Last reviewed: November 2026. How we work: our editorial standards, corrections policy and how Curemed is paid. General information, not advice. A personalised recommendation follows a written needs analysis under the FAIS Act.
By Hagop Jaghlassian, CEO at Curemed. Reviewed by Roxanne Hurter-Ehlers, Director of People and Governance.
Medical aid in South Africa means membership of a medical scheme registered with the Council for Medical Schemes (CMS) under the Medical Schemes Act 131 of 1998. Every registered scheme must cover Prescribed Minimum Benefits on every option, including 26 chronic conditions on the Chronic Disease List. For 2027 the CMS recommended that increases be anchored at 3.8%, while seven of the open schemes in this guide have announced average increases of between 7.35% and 8.7%. This guide explains how medical aid works, what it must cover, what 2027 will cost and how to choose, as at 3 November 2026.
In short: medical aid in South Africa for 2027
- The CMS Annual Report 2025/26 lists 70 registered medical schemes at 31 March 2026: 16 open to the public and 54 restricted to defined groups.
- Every scheme must cover Prescribed Minimum Benefits: emergency medical conditions, 271 listed conditions and 26 chronic conditions on the Chronic Disease List.
- CMS Circular 20 of 2026 recommends that 2027 contribution increases be anchored at 3.8%. It is guidance, not a cap.
- Stated 2027 averages at seven open schemes run from 7.35% (Bestmed) to 8.7% (Bonitas). Fedhealth states no scheme-wide average and says 60% of its members will see an average weighted 8.9%.
- The medical scheme fees tax credit for the 2027 year of assessment is R376 a month for the first person, R752 for the first two and R254 for each additional dependant.
- Gap Cover is separate short-term insurance. Its annual limit is R226,881.03 per insured person from 1 April 2026.
What is medical aid and how does it work?
A medical scheme pools the monthly contributions of its members and uses that pool to pay for healthcare. Schemes are run for the benefit of members by a board of trustees, and the CMS regulates them. Each scheme offers a set of benefit options, often called plans, and each option has its own contribution table and benefit limits.
Your contribution depends on the option you choose and on the number and type of dependants you register. Some entry level options also set contributions by household income. A scheme may not set your contribution according to your health, but it may add a late joiner penalty if you join at age 35 or older without enough previous cover. See our guide to the late joiner penalty.
How many medical schemes are there in South Africa?
According to the CMS Annual Report 2025/26, 70 medical schemes were registered at the end of March 2026. Sixteen are open schemes, which must accept any applicant, and 54 are restricted schemes, which only accept a defined group such as the employees of one employer or members of one profession. Together they cover about 9.17 million beneficiaries, on the 2024 figures in the report. Our list of medical aid schemes in South Africa explains the open schemes you can join.
What types of medical aid plans are there?
- Hospital plans pay mainly for in-hospital treatment and Prescribed Minimum Benefits, with little or no day-to-day cover.
- Savings plans add a medical savings account, a set amount of your contribution that you use for day-to-day costs such as GP visits and acute medicine.
- Comprehensive plans combine hospital cover with larger day-to-day benefits, savings or a threshold benefit, and broader chronic cover.
- Network options require you to use specific hospitals, GPs or pharmacies in exchange for a lower contribution.
- Income-based options set the contribution by household income and usually rely on networks.
Read more about how medical aid network plans work before choosing one.
What must every medical aid cover by law?
Every option at every registered scheme must pay for Prescribed Minimum Benefits (PMBs). According to the CMS, PMBs cover:
- any emergency medical condition;
- a defined list of 271 conditions, each linked to a broad treatment in a diagnosis and treatment pair; and
- the 26 chronic conditions on the Chronic Disease List, including asthma, diabetes and hypertension.
A scheme may require you to use a designated service provider for PMB care. If you choose another provider voluntarily when the designated one was available, a co-payment may apply. In an emergency, PMB care must be paid even if you could not reach the designated provider.
How much are medical aid contributions increasing for 2027?
On 31 July 2026 the CMS published Circular 20 of 2026, which recommends that contribution increases and cost assumptions for the 2027 benefit year be anchored at 3.8%, in line with the 2027 inflation forecast of the South African Reserve Bank. The circular is guidance. Trustees set the final increase and may go higher if they can justify it.
The open schemes below have announced their 2027 increases. Each figure is the one the scheme stated, which is an average across its membership and not the increase on any single option.
| Scheme | What the scheme stated for 2027 |
|---|---|
| Bestmed | 7.35% average weighted increase |
| Bonitas | 8.7% average across all plans |
| Discovery Health Medical Scheme | 8.2% weighted average, 7.4% to 8.9% by plan |
| Fedhealth | No scheme-wide average. sureFED 0%, myFED 8%, flexiFEDSavvy 8.4%; 60% of members see an average weighted 8.9% |
| KeyHealth | 8.5% overall weighted increase |
| Medihelp | 7.5% weighted average; 7% or less for 60% of members |
| Medshield | 7.9% weighted average |
| Momentum Medical Scheme | 7.9% annual average |
Your own increase can sit above or below these figures. The medical aid increase 2027 tracker gives the option by option ranges and the cut-off date each scheme sets for changing options, which falls before 1 January.
Do waiting periods apply when you join?
They can. Section 29A of the Medical Schemes Act allows a scheme to impose a general waiting period of up to three months and a condition-specific waiting period of up to 12 months. Which of these applies depends on your cover history and on how long it is since your previous cover ended. If you had no medical scheme cover in the 90 days before applying, PMBs may also be excluded during the waiting period. Our guide to medical aid waiting periods sets out each scenario.
How does the medical tax credit work for 2027?
SARS allows a monthly medical scheme fees tax credit that reduces the tax you pay. The credit belongs to the taxpayer who paid the contributions, which is not always the main member of the scheme.
| Who is covered | 2027 year of assessment | 2026 year of assessment |
|---|---|---|
| The taxpayer, or one dependant where the taxpayer is not a member | R376 | R364 |
| The taxpayer and one dependant, or two dependants where the taxpayer is not a member | R752 | R728 |
| Each additional dependant | R254 | R246 |
Use the medical aid tax credit calculator to work out your own figure.
What is Gap Cover and do you need it?
Specialists may charge more than your scheme pays for in-hospital treatment, and the difference is yours to pay. Gap Cover is short-term insurance, regulated by the FSCA and not by the CMS, that pays this shortfall. The Demarcation Regulations cap Gap Cover benefits at R226,881.03 per insured person per year from 1 April 2026, according to National Treasury. Complaints about a Gap Cover policy go to the National Financial Ombud Scheme. The Gap Cover guide explains what it pays and what it costs for 2027.
How is medical aid different from health insurance?
A health insurance policy, such as a hospital cash plan or a primary care insurance product, is an insurance contract and not a medical scheme. It does not have to cover PMBs and can pay fixed amounts rather than the cost of treatment. A medical scheme must cover PMBs in full on every option. Read medical aid versus health insurance for a side by side comparison.
How do you choose a medical aid for 2027?
Start with your health needs, then your preferred doctors and hospitals, then your budget. Check the chronic conditions in your family, any planned procedures or pregnancy, and whether a network option fits where you live. Compare the total cost for a year, including likely co-payments, not only the monthly contribution. Our step by step guide on how to choose a medical aid in South Africa covers this in detail, and our guide to eight open medical aids to join for 2027 describes each scheme and its 2027 changes. If cost is the main constraint, see the list of medical aids under R1000.
How can a broker help?
A broker accredited with the CMS can compare options across several schemes, complete a needs analysis under the FAIS Act and help with claims once you are a member. Curemed is accredited with the CMS (ORG 163) and licensed with the FSCA (FSP 44098). Schemes pay Curemed a monthly commission that is capped by law, and the contribution for an option is the same whether or not you use a broker. Read how Curemed is paid for the detail.
After you join, the CureClub team helps members with claims and queries. Read Meet CureClub: your dedicated healthcare support team.
Frequently asked questions
Is it compulsory to belong to a medical aid in South Africa?
No. Joining a medical scheme is voluntary. If you join later in life without enough previous cover, the scheme may add a late joiner penalty to your contribution, so delaying has a cost.
Can an open scheme turn me down because of a pre-existing condition?
No. An open scheme must accept any applicant who agrees to its rules. It may, however, apply waiting periods under section 29A of the Medical Schemes Act, depending on your cover history.
Does a hospital plan cover chronic medication?
A hospital plan must still cover the 26 Chronic Disease List conditions as Prescribed Minimum Benefits, usually through the designated service provider and medicine list of the scheme. Chronic conditions outside that list depend on the option.
Who can claim the medical scheme fees tax credit?
The credit belongs to the taxpayer who paid the contributions, not automatically to the main member. For the 2027 year of assessment it is R376 a month for the first person, R752 for the first two and R254 for each additional dependant.
Does Gap Cover replace medical aid?
No. Gap Cover is short-term insurance that pays specialist shortfalls in hospital in addition to a medical scheme. You need to belong to a registered medical scheme for it to work.
When do 2027 medical aid contributions start?
The 2027 benefit year for the schemes in this guide starts on 1 January 2027. The new contributions and benefits apply from then, subject to approval of the rule amendments by the Council for Medical Schemes.
Disclaimer: This article is general information, not financial advice, and does not supersede the registered Rules of any medical scheme. In the event of any discrepancy, the Rules of the scheme prevail. 2027 benefits and contributions are subject to approval by the Council for Medical Schemes. Curemed is a licensed financial services provider with the FSCA, FSP 44098, and is accredited with the Council for Medical Schemes, ORG 163.
