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Extension to health insurance companies for LCBOs

03 Apr 2025


The Council for Medical Schemes (CMS) has once more granted health insurance companies a two-year extension until March 31, 2027, allowing them to operate under a framework that allows low-cost benefit options (LCBOs). Business Day (1 April 2025)
“The extension allows 11 licensed insurers to continue operating with fewer restrictions, but no new health insurance licenses have been issued since 2017. The regulations (introduced in 2017) seek to, which are governed by different authorities.
The Board of Healthcare Funders (BHF) lost its court application for medical schemes to offer low-cost benefit options (LCBOs). – Citywire (2 April 2025).
The BHF announced that it would appeal the ruling.
“The BHF argued that the CMS had imposed a moratorium on medical schemes offering LCBOs and did not consider exemption applications from schemes to be allowed to offer these options.
In 2015 the CMS passed a resolution to adopt a framework for LCBOs to be offered by schemes but failed to put this into effect. They now argue that the delay in implementing LCBOs was due to the government’s National Health Insurance (NHI) rollout.

BHF argues that LCBOs could relieve state healthcare by offering primary coverage to low-income workers. However, Minister Aaron Motsoaledi has raised concerns about their practicality and alignment with National Health Insurance (NHI).”

LCBOs are simplified medical aid plans that provide affordable, essential primary healthcare services. They cover day-to-day medical needs and emergency care rather than prescribed minimum benefits (PMBs). 

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