Bad news for medical aid members in South Africa

Momentum Health marketing officer Damian McHugh says medical aid members in South Africa should expect hefty above-inflation price hikes in 2025.
Speaking at Momentum Health Solutions’ virtual Healthcare Insights Summit on Tuesday (30 July), McHugh noted that medical fund demands are rising, and attempts to contain contribution increases are causing medical schemes to incur additional costs.
This has resulted in medical schemes having to reduce or tighten benefits to keep increases lower than necessary—something which may spill over to 2025.
Despite these measures, medical aid contributions in 2024 still came in higher than inflation – something which McHugh said is likely to happen again in 2025.
Medical aids increased monthly contributions by between 8% and 9% in 2024, broadly in line with recommendations by the Council for Medical Schemes (CMS).
However, the increase was not flat across the board, and members of some medical aid plans—particularly on the higher, comprehensive end—saw much bigger increases.
For Discovery, the biggest medical aid scheme in the country, for example, increases ranged from 3% to 13%, with the biggest increases seen in the “premium” segment, which offers more comprehensive coverage.
Momentum announced a weighted increase of 9.6% for 2024 – the same as BestMed, which had the same average.
Bonitas had the lowest weighted average at 6.9, but even its “comprehensive” cover could not escape the premium ‘tax’, seeing a 9.6% surge in prices.

For context, ahead of the 2024 hiking season, the CMS recommended that medical aids in the country limit their price hikes to 5% “plus reasonable utilisation estimates”.
The council said at the time that historical data points to reasonable utilisation estimates, adding around 3.2% to 3.8% to the hikes – thus putting the “reasonable” increase in the region of 8.5%.
Headline inflation for 2024 is now expected to average around 5%, putting increases out of step and far above inflation.
In the past, medical aids have argued that medical inflation far outstrips headline inflation, running at a premium of between 3% and 4% higher than CPI.
The CMS has not yet published its recommended guidelines for 2025. However, South Africa is heading into hiking season, when various medical aid schemes will start announcing their increases for next year.
According to the CMS, over the past decade or so, medical aids have been hiking contributions by far higher than inflation, with medical aids themselves often positing an industry norm of CPI+4%.
This trend was heavily disrupted by the Covid-19 pandemic in 2020, which resulted in below-inflation hikes in 2021 and 2022, with a slight resurgence in 2023, where many schemes opted for deferred price hikes.
2024 marked a return to the CPI+4% positioning, with other changes to benefits and the delayed use of medical aid funds during the pandemic ‘helping’ to keep prices contained.
However, the CMS warned that the costs in the private healthcare sector have been rising faster than inflation, while growth in medical scheme membership has stalled.
“Lack of beneficiary growth, demographic changes and worsening health status of covered lives threaten the long-term sustainability of medical schemes,” it said in 2023.
Medical aid schemes typically start announcing price hikes and benefit changes in September and October. The CMS publishes its recommendations in late July or early August.
McHugh’s comments are a precursor to this, however, and set the tone for what medical aid members can expect in the coming months.
Read: 5 biggest medical aids in South Africa – what they offer and how much they cost right now