Momentum Health announces medical aid price increases for 2027
Momentum Health has announced a 7.9% average annual contribution increase for its medical aid scheme, broadly in line with the Council for Medical Schemes’ (CMS) recommendation.
According to the CMS’s latest medical scheme industry report (end-2024 data), Momentum Medical Scheme is the country’s third-largest open scheme, and the fifth-largest overall with over 285,000 beneficiaries.
The medical aid scheme said the annual increase comes as the healthcare industry faces continued pressure and rising delivery costs.
Momentum said the 7.9% increase “reflects the rising cost of healthcare delivery and the need to sustain meaningful benefits in a system under increasing pressure.”
Between 2019 and 2024, South Africa’s medical aid scheme market contracted by 3%, with the average age of members increasing.
Since 2019, the average age of medical scheme members has risen from 35 to 37, as fewer young South Africans have opted into the market.
Momentum said this trend “signals mounting pressure on the affordability and long-term sustainability of private healthcare.”
“With wage inflation under pressure and healthcare costs continuing to rise, Momentum has reviewed the product for 2027 to ensure long-term sustainability while responding to changing member needs,” the group said.
South Africa has seen high inflation and a rising cost of living in recent months, driven by pressure from high global oil prices.
Along with the annual increase, Momentum said it has made several changes to its benefits, including replacing COVID-19-related screenings with over-the-counter benefits.
“As part of our 2027 enhancements, we have increased specialist benefit limits, replaced underutilised COVID-19 screening benefits with an over-the-counter pharmacy medicine benefit, and introduced a third GP benefit tier,” Momentum Health CMO Damian McHugh said.
Earlier in September, the CMS published its medical aid contribution increase guidelines for 2027, which indicated that schemes should anchor price hikes by 3.8%.
While this anchor serves as a basis for an increase relative to the Consumer Price Index (CPI), it does not factor in “reasonable utilisation estimates”.
The Board of Healthcare Funders (BHF) said that the CMS not indicating what “reasonable utilisation” is could place unrealistic expectations on medical aid schemes.
Based on historical data on medical aid price increases, a “reasonable” increase could be between 5.8% and 7.3%, but more recent medical inflation rates have pushed this higher.
High increases expected
While Momentum’s annual 7.9% annual increase exceeded the range determined from historical data, global advisory group WTW projected medical aid costs to increase by 10.3% globally in 2026.
WTW also projected these increases to be closer to 11.3% for the Middle East and Africa regions in 2026.
These projections are based on a survey of 91 countries, which identifies factors, including new medical technologies, pharmaceuticals, utilisation, fraud, waste and abuse, and pressures affecting medical costs.
These projections would place Momentum Health’s increase within normal global expectations.
The CMS also said in an evaluation that there is an industry-wide, overall weighted contribution increase assumption of 8.10%, which is higher than Momentum’s increase.
McHugh said the group’s price increases were determined in a difficult environment and had to balance the rising cost of living and growing pressure in the medical sector.
“Our 2027 offering reflects a careful balance between affordability, innovation and meaningful cover,” he said.
He also noted that the largest expense for medical aid schemes was hospital cover, indicating a greater need for early prevention.
“Hospitalisation remains the largest area of expenditure in the medical scheme market, which is why prevention and early intervention cannot be treated as optional extras,” he said.
“A sustainable healthcare model must help people act before a health concern becomes a more serious, and often more expensive, event.”
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