{"id":838714,"date":"2025-09-30T16:06:33","date_gmt":"2025-09-30T14:06:33","guid":{"rendered":"https:\/\/businesstech.co.za\/news\/?p=838714"},"modified":"2025-09-30T16:06:38","modified_gmt":"2025-09-30T14:06:38","slug":"discovery-announces-medical-aid-increases-for-2026-with-a-big-catch","status":"publish","type":"post","link":"https:\/\/businesstech.co.za\/news\/lifestyle\/838714\/discovery-announces-medical-aid-increases-for-2026-with-a-big-catch\/","title":{"rendered":"Discovery announces medical aid increases for 2026 &#8211; with a big catch"},"content":{"rendered":"\n<p>Discovery is set to increase medical aid premiums by up to 7.9% in 2026, but increases will only kick in from April 2026.\u00a0<\/p>\n\n\n\n<p>The weighted average increase for members will be 7.2%, while members of the KeyCare, Executive, Comprehensive and Coastal plans will see 7.9% increases in 2026.&nbsp;<\/p>\n\n\n\n<p>Premiums for all other plans will increase by 6.9%, representing about two-thirds of all beneficiaries. Premiums for the Active Smart plan will remain unchanged at 0%.&nbsp;<\/p>\n\n\n\n<p>Although the weighted increases of 7.2% are far above the current inflation rate of 3.3%, members will save some funds due to the delay of the implementation to April.&nbsp;<\/p>\n\n\n\n<p>In summary, Discovery Health Medical Scheme members can expect the following increases: <\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Executive &#8211; 7.9% <\/li>\n\n\n\n<li>Comprehensive &#8211; 7.9% <\/li>\n\n\n\n<li>Coastal &#8211; 7.9% <\/li>\n\n\n\n<li>KeyCare &#8211; 7.9% <\/li>\n\n\n\n<li>Priority &#8211; 6.9%<\/li>\n\n\n\n<li>Saver &#8211; 6.9% <\/li>\n\n\n\n<li>Core &#8211; 6.9% <\/li>\n\n\n\n<li>Active Smart Plan &#8211; 0%<\/li>\n<\/ul>\n\n\n\n<p>All contribution increases are deferred from 1 January 2026 to 1 April 2026, saving members R1.5 billion, or around R1,100 per membership, the group said.<\/p>\n\n\n\n<p>Discovery Health Medical Scheme said that a family of four on Classic Comprehensive will save more than R5,100 thanks to the postponement of increases. A family of three on Classic Saver will save over R2,000.\u00a0<\/p>\n\n\n\n<p>It said the deferral is possible thanks to the Scheme\u2019s solvency position, which is projected to remain well-above 30% &#8211; above the minimum required of 25%.\u00a0<\/p>\n\n\n\n<p>This strength is driven by the better-than-expected claims experience and returns on Scheme Investments.<\/p>\n\n\n\n<p>\u201cThis strategic use of excess solvency enables the Scheme to offer members meaningful financial relief without compromising its long-term sustainability,\u201d said Ron Whelan, CEO of Discovery Health.&nbsp;<\/p>\n\n\n\n<p>\u201cContribution increases remain accurately priced, in line with medical inflation, ensuring affordability and long-term stability.\u201d&nbsp;<\/p>\n\n\n\n<p>However, Discovery noted that medical inflation continues to outpace CPI, which is driven by healthcare utilisation due to ageing populations, and the increasing availability of and cost of advanced medical treatments.&nbsp;<\/p>\n\n\n\n<p>Although the cost of healthcare services is expected to rise in line with CPI, utilisation of healthcare services is expected to drive an additional 3% to 4% increase in claims paid by the scheme.&nbsp;<\/p>\n\n\n\n<p>\u201cMedical inflation is a global challenge affecting all health systems &#8211; not just medical schemes in South Africa,\u201d said Whelan.<\/p>\n\n\n\n<p>On top of the fee increases, the scheme also introduced two new significant enhancements for 2026.&nbsp;<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Smart Saver Series<\/strong> \u2013 A new range of plans for young families&#8217; health and financial needs. Within the new Smart Saver series, two plan options are available: Classic Smart Saver and Essential Smart Saver.<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Enhanced Personal Health Fund Benefits<\/strong> &#8211; Adult members accumulate funds into their Personal Health Fund by completing \u2018next best actions\u2019 in their Personal Health Pathways, which can be used to finance day-to-day benefits.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Not the only one <\/h2>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large\"><a  data-lightbox=\"post-image\" href=\"https:\/\/businesstech.co.za\/news\/wp-content\/uploads\/2025\/02\/Discovery-main-logo-close.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"576\" src=\"https:\/\/businesstech.co.za\/news\/wp-content\/uploads\/2025\/02\/Discovery-main-logo-close-1024x576.jpg\" alt=\"\" class=\"wp-image-812771\" srcset=\"https:\/\/businesstech.co.za\/news\/wp-content\/uploads\/2025\/02\/Discovery-main-logo-close-1024x576.jpg 1024w, https:\/\/businesstech.co.za\/news\/wp-content\/uploads\/2025\/02\/Discovery-main-logo-close-300x169.jpg 300w, https:\/\/businesstech.co.za\/news\/wp-content\/uploads\/2025\/02\/Discovery-main-logo-close-768x432.jpg 768w, https:\/\/businesstech.co.za\/news\/wp-content\/uploads\/2025\/02\/Discovery-main-logo-close.jpg 1200w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/a><\/figure><\/div>\n\n\n<p>Discovery is not the only medical scheme to introduce above-inflation increases for medical aid in South Africa.&nbsp;<\/p>\n\n\n\n<p>The second largest scheme in the country, Bonitas, announced a weighted average increase of 8.8%. Medshield announced a weighted average increase of 7.5%.&nbsp;<\/p>\n\n\n\n<p>Bestmed has announced the implementation of an average weighted contribution increase of 6.8%.&nbsp;<\/p>\n\n\n\n<p>\u201cHealthcare inflation remains one of the biggest challenges facing households,\u201d said Leo Dlamini, CEO and Principal Officer of Bestmed.&nbsp;<\/p>\n\n\n\n<p>With the exception of Bestmed, which just hits the upper-end of the range, the average contribution increases from the major medical aids come in much higher than the recommendations by the Council of Medical Schemes (CMS).<\/p>\n\n\n\n<p>The CMS published a circular this month recommending that medical schemes limit their contribution increases for 2026 to inflation.<\/p>\n\n\n\n<p>Broadly, the CMS recommended that medical schemes limit their 2026 price hikes to 3.3% plus \u201creasonable utilisation estimates\u201d.<\/p>\n\n\n\n<p>In previous years, the council said its historical data points to \u201creasonable utilisation estimates\u201d, adding around 3.5 percentage points to the hikes.<\/p>\n\n\n\n<p>In its latest circular, the council noted that private medical inflation usually exceeds CPI by 2 to 3 percentage points.<\/p>\n\n\n\n<p>Thus, the \u201creasonable\u201d\u00a0<strong>increase for 2026 would be anywhere between 5.4% and 6.8%<\/strong>. Only Bestmed barely stuck to this guideline.<\/p>\n\n\n\n<p>The CMS has urged medical aids to keep as close to inflation as possible, noting that contribution increases outpaced inflation by 7.1 percentage points in 2025.<\/p>\n\n\n\n<p>Medical aid contribution increases in 2025 averaged 10.1%, against inflation of 3%. This was up from an already high 10.3% average increase in 2024.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Discovery Health Medical Scheme has announced its increases for the 2026 financial year, with increases set to start four months later. <\/p>\n","protected":false},"author":95,"featured_media":812768,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9876],"tags":[4883],"class_list":["post-838714","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-lifestyle","tag-discovery"],"_links":{"self":[{"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/posts\/838714","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/users\/95"}],"replies":[{"embeddable":true,"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/comments?post=838714"}],"version-history":[{"count":5,"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/posts\/838714\/revisions"}],"predecessor-version":[{"id":838720,"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/posts\/838714\/revisions\/838720"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/media\/812768"}],"wp:attachment":[{"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/media?parent=838714"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/categories?post=838714"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/tags?post=838714"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}