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.
A medical savings account is the part of your medical aid contribution that the scheme sets aside for day-to-day claims such as GP visits, acute medicine and dentistry. By law it may not exceed 25% of your total gross contribution for the year. The scheme makes the full year amount available in January and you repay it monthly, so if you spend more than you have repaid and then leave, you owe the difference. Unused savings carry over at schemes such as Discovery, Medihelp and Bestmed, and if you move to an option without savings or leave medical aid, the credit balance must be paid out to you.
In short
- Regulation 10 of the General Regulations under the Medical Schemes Act caps savings at 25% of total gross contribution, measured per member, for the exclusive benefit of you and your dependants.
- Savings are front-loaded: the year amount is available from January and repaid monthly, so a mid-year exit after heavy spending leaves a debt to the scheme.
- A positive balance carries over at Discovery, Medihelp and Bestmed, and must be transferred or paid out if you move to an option without savings, typically within about four to five months.
- For 2027, principal member savings range from R5,028 a year on Discovery Essential Saver to R20,256 a year on Discovery Classic Priority.
How does a medical savings account work on medical aid?
A contribution on a savings option has two parts. The larger part buys risk cover for hospital admissions and other scheme-paid benefits. The smaller part, capped at 25% by Regulation 10 of the General Regulations under the Medical Schemes Act, goes into your personal medical savings account.
Savings pay for everyday claims until the account runs out. What happens next depends on the option: on threshold options you enter a self-payment gap, and on others you pay day-to-day claims yourself unless the option has a separate benefit for them.
Why is the full year of savings available in January?
Schemes advance the annual savings amount at the start of the year, or pro rata from the month you join, and recover it in equal portions inside your monthly contribution. Discovery describes an amount given at the beginning of each year and paid back through the monthly contribution; Medihelp calls it a credit facility; Bestmed rules describe an interest free advance.
What happens if you overspend your savings and then resign?
Take a principal member on Discovery Classic Saver in 2027. She has R12,564 of savings available from January, repaid at about R1,047 a month within her contribution. By the end of April she has spent R9,000 and resigns to join her new employer scheme.
She has repaid four months, roughly R4,188, while the scheme has paid R9,000 on her behalf, so she owes the difference, about R4,812. This is an illustration and the exact amount follows the scheme calculation, but Discovery, Bestmed and the Council for Medical Schemes all confirm that the member is liable for the outstanding balance.
The same applies if you drop to a lower option mid-year, so read our guide to changing your medical aid plan during the year before you act.
Do unused savings carry over to the next year?
Now the opposite case. A member on the same option spends R3,000 of his R12,564 during 2027. At Discovery the unused balance carries over into 2028. Medihelp and Bestmed also carry savings forward and both state that the balance earns interest; Discovery may pay interest at its discretion.
If he instead moves to an option without a savings account, or leaves medical aid, Regulation 10(5) requires the scheme to pay the credit balance to him as a cash benefit, subject to tax laws. The regulation sets no deadline, but the CMS Model Rules say not later than four months after termination and Bestmed rules say within five months, so the money typically follows within about four to five months, depending on the scheme rules. If he moves to another option or scheme with a savings account, Regulation 10(4) requires the balance to be transferred instead.
What can a medical savings account not pay for?
Regulation 10 draws three lines. Savings may not offset your contributions. Savings may not pay for prescribed minimum benefits, so a PMB claim deducted from savings instead of risk is an error you can challenge. And the scheme may use your savings to settle a debt you owe it, but only once your membership has ended.
Who owns the money in a medical savings account?
In Genesis Medical Scheme v Registrar of Medical Schemes, decided on 6 June 2017, the Constitutional Court held that, absent a specific trust arrangement, savings funds are not trust property. They are assets of the scheme, which must show the balances as liabilities owed to members, and the scheme may keep investment income unless its rules say otherwise.
You have a clear claim to your balance under the scheme rules and Regulation 10, but it is not a ring-fenced bank account in your name.
How much savings do medical aid options give for 2027?
The savings percentage is a scheme choice up to the 25% ceiling. The table shows the share each scheme states for 2027 and the Rand amount for a principal member where published.
| Scheme | Option | Savings as stated share of contribution | Principal member savings for 2027 |
|---|---|---|---|
| Discovery Health Medical Scheme | Classic Priority | 25% | R20,256 a year |
| Discovery Health Medical Scheme | Classic Saver | 20% | R12,564 a year |
| Discovery Health Medical Scheme | Essential Priority | 15% | R10,440 a year |
| Discovery Health Medical Scheme | Coastal Saver | 15% | R7,992 a year |
| Discovery Health Medical Scheme | Essential Saver | 10% | R5,028 a year |
| Momentum Medical Scheme | Extender | 25% | Depends on hospital and chronic provider choice (example: Associated hospitals with Any chronic provider R32,832 a year) |
| Momentum Medical Scheme | Incentive | 10% | Depends on provider choice |
| Medihelp | MedSaver | 25% | R13,824 a year |
| Medihelp | MedPrime | 10% | R7,488 a year |
| Medshield | MediSaver | 15% | R10,632 a year |
| Bestmed | Beat3 Plus | 25% | Not stated in Rand here |
| Bestmed | Beat2 | 16% | Not stated in Rand here |
| Bestmed | Beat3 | 15% | Not stated in Rand here |
| Bestmed | Beat4 | 14% | Not stated in Rand here |
Bonitas and KeyHealth publish 2027 savings in Rand only, without a stated percentage, so they are not in the table; BonSave carries R13,032 of savings a year for a principal member in 2027 per the Bonitas 2027 BonSave and BonFit brochure. Fedhealth had not published 2027 figures when checked.
A higher percentage is not automatically an advantage: it moves more of your own contribution into an account you spend yourself. Our guide on how to choose a medical aid in South Africa explains how to weigh savings against risk benefits.
Where do savings fit with the self-payment gap and above threshold benefit?
On threshold options, savings are the first layer. Claims run through savings until the account is empty, you then pay claims yourself during the self-payment gap, and once your accumulated claims reach the annual threshold the above threshold benefit pays further claims, subject to limits. Our article on the self-payment gap and above threshold benefit explains each stage.
How does a medical savings account affect your tax?
The medical scheme fees tax credit for the 2027 tax year, 1 March 2026 to 28 February 2027, is R376 a month for the main member, R376 for the first dependant (R752 combined) and R254 for each additional dependant, per the SARS medical tax credit rates page. The credit is based on the contributions you pay, which include the savings portion.
Claims paid from your savings account do not count as qualifying out-of-pocket medical expenses for the additional medical expenses tax credit, because SARS treats them as paid by the scheme. Only expenses you paid personally and could not recover from the scheme, including from savings, qualify.
Who may claim the credit when a parent pays for an adult child?
The fees tax credit belongs to the taxpayer who paid the contributions, not automatically to the person named as member. If a mother pays the full contribution for her adult son, who is the principal member on his own plan, she claims the credit, provided he is her dependant for tax purposes. The same contributions cannot be claimed by both of them, and because the scheme certificate is in the name of the son, SARS may ask her for an affidavit on audit. Our guide on claiming medical expenses on your South African tax return covers what to keep on file.
How can a Curemed Advisor help you get the savings decision right?
The right savings percentage depends on how your household claims. A family with young children may run through a 10% account by winter, while a single member with few claims may be funding a 25% account that sits unused. A Curemed Advisor compares the 2027 options side by side, models your likely spend against the savings amount and risk benefits, and explains the carry-over and payout rules before you commit to a change for 1 January 2027. Curemed is an FSCA-licensed brokerage (FSP 44098), advising since 1992. Talk to a Curemed Advisor about your 2027 options.
Savings also create admin problems: a PMB claim wrongly taken from savings, or a refund or transfer still outstanding months after you switched. CureClub, an exclusive Curemed member benefit, is a dedicated healthcare support team that deals with the scheme on your behalf, from claim submissions and outstanding reimbursements to authorisations and escalations when the scheme gets something wrong. It is open to anyone on a registered South African medical scheme and over 4,500 people have joined. Find out how CureClub handles scheme admin on your behalf.
Frequently asked questions
Can you choose a medical aid plan without a savings account?
Yes. Momentum Custom has no savings account unless you add the optional HealthSaver, Medshield MediPlus gives a day-to-day limit instead of savings, and Medihelp MedPlus shows no savings account in its 2027 summary. If you move to one of these with a positive savings balance, Regulation 10(5) requires the scheme to pay that balance out to you, subject to tax laws.
Do dependants share the same savings account?
Regulation 10 describes the savings account as being for the exclusive benefit of the member and dependants, so one account funds claims for the whole family on the option. The Rand amounts in the table are for the principal member only; amounts for dependants differ, so check your option rules.
Can savings pay for over the counter medicine?
It depends on the option. Regulation 10 only prohibits using savings for prescribed minimum benefits, to offset contributions, or to settle a scheme debt before membership ends. Whether over the counter medicine is covered, and up to what amount, is set by the scheme rules for your option, so check your option rules before relying on it.
What should you check before switching options in January?
Confirm whether you ended the year with a positive or negative savings balance, because a negative balance is repayable, while a positive one carries over if you stay and must be transferred or paid out if you move. Confirm whether the new option has a savings account, since that decides between a transfer and a cash payout. And compare the new savings percentage to what your household actually spent on day-to-day claims this year.
How do savings claims appear on your medical scheme tax certificate?
The scheme issues the tax certificate in the member name and shows the contributions paid during the tax year. Claims the scheme paid from your savings account are treated by SARS as paid by the scheme, so they do not count as qualifying out-of-pocket expenses. Keep receipts for anything you paid personally and could not recover from the scheme, as only those amounts qualify.
