Medscheme International

What Medscheme International does

Medscheme International (Medscheme (Mtius) Limited) is an independent healthcare administrator headquartered in Ebène, Mauritius, founded in 1981 and operating as the only independent medical fund administration company on the island. The company provides third-party administration services for provident associations, insurers, and corporate medical schemes in Mauritius, managing approximately 75,000 lives. It is a wholly owned subsidiary of Medscheme Holdings (PTY) Ltd, which in turn sits within the AfroCentric Group listed on the Johannesburg Stock Exchange; the parent group administers roughly 5 million lives across seven African countries, providing scale, capital, and governance backing.

The service offering spans the full scheme-administration value chain: membership management, claims administration, prise en charge (pre-authorization), customer support, contribution and debtors management, financial reporting, business continuity and disaster recovery, and data warehousing. Medscheme operates one of the largest private healthcare data warehouses in Africa, holding longitudinal information on approximately 3 million beneficiaries, which supports reporting and analytics for client schemes. Layered on top of the core admin platform are member- and client-facing digital channels including an Online Member Portal (launched 2011), an Online HR Portal (launched 2013), the Medscheme Touch mobile application, Snap & Send photo-based claim submission, PayLess member cost-saving service, an online claim submission workflow, and a Broker Portal.

Medscheme generates revenue through fee-based contracts with B2B clients — insurers, provident funds, and corporate medical schemes — priced on a per-life-per-month or quote-driven basis for administration, pre-authorization, and member servicing. It is recognized among the Top 100 Companies in Mauritius and has a 35+ year track record, with Rajiv Gujjalu appointed Managing Director in October 2020. The go-to-market leverages the multi-portal ecosystem and broker channel alongside direct scheme contracts, while operational continuity is supported by dedicated BCP and disaster recovery infrastructure.

Name

Medscheme International

Legal name

Medscheme (Mtius) Limited

Website

https://medscheme.mu

Company type

Private

Founded year

1981

Operating status

Operating

Headcount range

101–250 employees

Short description

Medscheme International is an independent healthcare administrator based in Mauritius, providing third-party administration services — membership management, claims processing, pre-authorization, and digital self-service — to provident associations, insurers, and corporate medical schemes managing roughly 75,000 lives.

Ownership category

akta.pro rank

Product category

Health Insurance Administration

NAICS

Health and Welfare Funds (525120), Agencies, Brokerages, and Other Insurance Related Activities (5242)

SIC

Hospital & Medical Service Plans (6324)

akta.pro industry

PRIMARYHLAEADAC

Medigap Plan Administration (Enrollment, Billing & Member Services)

Healthcare & Life Sciences/Health Insurance & Managed Care/Medicare Supplement (Medigap) & Medicare Cost Plans

Keywords

• Health insurance administration
• Medical claims processing
• Provident fund administration
• Health risk management
• Medical scheme management

Headquarters

HQ city

Ebène

HQ country

Mauritius

HQ region

Africa

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Technology or R&D, Operations, Marketing or Sales, Infrastructure

Revenue model

1. Health Insurance Administration Services: B2B outsourced administrative services provided to provident associations, insurers, and corporate medical schemes. Services include membership management, claims administration, prise en charge, financial administration, and data warehousing. Revenue is generated through service fees charged to client schemes and employers.

Pricing tiers

Go-to-market motion1 record

Distribution channels6 records

Marketing channels5 records

Core offering

Medscheme International is a specialised health insurance and provident fund administrator that delivers outsourced end-to-end medical administration and health risk management services to provident associations, insurers, and corporate medical schemes. Its service portfolio covers membership management, claims administration, pre-authorisation (prise en charge), customer support, contribution and debtors management, financial reporting, data warehousing, and business continuity, complemented by digital self-service portals, a mobile application, and a co-payment discount network.

Product overview

Medscheme International offers a modular health insurance administration and health risk management platform. The core consists of 8 essential end-to-end administrative services: Membership Management, Claims Administration, Prise en Charge, Customer Support, Contribution & Debtors Management, Financial Reporting, Business Continuity & Disaster Recovery, and Data Warehousing. These core services are complemented by 7 innovative digital added services including the Online Member Portal (launched 2011), Online HR Portal (launched 2013), Online Claim Submission, Snap & Send, Medscheme Touch mobile app, PayLess discount service, and Broker Portal. The platform serves provident associations, insurers, and corporate medical schemes, managing approximately 75,000 beneficiaries in Mauritius since 1981.

Differentiator

Problem solved

Functional benefit

Brands

• Medscheme Touch: Mobile app allowing members to view claim progress, benefit limits, membership details, submit claims, and access their membership card.
• PayLess
• Snap & Send

Products and services

• Membership Management

Quantifiable outcome

• Manages medical benefits of nearly 75,000 lives in Mauritius
• +2 more outcomes

Named customers3 records

Segments4 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature8 records

Scale indicators6 records

Recent moves6 records

Expansion highlights5 records

Broad incumbents

• Britam Holdings: East African financial services group with a health insurance arm and embedded administration. Comparable as a broader incumbent providing group health cover that competes with Medscheme-administered schemes.
• Cigna Healthcare: Global health insurer and third-party administrator serving multinational employers with cross-border health benefits. Comparable as a global incumbent offering administration services to corporate medical scheme clients, including in Africa-adjacent corridors.
• Discovery Health: South Africa's largest private health insurance administrator, managing millions of lives via its own administration platform. Closest large-scale African peer to Medscheme in terms of administering private medical schemes and leveraging proprietary data assets.
• AfroCentric Group: JSE-listed parent investment holding company that owns Medscheme Holdings and other healthcare services and products businesses. Comparable as the broader healthcare-services group in which Medscheme International sits, providing portfolio-level context.

Regional players

• Jubilee Insurance: Pan-African health and general insurer with TPA-style administration for medical schemes in multiple countries. Comparable as a competitor for multinational and corporate health scheme clients across Africa.
• Swan Life: Mauritian life and health insurer offering group medical schemes that compete with the schemes Medscheme administers. Comparable as a regional player that combines underwriting with administration in the same geography.

Emerging players

• Resolution Insurance: East African health insurer offering group and individual medical cover with embedded administration. Comparable as an emerging African health insurance administrator competing for similar corporate scheme mandates.

Direct peers

• Medscheme Holdings (PTY) Ltd: Direct parent and operating peer that runs the same health administration business across other Southern African and European markets, managing roughly 5 million lives. Provides the closest functional and operational comparison point for Medscheme International's services.
• AAR Insurance: East African health insurer and administrator with both insurance underwriting and TPA-style administration capabilities. Comparable as a regional health insurance administrator operating across multiple African markets.
• Metropolitan Mauritius (MMI International): Direct competitor on Mauritius serving similar corporate and individual health insurance clients. Highly comparable given same domestic market, overlapping customer segments, and Medscheme's current MD previously served as CEO here.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat5 records

Key risks6 records

Key highlights6 records

Customer concentration

• Facebookfacebook.com/medschememtius
• LinkedInlinkedin.com/company/medscheme-mtius-ltd

Revenue estimate

Valuation estimate

Number of profiles

Profiles6 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Medscheme International