Medical aids in decline

REPORT: SHARP DROP IN COVERAGE WITH ONLY 14.7% OF POPULATION COVERED

- Roy Cokayne

Only 14.7% of South Africa's total population was covered by medical aid schemes last year, according to the latest Council for Medical Schemes (CMS) Industry Report.

It said the proportion of beneficiaries covered by medical schemes, relative to the national population, decreased to this level from 16% in 2000.

The report said this decrease occurred despite growth in medical aid beneficiaries from 9 039 259 in 2022 to 9 127 453 last year. However, the 2023 version of the report is noteworthy more for what it excludes than what it includes.

Information on the financial health of SA's medical aid schemes is missing from the 2023 report, including the solvency ratio of schemes.

This ratio refers to the accumulated funds of a scheme as a percentage of its gross annual contributions and indicates which schemes appear to be in financial trouble or heading in that direction.

Schemes are required in terms of the Medical Schemes Act to maintain their solvency ratio at or above 25%, the minimum statutory prescribed solvency level.

Delays

CMS spokesperson Stephen Monamodi told Moneyweb significant changes had to be made to the CMS statutory returns because of the implementation of the new accounting standard.

Monamodi said the development and testing of the data collection tool was significantly delayed, which resulted in the CMS only receiving the 2023 financial statements submissions at the beginning of November 2024, compared to the normal end-of-April submission date.

"CMS is therefore currently occupied with analysing the audited annual financial statements, and it is anticipated that the financial section of the industry report will only be published during March 2025," he said.