Bestmed medical aid announces price hikes and plan changes for 2027
South Africa’s fourth-largest open medical scheme, Bestmed, has announced an average contribution increase of 7.35% for 2027.
The increase is broadly in line with the Council for Medical Schemes’ recommendation of a 3.8% plus “reasonable utilisation” increase for the year, though this is not clearly defined.
In previous years, the CMS said its historical data pointed to reasonable utilisation estimates, adding around 3.5% (percentage points) to the hikes.
However, private medical inflation has historically exceeded CPI by 2% to 3%.
Thus, the “reasonable” increase for 2027 would be anywhere between 5.8% and 7.3%, with more recent medical inflation rates pushing this even higher.
According to WTW’s 2026 Global Medical Trends Survey, medical costs are projected to increase by 10.3% globally in 2026, following a 10% increase in 2025.
WTW also projected these increases to be closer to 11.3% for the Middle East and Africa regions in 2026.
This would put Bestmed’s increases lower than the expected global and MEA average.
According to the scheme, the increases come as South African households continue to face pressure from the rising cost of living.
Leo Dlamini, CEO and Principal Officer of Bestmed Medical Scheme, said the group’s approach for 2027 was to take stakeholder feedback into account.
This has led to increased cancer screening, HIV rapid testing, improved access to specialised imaging, additional medicine benefits and expanded cover for selected procedures.
For 2027, the Scheme’s Beat, Pace and Rhythm ranges will have greater access to preventative care, more out-of-hospital benefits, higher medicine and appliance limits, and enhanced clinical cover.
The group is also introducing a new benefit called “Best Bucks”, which will give qualifying members R1,000 in Best Bucks (per family)
Qualifying members are those who have completed their Tempo Lifestyle Screenings.
The Best Bucks can be used towards eligible consultations, radiology and pathology before claims are covered from medical savings or other day-to-day benefits.
Changes for 2027
The group said it was focusing on preventative healthcare in 2027, with proposed changes across its plans, including:
- Introduction of cover for Respiratory syncytial virus (RSV) antibodies for babies on all options
- Paediatric immunisations on Beat1.
- Maternity supplements of R151 per month on Beat2.
- Additional postnatal care, with two consultations available across the Beat and Pace ranges and on Rhythm2.
- Bone density screening for female members aged 45 and above every 24 months on Pace 1.
Bestmed is also extending human papillomavirus (HPV) vaccination to males, while eligible babies born between January and May will have access to respiratory syncytial virus (RSV) protection during the infection season.
“These preventative care benefits are funded from the Scheme’s risk pool rather than members’ savings or day-to-day allocations, subject to the applicable benefit option’s rules,” it said.
The 2027 benefits will also place emphasis on accessible out-of-hospital healthcare, with various benefit changes across its plans.
These include:
- Two separate casualty visits per family per year, up to R3,000 per visit on qualifying options, covering the consultation, facility fees, radiology, pathology and medication.
- Cover for clinically appropriate corneal cross-linking on selected Beat and Rhythm options.
- Medicine benefits for major depression on selected Beat options.
- Increased over-the-counter and take-home medicine benefits on selected options.
- Increased limits for orthopaedic and medical appliances.
Bestmed said it also plans to separate wound care and negative-pressure wound therapy limits, so that clinically appropriate negative-pressure wound therapy can be paid from risk at 100% Scheme tariff.
According to the CMS’s latest medical scheme industry report (end-2024 data), Bestmed is the country’s fourth-largest open scheme, and the sixth-largest overall, with over 250,000 beneficiaries.
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