The country's largest open medical scheme, Discovery Health Medical Scheme, has announced an increase in contributions ranging from 7.4% to 8.9% for 2027. This means that South Africans utilizing medical care will face an increase in costs of more than 7% next year. Furthermore, several of the largest schemes have announced increases that are approximately double the affordability benchmark set by the industry regulator.
Discovery Health Medical Scheme, as the largest open medical scheme, announced a rise in contributions between 7.4% and 8.9% depending on the chosen plan, with a weighted average increase of 8.2%, which they state corresponds to the level of medical inflation. Other schemes have also reported increases: Bestmed increased its weighted average by 7.35%, and Medihelp by 7.5%. Momentum Medical Scheme and Medshield announced an average increase of 7.9%.
Controlling Growth
In July, the regulator issued guidance stating that contribution increases and expenditure assumptions must be linked to the 3.8% figure, which aligns with the South African Reserve Bank's inflation forecast for the coming year. CMS emphasized that the growing gap between annual increases in medical scheme contributions and consumer inflation creates a significant financial burden for households, especially when wage growth is unlikely to compensate for inflation.
CMS acknowledged that private medical inflation usually exceeds consumer inflation by two to three percentage points. Nevertheless, schemes wishing to raise rates above the established benchmark must provide financial and actuarial justification. The regulator noted that given the potential financial impact on members, the registrar may require the medical scheme to obtain a second independent actuarial opinion to support contribution increases above the inflation rate, particularly if the underlying pricing assumptions cannot be properly substantiated.
Costs Continue to Rise
These increases come after medical contributions have already been rising significantly faster than inflation this year. According to data from Moonstone Information Refinery, in 2026, the weighted average increase in Discovery's contributions was 7.2%, Bonitas' was 8.8%, Medihelp's was 8.46%, and Bestmed's was 6.8%. Momentum increased contributions by 9.9%, compared to 9.4% in 2025. Excluding Momentum, the growth was generally lower than what was announced for 2025.
CMS stated that the increase in medical scheme rates consistently exceeds consumer inflation. In 2025, the industry-wide average contribution increase was 10.1% against a projected average inflation of 3%, representing a difference of 7.1 percentage points.
However, healthcare costs themselves are also rising much faster than overall inflation. Aon forecasts the pace of medical trends in South Africa at 9.5% in 2026, while general inflation will be 4.5%. Aon's medical trend indicator assesses the growth in patient treatment costs and provision of medical services, not just the increase in medical scheme contributions. Aon cited higher utilization of medical services, growing demand for private healthcare, and advancements in medical technology as factors contributing to the rise in global healthcare costs.
Shrinking Affordability
Nevertheless, these increases will affect only a relatively small portion of the South African population. According to a Statistics South Africa report on household healthcare spending in South Africa for 2022/23, 14.1% of the population has medical coverage. Male-headed households spent 71.8 billion rand on medical scheme contributions during the reporting period, while female-headed households spent 31.7 billion rand, totaling 103.5 billion rand.
CMS warned that persistently high increases exceeding inflation could deter new participants from joining medical schemes and ultimately lead to existing members losing coverage due to inability to pay. The regulator specifically cautioned that high contribution rates create a barrier to entry for young members into schemes, threatening the long-term sustainability of the industry. Statistics South Africa found that people aged 20 to 24 already have the lowest level of medical coverage among all age groups.
The regulator also advised schemes that contribution increases should not replace control over their own spending, insisting that trustees seeking increases above their set benchmark must demonstrate measures to improve efficiency, manage utilization, and reduce preventable costs.
