The Council for Medical Schemes (CMS) has published its latest medical scheme industry report, detailing the membership numbers and financial status of South Africa’s open and restricted medical aid schemes.

For the 2022/23 period, the CMS regulated 72 medical schemes, down from 75 schemes in the previous year.

South Africa’s medical schemes industry has halved over the last 22 years, with the industry consistently consolidating since 2000. At the start of the new millennium, there were 144 schemes under the CMS’s purview; now, there are only 72.

Over the same time, however, the existing schemes broadened their benefit options from an average of five plans in 2000 to an average of seven in 2022/23.

The number of beneficiaries has also increased, climbing from 6.73 million to 9.04 million over the years.

Over the last year, seven schemes showed significant expansion, the CMS said, with Bestmed, Thebemed, Medihelp, Umvuzo, Platinum Health, Retail Medical Scheme and GEMS, all demonstrating increases in their enrolments and beneficiary numbers exceeding 5%.

Bestmed showed the largest growth, boosting membership by 10%.

On the other side of the business, Sisonke Health Medical Scheme, Transmed, Lonmin, BP Medical Aid, Fedhealth, Motohealth and Cape Medical all saw declines in membership exceeding 5%.

Sisonke and Transmed both saw declines of 12% – the worst performers.

Biggest medical aids

However, outside of growth and declines, Discovery remains the largest medical scheme in the country, with 1.36 million members and close to 2.8 million beneficiaries.

This is an increase from the 1.33 million and 2.7 million seen in the year before.

Most of the country’s medical aid members are subscribed to open (O) schemes, accounting for 2.38 million members and 4.86 million beneficiaries.

Discovery makes up around 58% of these totals.

Restricted (R) medical schemes – which focus on industry-specific or company-specific coverage – make up the balance (1.75 million members and 4.2 million beneficiaries).

In this category, the Government Employee Medical Scheme (GEMS) is by far the biggest player, counting 805,500 members and 2.14 million beneficiaries (around 46% and 51% of restricted members and beneficiaries, respectively).

What is notable about South Africa;s medical scheme landscape is that only seven of 72 schemes have over 100,000 members, and only 13 have over 100,000 beneficiaries.

In fact, the top 10 schemes account for 80% of total membership in the country.

The table below outlines the 20 biggest medical schemes in the country, ranked by the number of beneficiaries.

#	Medical Scheme	Type	Members	Beneficiaries
1	Discovery Health Medical Scheme	O	1 360 045	2 788 312
2	Government Employees Medical Scheme (GEMS)	R	787 480	2 083 603
3	Bonitas Medical Fund	O	353 905	729 904
4	SA Police Service Medical Scheme (POLMED)	R	177 166	491 509
5	Momentum Medical Scheme	O	156 044	296 119
6	LA-Health Medical Scheme	R	94 697	240 457
7	Bestmed Medical Scheme	O	109 806	228 968
8	Bankmed	R	104 728	216 678
9	Medihelp	O	90 871	198 501
10	Sizwe Hosmed Medical Fund	O	63 577	152 421
11	Medshield Medical Scheme	O	72 807	145 710
12	Fedhealth Medical Scheme	O	65 217	122 943
13	Platinum Health	R	56 036	100 964
14	Umvuzo Health Medical Scheme	R	47 888	86 188
15	Sasolmed	R	29 274	77 561
16	SAMWUMed	R	35 715	76 716
17	Profmed	R	36 227	74 589
18	Keyhealth	O	34 736	73 161
19	Chartered Accountants (SA) Medical Aid Fund	R	25 683	47 005
20	Remedi Medical Aid Scheme	R	20 365	45 280

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