What happens to health insurance after 31 March 2027?
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In short
- Day-to-day (primary healthcare) and hospital indemnity insurance products count as the business of a medical scheme under the Demarcation Regulations.
- Insurers may sell them only under an exemption from the Council for Medical Schemes. The current exemption framework runs until 31 March 2027.
- No decision on what replaces it had been published when we last checked this page.
Why is there a deadline?
The Demarcation Regulations took effect on 1 April 2017. Under them, a provider of primary healthcare and hospital indemnity products is deemed to be conducting the business of a medical scheme. The Council for Medical Schemes set up an exemption framework as a transitional arrangement while the National Department of Health developed a Low-Cost Benefit Option (LCBO) guideline for medical schemes (CMS Circular 9 of 2025).
How often has it been extended?
| Period | What the CMS did |
|---|---|
| 1 April 2017 to 31 March 2019 | Original two-year exemption framework |
| 1 April 2019 to 31 March 2021 | Renewal framework |
| To 31 March 2022 | Extended by one year because of COVID-19 |
| 1 April 2022 to 31 March 2024 | Automatic two-year extension |
| 1 April 2024 to 31 March 2025 | One-year renewal |
| To 31 March 2027 | Two-year extension, announced 30 March 2025 |
The CMS gave the reason for the latest extension: the Minister of Health published the CMS LCBO report for public comment on 17 February 2025, and the consultation needed time to finish before a final decision.
What does this mean if I buy health insurance now?
- Your policy is valid while the insurer holds its exemption.
- What happens to existing policyholders after March 2027 depends on decisions that have not been published.
- Ask the insurer or Advisor to confirm the product's CMS exemption reference before you join.
How can I check this myself?
Read the circular linked below and search the Council for Medical Schemes circulars page for anything newer than 30 March 2025. We will update this page when a decision is published.
Common questions
Will my health insurance stop on 31 March 2027?
Not necessarily. The date is when the current exemption framework ends. The Council for Medical Schemes has extended it several times since 2019. What happens next has not been announced.
Who decides what happens after March 2027?
The Council for Medical Schemes, in consultation with the National Department of Health, National Treasury, the Prudential Authority and the FSCA. The Minister of Health is considering the Low-Cost Benefit Option report.
Should I wait before buying health insurance?
That is a personal decision. If you need GP cover now, waiting leaves you uncovered today. Ask the Advisor what your insurer says about the exemption before you sign.