South Africa Medical Aid Funding Report 2020 with Profiles of Discovery Health, Medscheme, Momentum Health, South African Police Service Medical Aid, Sasolmed, Bestmed and Medshield –

South Africa Medical Aid Funding Report 2020 with Profiles of Discovery Health, Medscheme, Momentum Health, South African Police Service Medical Aid, Sasolmed, Bestmed and Medshield –


DUBLIN–()–The “Medical Aid Funding in South Africa 2020” report has been added to’s offering.

This report focuses on Medical Aid Funding, and includes information on the state and size of the sector, developments and corporate actions of its major players, and influencing factors including regulation and the effect of the coronavirus pandemic.

There are profiles of 31 companies including major administrators such as Discovery Health, Medscheme and Momentum Health, restricted schemes such as the Government Employees Medical Scheme, South African Police Service Medical Aid and Sasolmed, and open schemes such as Bestmed and Medshield.

Medical Aid Funding:

South Africa spends more on private health insurance as a percentage of total health expenditure than almost any other country. Although the sector performs a critical role in the health system, medical scheme membership remains out of the reach of over 85% of the population. Although the details remain unclear, the implementation of the National Health Insurance Fund will invariably affect the public and private healthcare systems, including the medical aid funding sector.


Medical aid premiums continue to rise faster than inflation. In response to the high cost of medical scheme plans, many members opt for cheaper options, which saves them on monthly premiums but increases their out-of-pocket medical expenses. Many scheme members rely on gap cover to mitigate the financial burden of their medical expense shortfalls. South Africa’s poor economic performance has augmented the trend of members downgrading their benefit options without readjusting expectations. Reacting to rising costs and sluggish membership growth, and medical schemes have created bare-minimum hospital plans. There are long-term concerns around the exclusivity of private medical schemes because of their unaffordability for majority of people.

Low-Cost Benefit Options:

The Council for Medical Schemes announced its intention to discontinue low-cost benefit options which target low income market segments. From March 2021, none of the demarcation products that were established in line with the exemption framework will be allowed and no new products will be permitted. Demarcation products include insurance options from as little as R300. These products provide private healthcare access to over 400,000 people. Many insurance providers are appealing the decision.

Key Topics Covered:

1. Introduction

2. Description of the Industry

2.1. Industry Value Chain

2.2. Geographic Position

3. Size of the Industry

4. State of the Industry

4.1. Local

4.1.1. Corporate Actions

4.1.2. Regulations

4.1.3. Enterprise Development and Socio-Economic Development

4.2. Continental

4.3. International

5. Influencing Factors

5.1. Economic Environment

5.2. Government Interventions and Regulations

5.3. Population Health

5.4. Coronavirus

5.5. Input Costs

5.6. Fraud, Waste and Abuse

5.7. Research and Development (R&D), Technology and Innovation

5.8. Labour

5.9. Environmental Concerns

5.10. Cyclicality

6. Competition

6.1. Barriers to Entry

7. SWOT Analysis

8. Outlook

9. Industry Association

10. References

10.1. Publications

10.2. Websites

Appendix – Summary of Notable Players

  • Major Open Medical Schemes
  • Major Restricted Medical Schemes
  • Major Medical Fund Administrators
  • Profiles of Notable Open Medical Schemes
  • Bestmed Medical Scheme
  • Bonitas Medical Fund
  • Discovery Health Medical Scheme
  • Fedhealth Medical Scheme
  • Keyhealth Medical Scheme
  • Medihelp Medical Scheme
  • Medshield Medical Scheme
  • Momentum Health
  • Sizwe Medical Fund
  • Profiles of Notable Restricted Medical Schemes
  • Anglo Medical Scheme
  • Bankmed Medical Scheme
  • Chartered Accountants Medical Aid Fund
  • Government Employees Medical Scheme
  • La-Health Medical Scheme
  • Moto Health Care
  • Nedgroup Medical Aid Scheme
  • Platinum Health Medical Scheme
  • Profmed Medical Scheme
  • Samwu National Medical Scheme
  • Sasolmed Medical Scheme
  • South African Police Service Medical Scheme
  • Transmed Medical Fund
  • Profiles of Notable Medical Fund Administrators
  • 3Sixty Health (Pty) Ltd
  • Agility Holdings (Rf) (Pty) Ltd
  • Discovery Health (Pty) Ltd
  • Medscheme Holdings (Pty) Ltd
  • Metropolitan Health Corporate (Pty) Ltd
  • Momentum Health Solutions (Pty) Ltd
  • Momentum Thebe Ya Bophelo (Pty) Ltd
  • Professional Provident Society Healthcare Administrators (Pty) Ltd
  • Universal Healthcare Administrators (Pty) Ltd

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