Tag: Council for Medical Schemes (CMS)

Medical aid contribution increases for 2026 are generally lower than the sharp hikes seen in 2025. This offers some relief to members after last year’s double-digit adjustments.

There is a lot of confusion and misunderstanding when it comes to medical aid versus medical insurance, and where hospital plans fit in, and this can make it difficult to decide what the best solution is to meet your needs. The reality is that they are not the same, and you cannot actually compare them, as they offer completely different benefits and serve different purposes.

In the case of Keyhealth Medical Scheme v the Honourable Mr Justice SM Ngoepe N.O, the Registrar of Medical Schemes and William Reed, Case Number: A203/2021, a full bench of the Pretoria High Court held that prescribed minimum benefits (PMBs) must not be paid from a member's personal medical savings but must be paid from the medical scheme's PMB risk pool. 

The Medical Schemes Act (MS Act) requires a person to be accredited by the Council for Medical Schemes (CMS) as a broker, before being allowed to provide “broker services”. The MS Act defines “broker services” as the provision of service or advice in respect of access to or benefits offered by a medical scheme.

Brokers are a feature of the medical schemes market and subject to extensive regulation in terms of the Medical Schemes Act, its regulations, and circulars issued by the Council for Medical Schemes (CMS). The CMS has announced it intends to revise Circular 20 of 2010, the prevailing circular dealing with brokers and has called for public comment.

The recent presentation at the Board of Healthcare Funder’s annual conference by Christoff Raath, joint-CEO of Insight Actuaries, should garner wide support from the private healthcare industry. Raath quite rightly lamented the incredibly slow pace and prevaricating by the Council for Medical Schemes (CMS) in developing lower cost medical scheme options that could introduce millions more members into the private health sector.

Many South African’s feel the economic impact of the pandemic, which has ultimately affected their pocket. People are forced to make difficult decisions in order to rearrange their finances to suit their current financial constraints. 

As South Africa braces itself to reach the peak in the fight against the coronavirus pandemic, Government statistics have shown that the country could reach 400,000 infections by mid-July. While lockdown conditions may have been eased to level 3 for now, South Africa, and much of the world, is nowhere near the end of the pandemic, and the economic and health repercussions of COVID-19 are going to persist for months to come.

The circular released on the 10th April 2020 by the Council for Medical Schemes (CMS) entitled 'COVID-19 Medical Schemes Industry Guidelines' outlines the relief measures which schemes may offer their members – individuals and employer groups – detailing what they can and can’t do to alleviate the economic suffering during this pandemic and lockdown period.

While people who contract COVID-19 (corona virus) who are under the age of 80 and do not have any pre-existing conditions - such as cardiovascular disease, diabetes, chronic respiratory disease, hypertension or cancer - are most likely to experience only flu-like symptoms, those who are over 80 years’ of age or individuals with pre-existing conditions are certainly at a much greater risk.