How South Africa's medical schemes really rate.
An objective star rating for the six major open medical schemes — built from official audited data, not testimonials or marketing. Updated when new reports are published.
Overall ranking.
Solvency
61.4%
Claims paid
—
UnratedComplaints / 1,000
—
UnratedMember growth
+2.57%
Accumulated funds solvency ratio 61.4% (well above 25% statutory minimum). Membership growth 2.57% in a stagnant industry. 71,457 principal members; 138,798 beneficiaries. Net surplus R9.8m before amounts attributable to future members.
Solvency
38.6%
Claims paid
95.9%
Complaints / 1,000
—
UnratedMember growth
+2.2%
Solvency 38.6% (down from 41.5% in 2023). Net claims ratio 95.9%. Beneficiaries grew from 715,856 to 731,576 (+2.2%). Per-1000 complaints not yet broken out per scheme — pending CMS Industry Report 2024.
Solvency
32.33%
Claims paid
94%
Complaints / 1,000
—
UnratedMember growth
—
UnratedSolvency 32.33% (well above 25% statutory minimum). 56,018 principal members; 100,357 beneficiaries. 94c of every Rand spent on benefits. AA- Global Credit Rating (18th consecutive year). Loss for year before amounts attributable to future members R89.95m. Investment ROI 13.7%.
Solvency
31.5%
Claims paid
—
UnratedComplaints / 1,000
—
UnratedMember growth
—
UnratedDHMS year-end 2024 solvency ratio of 31.5%, comfortably above the 25% statutory minimum. Higher-than-anticipated investment returns enabled DHMS to defer the 2026 contribution increase by three months — the first such deferral since the COVID pandemic.
Solvency
20.99%
Claims paid
94%
Complaints / 1,000
—
UnratedMember growth
—
UnratedSolvency 20.99% (down from 23.84% in 2023; below 25% statutory minimum — three-year recovery plan approved by CMS). Claims ratio 94% (down 6.8 percentage points). 202,404 beneficiaries; 95,540 main members.
Solvency
—
UnratedClaims paid
—
UnratedComplaints / 1,000
—
UnratedMember growth
—
UnratedMomentum Medical Scheme 2024 audited financial statements have not been published in a publicly accessible per-scheme breakdown at the time of last update. Scorecard pending — refresh once CMS Industry Report 2024 figures are available or scheme publishes its 2024 AFS.
What we measure.
Four metrics, all sourced from the CMS, all weighted transparently. Full methodology & thresholds →
Solvency ratio
30%Reserves the scheme holds, expressed as a percentage of annual contributions. The Council for Medical Schemes requires a minimum of 25%. Higher means a stronger financial buffer to pay future claims.
Claims-paying ratio
30%The percentage of every rand you contribute that gets paid back out as claims to members. Higher means better value flows to you rather than to admin or surplus.
Complaints per 1,000 members
25%The number of complaints adjudicated against the scheme by the CMS Adjudicator's office, per 1,000 average beneficiaries. Lower means happier members and fewer escalated disputes.
Member growth
15%Year-on-year change in total beneficiaries. A scheme growing its membership is generally one members are choosing voluntarily — a useful market-confidence signal.
What these ratings aren't.
- It's not a plan recommendation. A great scheme can offer a plan that's wrong for your family. Use the calculator for that.
- It's not advice. We're not a registered financial services provider. We compile public data so you can compare like with like.
- It's not based on customer reviews. Star ratings on review sites are easy to game. CMS-reported figures are audited, regulated, and consistent across all schemes.
- It's not opinion. The scoring thresholds are fixed and published. Run the same numbers through them, get the same stars.