Discovery announces big medical aid price hikes for 2025
South Africa’s largest medical aid scheme Discovery has announced that contributions will increase by a weighted average of 9.3% for 2025.
Across the various plans, contributions will be increasing between 7.4% and 10.9%.
The group said that around half of its members will experience a contribution increase of 8.4% or less, but the varying increases are so that the group can manage the different levels of medical inflation across the various schemes.
The gross contribution increases for 2025 across benefit plans are:
- Keycare Start: 7.4%
- KeyCare Core: 7.4%
- KeyCare Plus: 9.9%
- Smart: 7.4%
- Core: 9.9%
- Saver: 8.4%
- Coastal (Core/Saver) Plans: 10.9%
- Priority: 9.9%
- Comprehensive: 10.9%
- Executive: 10.9%
Discovery said that its contribution increases and benefit updates for 2025 have been submitted to the Council for Medical Schemes (CMS) for their approval.
The contribution increases and benefit updates will be effective from 1 January 2025, subject to approval by the CMS, it said.
Discovery’s coming price hikes are well outside the CMS’ recommendations.
At the beginning of August, the CMS published its recommendations and pricing guidelines for 2025, urging medical aid schemes in the country to limit their tariff hikes.
As was the case for the 2024 hikes, the CMS asked medical aid schemes to try and keep pricing as close to CPI as possible, recommending a 4.4% increase, plus “reasonable utilisation estimates”.
In previous years, the council said its historical data pointed to reasonable utilisation estimates adding around 3.5 percentage points to the hikes, while private medical inflation generally exceeds CPI by 2% to 3%.
Thus the “reasonable” increase for 2025 should be anywhere between 6.4% and 7.9%. Discovery’s weighted average is 9.3%; however, its cheapest plans have been contained to 7.4%, which is at least within the range.
Discovery said that the medical aid contributions are in line with the increases seen in medical inflation.
“Across the world, medical inflation is estimated to exceed consumer price inflation (CPI) by 6.4% in 2024. Medical inflation outpaces CPI due to ageing populations and a growing number of people being in poor health, which leads to a greater demand for healthcare services, over and above the increase in the cost of those services,” it said:
Other factors leading to the sizeable increase are:
- Increases in the price of healthcare services, typically in line with CPI;
- Increases in the demand for healthcare services as a result of a gradually ageing membership;
- Increasing prevalence of chronic illnesses, and an increasing proportion of high-cost claimants;
- Increases in the supply of healthcare services through new medicine, new medical technologies, advances in medical procedures and increased need for specialised care.
Other changes
In addition to the changes to contributions, Discovery also announced that it would be expanding its Smart Series to include a new plan—Active Smart—which is specifically targeting young professionals with an affordable price point.
The group also announced that Discovery Health Medical Scheme members will have access to additional day-to-day benefits through a new Personal Health Fund from January 2025, which will be tied to its “Personal Health Pathways” platform—and app-based behavioural system.
The fund will be available to all members and provide up to R10,000 per annum in additional risk-funded benefits for day-to-day medical expenses.
“Members can accumulate funds towards their Personal Health Fund by completing clinically appropriate actions through Personal Health Pathways, a world-leading innovation that enables precise, predictive, personalised healthcare for adult members of the Scheme,” Discovery said.
“New members joining the Scheme in 2025 will be able to access an additional once-per-lifetime benefit of up to R10,000 through the Personal Health Fund,” it said.
Personal Health Pathways is available through the Discovery Health App and via WhatsApp.
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