The Medical Aid Funding Report describes the industry, major players and recent trends. It examines the initial Competition Commission findings and new legislation and factors influencing the sector’s success. It provides comprehensive profiles of 31 medical schemes and fund administrators including the major players in the private and public sector and smaller schemes such as Keyhealth and the Chartered Accountants Medical Aid Fund.
Medical Aid Funding
The South African medical aid funding industry provides cover to over 8.8 million beneficiaries whose gross contributions amounted to R179.8bn in 2017. The total number of registered medical schemes declined from 124 in 2006 to 80 at end-March 2018. Discovery Health is the dominant player with over 2.7 million beneficiaries or around 31% of the total domestic market and over 50% of the open medical schemes segment. The Government Employees Medical Scheme dominates the restricted medical schemes segment with a market share of 47%. Medical scheme membership remains out of the reach of over 83% of the South African population.
The Competition Commission’s health market enquiry and the National Health Insurance (NHI) Bill and the Medical Schemes Amendment Bill are set to shake up the public and private healthcare systems. The medical aid funding industry is characterised by consolidation, contracting medical scheme benefits and rising gross monthly contributions per beneficiary. The industry faces numerous challenges including slowing membership growth and rising healthcare costs.