Formal complaints to the Council for Medical Schemes (CMS) rose by 25.1% in 2025/26, according to the CMS Annual Report. Meanwhile, total benefits paid by medical schemes increased by 8.52% to R259.3bn in 2024. – CMS (7 Oct 2026)
The industry recorded a solvency ratio of 40.87% in 2024; well above the statutory minimum of 25%.
Claims paid per beneficiary rose by 7.84%. and spending on prescribed minimum benefits (PMBs) increased 9.09% to R135.66bn, while out-of-pocket expenditure reached R46.3bn.
Beneficiary numbers grew only slightly, from about 9.13m in 2023 to 9.17m in 2024.
(The CMS oversees 70 medical schemes, comprising 16 open and 54 restricted schemes, covering about 9.17m beneficiaries. Thirty-six administrators support the industry, along with 42 managed care organisations, 7,793 individual brokers, and 2,182 brokerages.)