CMS regulates 75 registered medical plans in 2021, up from 76 in 2020.

The group noted that South Africa has seen steady consolidation of the medical aid market over the past 20 years, driven by a consolidation of voluntary schemes.

South Africa has seen a decline in regimes from 144 regimes in 2000 to 75 regimes reported to be active in 2021, with the largest decline occurring between 2007 and 2010. 75 modes reported in 2021, 18 open and 57 restricted.

Although the number reported for the year was 75 plans, the board noted that Hosmed Medical Scheme has merged with Sizwe Medical Fund, and Quantum Medical Aid Society has merged with Discovery Health Medical Scheme, bringing the total number of programs. active program to 73 in December 2021

The council said the industry as a whole has seen a drop in the number of health plans, but breaking down health plans by plan size also shows a significant shift.

Small plans exceeded medium and large plans from 2002 to 2013. While the number of medium plans increased slightly in recent years, the number of large plans decreased.

The number of beneficiaries covered by health plans has remained stagnant over the past decade, not exceeding the nine million mark. Health plans serve 8.94 million beneficiaries in 2021, up slightly from 8.9 million in 2020, but down from a peak of 8.99 million in 2019.

The only significant environmental increase came after the introduction of GEMS in 2006. By 2021, GEMS has crossed the 700,000 mark, with 773,512 core members and its beneficiaries now exceeding 2 million. people, or 2,036,102.

The proportion of beneficiaries covered by health plans, expressed as a percentage of the country’s population, decreased during the period under review, from 16% in 2000 to 14.86% in in 2021.

Open plans represent more than half of health plan costs. population (54.03%), while restrictive diets account for the remainder (45.97%) in 2021. 0.55% respectively – compared to last year.

Open plans have 2,351,958 members and 4,835,649 beneficiaries, the balance is registered for limited plans.

Discovery continues to lead the health plan industry in South Africa, with over 1.3 million members and 2.7 million beneficiaries. Notably, amid the overall decline in beneficiaries in open programs in South Africa, Discovery’s numbers remained stable, losing just 106 beneficiaries.

The second largest open plan in the country, Bonitas Medical Fund, saw a slight decrease of 0.3% in the number of beneficiaries to just under 715,000, however, the number of members increased by 1.4%.

The Public Employee Health Program remains the largest limited program with 1.92 million beneficiaries, also the second largest in the nation.

The table below shows the 20 largest health plans in the country, ranked by number of beneficiaries.