October 15, 2021

This is how many people left South Africa’s biggest medical aid schemes in the last year

The Council for Medical Schemes (CMS) has revealed its annual trade report, exhibiting how South Africa’s registered medical schemes navigated the Covid-19 pandemic in 2020, and how they fared in phrases of membership.

In keeping with the CMS, the general medical aid trade noticed Covid-19 claims to the worth of R10.1 billion in 2020. There have been 422,894 members of medical schemes contaminated with Covid-19 in 2020, and out of that quantity, 383,585 recoveries, representing a mortality fee of three.02%.

These numbers are primarily based on knowledge from 73 schemes, representing 99.84% of medical scheme beneficiaries, it stated.

South Africa now has 76 registered medical schemes, two fewer than in 2019 on account of two mergers. Topmed Medical Scheme amalgamated with Fedhealth Medical Scheme on 1 August 2019, and Selfmed Medical Scheme amalgamated with Compcare Wellness Medical Scheme on 1 September 2019.

These 76 schemes had a complete subscription of 8.89 million beneficiaries in 2020, down from 8.99 million in 2019 – a year-on-year lower of 1.15%.

The variety of beneficiaries lined by restricted schemes grew by 45,525 beneficiaries, and the variety of beneficiaries lined by open schemes declined by 148,752 beneficiaries between 2019 and 2020 – a web lack of 103,227 beneficiaries throughout all schemes.

Biggest winners and losers

Discovery stays the largest medical scheme in the nation, with 1.33 million members and a pair of.76 million beneficiaries. This is adopted by the Authorities Workers Medical Scheme (GEMS) with 750,000 members and over 1.96 million beneficiaries.

The desk beneath outlines the 15 biggest open and restricted schemes.

Scheme Kind 2020 Members 2020 Beneficiaries
Discovery Well being Medical Scheme Open 1 330 513 2 758 340
Authorities Workers Medical Scheme (GEMS) Restricted 750 935 1 963 758
Bonitas Medical Fund Open 333 141 710 157
South African Police Service Medical Scheme (POLMED) Restricted 174 447 502 631
Momentum Medical Scheme Open 152 228 293 457
LA-Well being Medical Scheme Restricted 89 041 222 882
Bankmed Restricted 106 467 218 930
Bestmed Medical Scheme Open 97 335 204 399
Medihelp Open 89 056 194 941
Medshield Medical Scheme Open 75 285 150 975
Fedhealth Medical Scheme Open 74 494 143 970
Sizwe Medical Fund Open 48 213 115 156
Platinum Well being Restricted 52 062 92 255
Sasolmed Restricted 28 953 77 002
SAMWUMed Restricted 34 403 75 342

Discovery Well being, which accounts for the lion’s share of the open scheme market, registered a lack of almost 50,000 beneficiaries (-49,770 beneficiaries), adopted by Fedhealth and Bonitas.

“Covid-19 undoubtedly negatively impacted the exposure data, with many individuals being laid off or losing their jobs, resulting in many members being unable to afford private health care,” the CMS stated.

Being the largest medical scheme, Discovery’s bigger lack of beneficiaries is smart – nevertheless, it solely represents a 1.8% decline in the general quantity. A smaller medical scheme, like Thebemed, by comparability, suffered a bigger loss, relative to its whole beneficiaries (-28.5%).

The tables beneath define the 10 medical schemes which noticed the biggest drop in beneficiaries in 2020, and the 10 schemes which noticed the biggest enhance.

Scheme 2019 Beneficiaries 2020 Beneficiaries Change
Discovery Well being Medical Scheme 2 808 106 2 758 340 -49 766
Fedhealth Medical Scheme 156 904 143 970 -12 934
Bonitas Medical Fund 722 943 710 157 -12 786
Medihelp 204 305 194 941 -9 364
Thebemed 29 040 20 750 -8 290
Medshield Medical Scheme 158 996 150 975 -8 021
Momentum Medical Scheme 298 852 293 457 -5 395
South African Police Service Medical Scheme (POLMED) 507 764 502 631 -5 133
Transmed Medical Fund 34 703 30 211 -4 492
Motohealth Care 41 615 37 140 -4 475
Scheme 2019 Beneficiaries 2020 Beneficiaries Change
Authorities Workers Medical Scheme (GEMS) 1 892 295 1 963 758 +71 463
LA-Well being Medical Scheme 208 258 222 882 +14 624
Bestmed Medical Scheme 199 297 204 399 +5 102
Sizwe Medical Fund 111 409 115 156 +3 747
Platinum Well being 88 724 92 255 +3 531
Profmed 72 850 74 822 +1 972
SAMWUMed 73 570 75 342 +1 772
Makoti Medical Scheme 7 746 9 300 +1 554
Keyhealth 67 476 68 702 +1 226
Constructing & Development Trade Medical Aid Fund 11 092 11 727 +635

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