Medihelp announces big price hike and medical aid changes for 2025

Medihelp Medical Scheme has announced a 10.8% increase on all its plans from 1 January 2025, except for its student option, where students will pay 50% less.

It said that the increase will come with new and improved plan offerings.

This was revealed at the Medihelp 2025 Product Preview held on 1 October 2024 in Pretoria.

Speaking about the increases (bar the student option), Varsha Vala, Principal Officer of Medihelp said that the “contribution increase is sensitive to the pockets of members,” yet is a quantum that it says is in line with expected medical inflation for 2025.

At the beginning of August, the Council for Medical Schemes 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%.

Vala said that Medihelp’s “rapid growth and previous price adjustments placed our solvency under pressure, but we are ahead of our budgeted solvency ratio, which we attribute to our profile of members and our risk management strategy.”

She emphasised that “many other [medical aid price increases] are layered with co-payments, benefit reductions and more hidden fees”; however, this increase “comes with no hidden fees and value enhancements to the offerings.”

At the event, Medihelp unveiled three new enhancements to its plans, which it said are aimed at supporting budget-conscious South Africans and justifying the increases.

Medihelp’s product offerings for 2025 (the year it celebrates its 120-year anniversary) include:

• MedElect: Targeted for employer groups, this plan provides comprehensive benefits at competitive prices, with a 94% increase in the day-to-day limit per beneficiary and an extension of the child beneficiary age from 21 to 26.

• MedSaver: Members will receive R2,500 once their medical savings account is depleted—an increase of 110%—for GP consultations, specialists, and medicine, with annual day-to-day benefits rising by 80%.

• MedMove!: Students will have access to quality healthcare for R750 a month, resulting in nearly a 50% reduction in contributions. Overall limits will increase by 5%.

However, “all these changes still have to be approved by the Council for Medical Schemes,” said Vala.

The scheme also introduced a co-operative strategy designed to offer gap cover and primary care products.

“We’re excited about the Omnihelp co-operative strategy, which, combined with the Medihelp products, will provide a complete and compelling value proposition,” said Vala.

Medihelp said that this looks to provide “comprehensive care, affordability, and innovation” through partnerships to enhance member healthcare experiences, improve access to quality care, and alleviate the financial burdens associated with private medical services.

At the launch, Medihelp said that it is now leveraging technology to personalise member interactions and improve care management.

Each member will have access to a personalised Electronic Consumer Record, facilitating expert managed care and real-time monitoring of chronic conditions.

“By leveraging AI-driven data analytics, traditional case managers have become healthcare coaches,” said Vala.

The scheme will also make a home monitoring app available to eligible members and technology to measure vitals. Another digital innovation is the introduction of digital health kiosks at corporate wellness days. 

In addition to plan enhancements, Medihelp will roll out personalised care initiatives, including:

• A digital companion and personal assistant for new parents;
• A dedicated program for members with depression, now including social worker support;
• A post-hospital care initiative that has allegedly “reduced preventable readmissions by 15% and reclaimed over 2,500 productive hours for members.”

“Our members have been overwhelmed by the care and benefits they have received after being discharged from hospital through the post-hospital care innovation,” said Vala. 

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