01/07/2026
The medical schemes regulator has blocked the Government Employees Medical Scheme, GEMS, from cutting its 2026 fee increase to 7.5%. GEMS wanted a lower increase to help members with cost-of-living pressure, and unions backed it. But the Council for Medical Schemes says GEMS is not financially strong enough.
By law, medical schemes must keep a “solvency ratio” of at least 25% as a safety buffer. GEMS is below that. At 7.5%, the scheme would run a deficit and its solvency would drop to 22.9% in 2026 and 21% later, only recovering to 25% by 2030 if fees go up much higher or it saves R2.7 billion. The regulator also says GEMS’ planned savings aren’t guaranteed, and even GEMS’ own actuary couldn’t support the 7.5% cut.
GEMS had already lowered its increase from 9.8% to 9.5% from April with regulator approval, but unions pushed for 7.5% from July before getting permission. The regulator has now said no, and GEMS says it respects the decision but remains focused on affordability for members.