Medical Aid Increase 2027 in South Africa: What the CMS Guidance Means

Last reviewed: October 2026. We review our guides regularly to keep them accurate.

By Hagop Jaghlassian, CEO at Curemed. Reviewed by Roxanne Hurter-Ehlers, Director of People and Governance.

If you are trying to work out what the 2027 medical aid increase will be, here is the position as at 9 October 2026. The Council for Medical Schemes (CMS) has recommended that 2027 contribution increases be anchored at 3.8%. Six schemes have now published 2027 contributions, Fedhealth, Bestmed, Momentum Health, Medihelp, Discovery Health Medical Scheme and KeyHealth, and every published figure is well above that anchor. History says the rest will be too: for 2025 the industry average increase was 10.1% against a projected CPI of 3.0%, and the eight schemes tracked below raised 2026 contributions by between 6.76% and 9.9%. This page is updated as each scheme publishes.

What has the CMS recommended for medical aid increases in 2027?

On 31 July 2026 the CMS published Circular 20 of 2026, titled Guidance on contribution increases and benefit changes for 2027. The central recommendation is set out in the circular as follows:

The CMS recommends that contribution increases and cost assumptions for the 2027 benefit year be anchored at 3.8%.

The circular aligns that figure with the 2027 CPI projections of the South African Reserve Bank (SARB).

The circular also recommends that increases in non-healthcare expenditure, meaning administration and managed care fees, be capped at 3.8% for 2027.

What the circular does not do is bind any scheme to 3.8%. It states that Trustees remain responsible for determining the final annual contribution increases, and it sets out a justification process for any scheme that wants to go higher. The 3.8% is a starting point, not necessarily the number that will appear on your 2027 contribution table.

Why is the recommended figure below current inflation?

The 3.8% is a forecast rather than a current inflation reading. In the July 2026 Monetary Policy Statement, the SARB projected that headline inflation would average 3.8% in 2027, moderating to 3.1% in 2028.

Actual inflation is still running above the anchor. Stats SA reported on 19 August 2026 that headline CPI was 4.3% in July 2026, down from 5.0% in June 2026. The CMS has anchored 2027 to where inflation is expected to settle, not to where it stands today.

Which schemes have published 2027 increases so far?

Fedhealth moved first, on 15 September 2026. It published a 0% increase on the two new sureFED Traditional Plans, 8% on myFED and 8.4% on flexiFEDSavvy, and stated that 60% of members face an average weighted increase of 8.9%. It has not published a scheme-wide average.

Curemed compared the Fedhealth 2026 and 2027 tables option by option. On the remaining options the increases are higher, reaching 13.5% on the flexiFED 3 and flexiFED 4 families. Our full working is in the Fedhealth 2027 increase analysis.

Bestmed announced on 30 September 2026 an average weighted increase of 7.35%. Curemed calculates principal member increases of 6.5% to 8.5% on every option except Rhythm2, where a change from three income bands to two means increases of up to 17.0%. The detail is in the Bestmed 2027 increase analysis.

Momentum Health also announced on 30 September 2026, with an annual average increase of 7.9%. Curemed calculates principal member increases from 7.24% on Evolve to 8.51% on Summit. The working is in the Momentum 2027 increase analysis.

Medihelp published on 1 October 2026 with a weighted average of 7.5%, and said increases are limited to 7% or less for 60% of members. Our calculation from the published tables puts the per-plan range at 6.5% to 8.5% across its twelve plans, so the spread above the headline is narrow. The detail is in the Medihelp 2027 increase analysis.

Discovery Health Medical Scheme announced on 1 October 2026 a weighted average of 8.2%, with plans rising between 7.4% and 8.9%. Our plan by plan comparison is in the Discovery 2027 increase analysis.

KeyHealth has published its 2027 contribution schedule by option but no average. Curemed calculates increases from 7.9% on Origin to 9.9% on Platinum, with Essence at 9.3% and Equilibrium, Silver and Gold at about 8.5%. The tables are in the KeyHealth 2027 increase analysis.

Medshield was reported by IOL on 2 October 2026 with an average increase of 7.9%. Curemed has not yet worked through its tables, so that figure is as reported and carries no per option analysis.

How much did medical schemes increase contributions for 2026?

A useful guide to what 2027 may bring is what schemes did for 2026. The eight schemes below announced weighted average increases of between 6.76% and 9.9%, every one of them well above the 3.8% now proposed for 2027 and above the July 2026 CPI reading of 4.3%.

Two things in this table are easy to misread. A weighted average is not the increase on your option: at Discovery, 65% of members saw 6.9% against a 7.2% average. And the effective date is not always 1 January. Discovery deferred the 2026 contribution increase to 1 April 2026 while benefit changes still applied from 1 January 2026.

What is driving medical scheme costs higher?

Circular 20 of 2026 explains the gap itself. It records that private medical inflation generally exceeds CPI by between 2 and 3 percentage points, and that an ageing beneficiary population and an increasing prevalence of chronic conditions place additional pressure on the sustainability of risk pools.

For 2025 the industry average contribution increase was 10.1% against a projected average CPI of 3.0%. Nothing in the 2027 circular removes those pressures.

What does the gap between 3.8% and 9% mean in rand?

Take a household paying R6,000 a month in contributions. Both numbers here are for illustration: R6,000 is an example contribution chosen for simple arithmetic rather than a market average, and 9% is used because it sits inside the range schemes actually applied for 2026, not because anyone has forecast it for 2027.

A 3.8% increase adds R228 a month, taking the contribution to R6,228. A 9% increase adds R540 a month, taking it to R6,540.

The difference is R312 a month, or R3,744 over a full year. That is the size of the budgeting error a household makes if it treats the CMS anchor as a promise. A safer approach is to budget for an increase in the range schemes delivered for 2026. For context on contribution levels, see our guide to how much medical aid costs in South Africa.

What should members do before 1 January 2027?

Planning around 1 January is a mistake that catches members out every year. The date that decides whether you can still change anything is the cut-off set by your own scheme, and it falls earlier.

How should you read the increase notice from your scheme?

Under section 29(1)(l) of the Medical Schemes Act 131 of 1998, a scheme must give members advance written notice of contribution and benefit changes, with a disclaimer that the amendments become effective only on Registrar approval. That disclaimer matters: under section 31(2), any amendment to the rules of a scheme is valid only once the Registrar has approved it, and contribution tables form part of those rules.

Read the notice for three things: the increase on your own option rather than the weighted average quoted in the media, the date from which the new contribution applies, and any benefit changes that take effect even if the contribution increase is deferred, as happened at Discovery for 2026.

When does the deadline to change your option actually fall?

Each scheme sets its own administrative cut-off for changing benefit options. That cut-off is separate from 1 January, which is only the date a new option takes effect, and schemes apply it strictly. Medshield states on the option change form for 2026 that no late submission or mid-year option change will be permitted.

The dates also vary between schemes by as much as a month, so a deadline you remember from a previous scheme is not a safe guide. These were the published deadlines for the 2026 benefit year:

The first 2027 deadlines are already set for two schemes. The Fedhealth Option Selection Form 2027 states that the form must be received by no later than 30 November 2026. The Medihelp Plan choice 2027 form sets two dates: 30 November 2026 for civil servants paid through PERSAL, and 15 December 2026 for all other members, and states that late requests will not be considered. Other schemes publish their dates with the option change forms that follow their contribution announcements, so check your scheme notice in October 2026.

Act as soon as the notice from your scheme arrives rather than waiting for December. The CMS gave the same advice in its Open Season guidance for the 2026 year, encouraging members to finalise a decision by late November or early December.

Does your current option still fit the way your household uses cover?

Look at how your household actually claimed this year: hospital admissions, chronic medicine, day-to-day expenses and any shortfalls you paid yourself. Compare that pattern against the 2027 benefits and contribution on your option and on the options one step up and one step down. A lower contribution is only a saving if the benefits you rely on remain in place.

Our article on changing your medical aid plan mid-year covers the practicalities, and our medical aid comparison guide helps you weigh options against each other.

What applies if you move to a new scheme?

Moving schemes brings section 29A of the Medical Schemes Act into play. The waiting periods a new scheme may impose depend on your cover history:

• No cover in the preceding 90 days: a general waiting period of up to 3 months and a condition-specific waiting period of up to 12 months may both apply, and Prescribed Minimum Benefits may be excluded.
• Up to 24 months of continuous cover and a gap under 90 days: only a condition-specific waiting period of up to 12 months may apply, and not for Prescribed Minimum Benefits.
• More than 24 months of continuous cover and a gap under 90 days: only a general waiting period of up to 3 months may apply, and not for Prescribed Minimum Benefits.

Keep any gap between memberships under 90 days, and do not resign from your current scheme until the new one has confirmed acceptance in writing. Our guide on how to choose medical aid in South Africa is a useful starting point.

If you would like a second pair of eyes on your notice when it arrives, a Curemed Advisor can talk you through the increase on your option, compare it with alternatives inside your scheme and across the market, and help you decide whether Gap Cover belongs alongside it for 2027. Curemed has advised South African households on medical scheme cover since 1992 and works with members in all nine provinces. There is no obligation.

Which other questions come up about the 2027 increase?

When will schemes announce their 2027 contribution increases?

Fedhealth published on 15 September 2026, Bestmed and Momentum Health on 30 September 2026, and Medihelp and Discovery Health Medical Scheme on 1 October 2026. KeyHealth has published its 2027 contribution schedule by option. Medshield was reported by IOL on 2 October 2026. Bonitas and Profmed had no 2027 figure confirmed by Curemed as at 9 October 2026. For the 2026 benefit year announcements arrived between 23 September 2025 and 17 October 2025, so the rest are due shortly. Watch for the written notice from your scheme rather than relying on media reports.

What happens if I miss the cut-off for changing my option?

Do not assume there is a way back. Medshield states on its option change form that no late submission or mid-year option change will be permitted, which would leave a member on the existing option for the full benefit year. Other schemes use their own wording, so check what your scheme says before the date passes rather than after.

Can the CMS block a scheme from going above the anchor?

Not automatically. The 3.8% is guidance, and a scheme that wants to exceed it must submit a comprehensive business plan supported by clear financial and actuarial justification that complies with Actuarial Practice Note APN 303. The Registrar may also require a second independent actuarial opinion before approving the increase.

Does switching to a lower-cost option within my scheme trigger a waiting period?

In general, no. Section 29A(4) of the Medical Schemes Act prevents a scheme from imposing a new general or condition-specific waiting period on a member who changes benefit options within the same scheme. The exception is a member who is already serving an unexpired waiting period.

Can I belong to two medical schemes at the same time?

No. A person may not validly hold membership of two medical schemes at the same time. Get written confirmation of acceptance and a start date from the new scheme first, then resign from the current one so that the end and start dates line up.

What notice period applies when I resign from my medical scheme?

There is no single notice period in the Medical Schemes Act. Each scheme sets a resignation notice period in the registered rules of that scheme. Check it before agreeing a start date with a new scheme, because a notice period that runs past 1 January 2027 may leave you paying the 2027 contribution to your old scheme for part of the new year.

Hagop Jaghlassian

CEO | Curemed Health and Wealth Consultants

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