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The world of medical schemes is a changing one. Here are some quick facts on schemes in SA which all scheme members should really know.
1. The Medical Schemes Act of 1998 regulates the operation of medical schemes in South Africa, and the Council for Medical Schemes is the industry’s regulatory body.
2. In the year 2000 there were 144 registered medical schemes and at the end of 2014 there were 83 – a decrease of 42%. This includes both restricted and open schemes. During these 15 years the number of open schemes decreased by 51% and the number of restricted or closed schemes by 38%.
3. While there are fewer registered schemes, there were 1.4 million more principal members and 2.2 million more beneficiaries in 2014 compared to the year 2000. It is thought that financial pressure contributed to the fact that principal members added fewer beneficiaries during 2014.
4. In total by the end of 2014 there were 3.9 million principal members of medical schemes in SA and 8.8 million beneficiaries in SA. Of these 58.5% were members of open schemes.
5. The Council for Medical Schemes (CMS) requires a scheme to have 6000 members in order to be registered. The larger a scheme, the smaller is the financial impact of one or two high-claiming members.
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