The Council for Medical Schemes’ latest annual report shows that the Discovery Health Medical Scheme (DHMS) remains the biggest in the country, despite having lost almost 50 000 beneficiaries in 2020, and also stands out as having the highest administration fees of all schemes.
The report detailed medical scheme membership movements between the end of 2019 and the end of 2020. Following DHMS’s 49,770 beneficiary loss was Fedhealth, which lost 13,015 beneficiaries. Bonitas lost 12,858.
The relatively unknown smaller schemes, conversely, had high overall growth in beneficiaries in the middle of a pandemic, reports News24, with Makoti Medical Scheme growing beneficiaries by 20.3%; LA-Health Medical Scheme gaining 7.1% more people and Building & Construction Industry Medical Aid Fund’s beneficiaries swelling by 5.9%.
Of the bigger schemes, only the Government Employees' Medical Scheme (GEMS) stood out by registering 71,463 more beneficiaries, a 3.8% growth year-on-year.
The CMS data showed that the total number of registered medical schemes in South Africa has consistently declined over the past 10 years, dropping from 144 in 2000 to just 76 in 2020. Despite its loss of beneficiaries, DHMS covered almost 2.8m people at the end of 2020; GEMS had more than 1.9m beneficiaries, and the third-biggest scheme, Bonitas, had just more than a quarter of DHMS’s market share at 714,989 beneficiaries.
DHMS also boasted the highest administration fees at R336.84, the industry average for open schemes being R305.54 per average member per month.
Of the three fastest-growing medical schemes last year, LA-Health was the biggest in terms of people covered by the scheme. It is as big as Bankmed and bigger than Bestmed and Medshield. But like DHMS, it also has higher admin fees than most of its peers in the restricted schemes arena, save for Profmed.
Beneficiaries covered by medical schemes now comprise 14.78% of SA’s population, declining from 16% in 2000.
News24 article – Medical schemes: The biggest winners and losers in 2020 (Open access)
Full CMS Industry Report 2020 (Open access)
See more from MedicalBrief archives:
Agility Health: How responsible are medical schemes’ funding models for next year?
HPCSA"s presentation on medical schemes’ role in NHI was 'incoherent'
Big Three schemes dominance is bad news for medical consumers
Medical scheme membership becomes unaffordable to many