Sizwe Hosmed Medical Fund
Open scheme · Under provisional curatorship (Gauteng High Court, Sep 2025) · Administered by 3Sixty Health
Overview
Sizwe Hosmed Medical Fund is a registered open medical scheme regulated by the Council for Medical Schemes under the Medical Schemes Act 131 of 1998. The Fund was formed in November 2021 from the amalgamation of two established schemes: Sizwe Medical Fund (previously one of South Africa's larger mid-tier open schemes, historically strong in the employer group and low-cost market) and Hosmed Medical Aid Scheme.
Important — current regulatory status: The Gauteng High Court placed Sizwe Hosmed under provisional curatorship in September 2025, appointing Lebogang Grace Mpakati as provisional curator, following sustained solvency concerns and regulatory non-compliance. The curator's mandate includes advising on the Fund's future — which may include wind-down, amalgamation with another scheme, or stabilisation. Prospective members should review the latest CMS communications and curator updates at sizwehosmed.co.za before considering any application to the Fund.
3Sixty Health (an AfroCentric subsidiary) administers the Fund under curator oversight. Despite the curatorship, Sizwe Hosmed continued to offer benefit options for 2026 with a 5% benefit increase and no contribution increase for January 2026, per curator decision.
Source: IOL — "Gauteng High Court places Sizwe Hosmed Medical Scheme under provisional curatorship" (4 Sep 2025); Moonstone — "Provisional curator to advise on future of medical scheme"; IOL — "Sizwe Hosmed Medical Scheme faces challenges but curator remains optimistic" (8 Nov 2025).
Membership Profile
Sizwe Hosmed was formed from the November 2021 merger of Sizwe Medical Fund and Hosmed Medical Aid Scheme — both established, mid-tier open schemes with roots in the employer group and municipal/government-adjacent market. At the time of the merger, the combined entity was positioned as a significant player in the accessible-cover and low-cost segment of the open scheme market, particularly for employer groups in the non-financial private sector and certain public-sector-adjacent employers.
However, membership has declined substantially since the merger. At December 2023, Sizwe Hosmed reported 58,269 principal members and 138,507 beneficiaries — at that point the eighth-largest open scheme by membership. The subsequent period saw further membership contraction, with the Fund failing to maintain accreditation with the South African Local Government Bargaining Council (SALGBC) for the 2026 year — a significant loss of an employer group channel.
Open to all South African residents
Sizwe Hosmed is technically open to any South African resident — standard Medical Schemes Act waiting periods apply — but given the curatorship and declining membership trend, prospective members should obtain current curator communications before applying.
Source: IOL — Provisional curatorship (Sep 2025); IOL — Curator update (Nov 2025); Moneyweb — "Two medical schemes fail to maintain prescribed solvency ratio".
Financial Health
Sizwe Hosmed's solvency trajectory since the 2021 merger has been one of consistent deterioration. Starting from 36.5% at the November 2021 merger, the statutory solvency ratio fell to 25.4% by November 2022, crossed below the mandatory 25% minimum in early 2023, and has continued declining. The most recently publicly reported figures are approximately 5.6% (June 2025) and 6.62% (July 2025) — far below the 25% minimum required under Regulation 29(2) of the Medical Schemes Act.
The Fund's solvency collapse was driven by a combination of factors: adverse claims experience post-merger, membership contraction reducing the premium base, higher-than-anticipated administration and integration costs following the Sizwe/Hosmed amalgamation, and the compounding effect of each year's deficit on reserves.
The provisional curator's mandate from the Gauteng High Court is to advise on the Fund's future — which could include: continued trade and stabilisation; amalgamation with another scheme; or an orderly wind-down under CMS supervision. Under any scenario, existing members retain their Prescribed Minimum Benefit entitlements under the Medical Schemes Act.
Source: Moneyweb — "Two medical schemes fail to maintain prescribed solvency ratio"; IOL — "Sizwe Hosmed Medical Scheme faces challenges but curator remains optimistic" (8 Nov 2025); IOL — Provisional curatorship (Sep 2025).
Plans & Options
Sizwe Hosmed continues to offer benefit options for 2026 under curator supervision. The 2026 product range includes a 5% benefit increase applied from 1 January 2026, with no corresponding contribution increase. Plans cover the spectrum from hospital-only through to comprehensive cover, maintaining the core range established before the curatorship.
Given the curatorship, the 2026 plan range and benefit details should be confirmed directly with Sizwe Hosmed or the curator's communications at sizwehosmed.co.za, as changes may be implemented during the curatorship period.
| Plan tier | Category | Network model | Key feature |
|---|---|---|---|
| Hospital option | Hospital-only | Network (DSP) | In-hospital events only; 27 PMB CDL conditions |
| Savings option | Hospital + MSA day-to-day | Hybrid | Medical savings account for day-to-day; hospital cover |
| Standard option | Traditional comprehensive | Hybrid | Structured day-to-day; chronic list; specialist access |
| Comprehensive option | Full comprehensive | Broader network | Higher benefit limits; broader day-to-day and chronic cover |
Source: Sizwe Hosmed 2026 Benefits; IOL — Curator update (Nov 2025).
Key Benefits & Differentiators
PMB cover protected regardless of solvency. Existing Sizwe Hosmed members retain full Prescribed Minimum Benefit (PMB) entitlements under the Medical Schemes Act, regardless of the Fund's solvency position or curator status. The CMS ensures PMB obligations are honoured even in the event of a scheme under curatorship. This is the most important benefit protection for current members to understand.
Low-cost focus heritage. Prior to its financial difficulties, Sizwe (the pre-merger entity) was well-established in the accessible-cover and low-cost employer group market. The scheme was known for network-based plans at contribution levels accessible to lower-income workers — a positioning that attracted employer groups in the manufacturing, retail, and services sectors.
27 PMB Chronic Disease List conditions. All plans cover the 27 CDL conditions at legislated cost. Chronic disease management support is included in the standard administered-scheme protocols via 3Sixty Health.
5% benefit increase for 2026 at 0% contribution increase. The curator's decision to maintain a contribution freeze while implementing a 5% benefit increase for 2026 provides some short-term value protection for existing members, though this decision must be viewed in the context of the Fund's overall financial position.
Source: IOL — Curator update (Nov 2025); Medical Schemes Act 131 of 1998, PMB regulations; sizwehosmed.co.za.
Wellness & Loyalty
Sizwe Hosmed offers a wellness benefit on all plans, covering standard preventive screenings and health assessments. The Scheme does not operate a separate points-based wellness rewards programme. Under curatorship, wellness programme continuity should be confirmed with the Fund directly.
Source: sizwehosmed.co.za wellness pages.
Claims & Service
Administration is run by 3Sixty Health (AfroCentric), which handles claims processing, pre-authorisation, and member services on behalf of the Fund. Under curatorship, 3Sixty Health continues this function under the curator's oversight. Members can submit claims via the member portal, email, and through provider direct-billing with network hospitals and specialists.
Disputes regarding claims should be directed to Sizwe Hosmed's member services channel first. The Medical Schemes Act process (internal dispute → CMS adjudication) remains available to members under curatorship. For matters related to the Fund's future or curator decisions, members should monitor the official curator communications at sizwehosmed.co.za.
Source: sizwehosmed.co.za; IOL — Curator update (Nov 2025).
How the Scheme Is Set Up
Current Sizwe Hosmed members should be aware of the following: PMB cover is protected regardless of the curatorship. Monitor curator communications and CMS updates closely. If the Fund is wound down or amalgamated, the CMS and curator will communicate the process for transitioning to another scheme. Medical Schemes Act portability provisions protect existing conditions in any transfer scenario.
Prospective members should approach any new application with caution. With the Fund at 6.62% solvency and under provisional curatorship, the risk of a forced wind-down or amalgamation is material. If you are not currently a member, AURA presents considering financially stable open-scheme alternatives unless there is a specific employer-group or benefit reason to prefer Sizwe Hosmed.
Employer groups that currently use Sizwe Hosmed as their employer medical scheme should review their obligations to employees under a curatorship scenario and engage directly with the curator for guidance on their specific arrangements.
Source: IOL — Provisional curatorship (Sep 2025); IOL — Curator update (Nov 2025); Medical Schemes Act 131 of 1998.