Discovery, Momentum among medical aid hikes nearly double CMS’s 3.8% benchmark

Discovery Health Medical Scheme, the country’s largest open medical scheme, has announced contribution increases of between 7.4% and 8.9% for 2027.

South Africans with medical aid face contribution increases of more than 7% next year, with several of the country’s largest schemes announcing hikes at roughly double the affordability benchmark recommended by the industry regulator.

Discovery Health Medical Scheme, the country’s largest open medical scheme, has announced contribution increases of between 7.4% and 8.9% for 2027, depending on the plan, with a weighted average increase of 8.2%, which it said was “in line with medical inflation”.

Bestmed has announced a weighted average increase of 7.35%, while Medihelp’s contributions will increase by a weighted average of 7.5%. Momentum Medical Scheme has announced an average increase of 7.9%, as has Medshield.

The increases are substantially higher than the 3.8% benchmark recommended by the Council for Medical Schemes (CMS) for 2027.

In guidance issued to medical schemes in July, the regulator recommended that contribution increases and cost assumptions be anchored at 3.8%, in line with the South African Reserve Bank’s inflation forecast for next year.

“The widening gap between medical scheme annual contribution increases and consumer inflation places a significant financial burden on households, particularly in an environment where salary increases are unlikely to keep pace with inflation,” CMS said.

The CMS acknowledged that private medical inflation generally exceeds consumer inflation by between two and three percentage points, while noting that schemes wanting increases above the benchmark are required to provide financial and actuarial justification.

“Given the potential financial impact on members, the registrar may require a medical scheme to obtain a second independent actuarial opinion to support above-inflationary contribution increases, particularly where the underlying pricing assumptions cannot be adequately substantiated,” it said.

The increase differential between medical aid costs and inflation.

The increases come after medical aid contributions already rose well ahead of inflation this year.

According to Moonstone Information Refinery, Discovery’s weighted average contribution increase for 2026 was 7.2%, Bonitas’ 8.8%, Medihelp’s 8.46% and Bestmed’s 6.8%. Momentum increased contributions by 9.9%, compared with 9.4% in 2025. With the exception of Momentum, the increases were generally lower than those announced for 2025.

The CMS said medical scheme increases have consistently exceeded consumer inflation. The industry-wide average contribution increase was 10.1% in 2025, compared with projected average inflation of 3%, a difference of 7.1 percentage points. Circular-20-of-2026

However, healthcare costs themselves are also rising considerably faster than general inflation.

Aon forecast South Africa’s medical trend rate at 9.5% for 2026, against general inflation of 4.5%. Its medical trend measure estimates the increase in the cost of treating patients and providing healthcare services, rather than medical scheme contribution increases.

Aon identified higher healthcare use, growing demand for private healthcare and advances in medical technology among the factors driving medical costs globally.

Yet, the increases will affect a relatively small proportion of South Africans.

According to Statistics South Africa’s Household Expenditure on Health in South Africa: Findings from the Income and Expenditure Survey, 2022/23 report, 14.1% of the population is covered by medical aid.

Households headed by men spent R71.8 billion on medical aid contributions during the survey period, while female-headed households spent R31.7 billion, taking their combined spending to R103.5 billion.

The CMS has warned that persistently above-inflation increases could discourage new members from joining medical schemes and ultimately cause existing members to lose healthcare cover because they can no longer afford it.

It specifically warned that high contribution rates create a barrier to younger members joining schemes, threatening the long-term sustainability of the industry. Statistics South Africa found that people aged 20 to 24 already have the lowest medical aid coverage of any age group.

The regulator has also told schemes that contribution increases should not substitute for controlling their own costs, saying trustees seeking increases above its benchmark should demonstrate measures to improve efficiency, manage use and reduce avoidable expenditure.