Gap cover, medical schemes and primary healthcare plans are shifting costs between one another, undermining efforts to contain healthcare spending, actuaries have warned. Four Medscheme actuaries presented the findings at the Actuarial Society of South Africa convention in Cape Town.
According to senior actuarial analyst Elizabeth Greyling, prescribed minimum benefits (PMBs) accounted for 70% of healthcare spending on Medscheme-administered schemes in 2025, excluding savings accounts. As a result, schemes have less room for non-PMB benefits. She noted that PMBs have not been regularly reviewed as the law requires.