FEATURES

SOUTH AFRICA’S LARGEST MEDICAL SCHEMES5

There were 79 medical schemes in South Africa at the end of 2018, according to the 2018/19 annual report by the Council for Medical Schemes, down from a high of 146 in 2001. Of the 79 existing schemes, 21 are open schemes, meaning their membership is open to the public, and 58 are restricted schemes, which means they serve only certain industries or organisations. In total, almost nine million South Africans belonged to a medical scheme, either as a member or as a dependant. About four million belonged to restricted schemes and about five million to open schemes. The five biggest schemes by number of beneficiaries (members and dependants) at the end of 2018 comprised two restricted schemes and three open schemes. Among them they service over two-thirds of the market.

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DISCOVERY HEALTH MEDICAL SCHEME

Discovery, an open scheme, with 2.8million beneficiaries, is the biggest scheme in South Africa. Its net assets at the end of 2018 were R17.6billion. The average age of its beneficiaries was 33.98 years, and 9.06% of its beneficiaries were pensioners. In 2018, 88.43c of each rand in members’ contributions went towards health care benefits.

GOVERNMENT EMPLOYEES MEDICAL SCHEME (GEMS)

This closed scheme for government employees is the second-largest scheme in the country, with 1.8 million beneficiaries. Its net assets at the end of 2018 were R9.5billion. The average age of its beneficiaries was 30.73 years, and 6.24% of its beneficiaries were pensioners. In 2018, 86.64c of each rand in member contributions was spent on health care for members.

BONITAS MEDICAL FUND

Bonitas is South Africa’s second-largest open scheme, with 713 190 beneficiaries. Its net assets at the end of 2018 were R4.1 billion. The average age of its beneficiaries was 34.60 years, and 9.53% of its beneficiaries were pensioners. In 2018, 91.12c of each rand contributed by members went towards their health care.

SA POLICE SERVICE MEDICAL SCHEME (POLMED)

This closed scheme for SAPS members had 502 996 beneficiaries at the end of 2018. Its net assets amounted to R4.0 billion. The average age of its beneficiaries was a young 27.60 years, and only 3.10% of the beneficiaries were pensioners. In 2018, the scheme spent 102.12c on healthcare for each rand contributed by members, which means the scheme was losing money.

MOMENTUM HEALTH

This open scheme operated by the Momentum Metropolitan group had 298 071 beneficiaries at the end of 2018. Its net assets were R1.1 billion. The average age of its beneficiaries was 32.99 years, and 8.41% of its beneficiaries were pensioners. Of each rand that members contributed in 2018, 92.97c went towards their healthcare.