Three medical schemes, Medihelp, Sizwe Hosmed Medical Scheme, and Transmed Medical Fund, did not maintain their solvency ratios at or above the statutory minimum of 25% in 2023, according to the latest Council for Medical Schemes (CMS) Financial Performance Industry Report 2023. – Moneyweb (16 May 2025)
Transmed Medical Fund improved its solvency ratio to 23.79% in 2023 from 17.7% in 2022. However, this marks at least the fourth consecutive year it has failed to meet the 25% threshold, having recorded ratios of 19.72% in 2021 and 22.37% in 2020.
Sizwe Hosmed Medical Scheme’ solvency ratio is down to 15.73% in 2023 from a compliant 25.59% in 2022.
Medihelp’s ratio declined to 23.84% in 2023 from a healthy 33.93% the previous year.
The report noted that the overall industry solvency, while declining from 47.14% in 2022 to 43.45% in 2023, "exceeds pre-Covid-19 pandemic levels" (34.54% in 2018 and 35.61% in 2019) and remains "significantly higher than the minimum required level of 25%”.
According to Dr Musa Gumede, CMS Chief Executive and Registrar a significant factor straining medical schemes is the escalating cost of healthcare. Healthcare claims per average beneficiary per month surged by 8.7% in 2023, from R1,840.48 in 2022 to R2,000.57, continuing a pre-pandemic trend of above-inflation increases.