine. SAHPRA registration means Shingrix can…
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Bonitas Tender Dispute Puts Scheme Governance Under Spotlight
The Bonitas Tender Dispute has placed fresh scrutiny on major operational changes at South Africa’s second-largest open medical scheme. The legal matter between Medscheme and Bonitas Medical Scheme was expected to be heard this week. It has now been postponed again. At the centre of the case are four tenders. These shifted key Bonitas functions away from Medscheme and other…
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Medical Scheme Financial Pressure Escalates As Costs Soar
South Africa’s private healthcare sector is facing a severe sustainability crisis. According to a new report by Alexander Forbes Health, the medical scheme industry is trapped in a tightening financial vice. Rising provider fees, escalating utilisation, and rapid technological advances are driving up the cost of care across the board. Paresh Prema, the head of technical and actuarial consulting at…
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Excessive Dialysis Product Pricing: Adcock Ingram Referred
South Africa’s Competition Commission has referred pharmaceutical manufacturer Adcock Ingram’s hospital division to the Competition Tribunal for prosecution over alleged excessive pricing of kidney dialysis products. The referral, announced on 3 June 2026, targets Adcock Ingram Critical Care (AICC) and covers pricing for peritoneal dialysis and continuous renal replacement therapy (CRRT) products between July 2019 and June 2024. The commission…
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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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Concourt Ruling Strips Government Of Private Sector Controls
South Africa’s National Health Insurance (NHI) project has suffered a significant legal setback. The recent ConCourt Ruling confirmed that key provisions in the National Health Act are unconstitutional and invalid. The unanimous judgment was written by Justice Kate Savage. It upheld a high court order declaring sections 36 to 40 of the National Health Act inconsistent with the Constitution. These…