Big medical schemes set 2027 increases of 7.35% to 8.7%, about double the regulator's 3.8% guide

Members of five of South Africa's large open medical schemes will pay between 7.35% and 8.7% more on average from January 2027. That is roughly twice the 3.8% the Council for Medical Schemes asked schemes to anchor their increases to.

Bonitas is highest at 8.7%, followed by Discovery Health Medical Scheme at 8.2%, Momentum Medical Scheme at 7.9%, Medihelp at 7.5% and Bestmed at 7.35%. Discovery and Bestmed say their 2027 changes remain subject to approval by the council. The figures below come from the schemes' own announcements as reported by Moonstone and BusinessTech, and from Business Day's report of the Board of Healthcare Funders' response. This piece did not quote the council's circular itself.

Members usually choose next year's options before the end of the year, and the gap between the regulator's guidance and what schemes charge is the number many households will feel. An average is not a bill. The figure that lands on a debit order is the one for a named option, sometimes for a named income band.

What the regulator asked for

In its guidance for 2027, the council asked schemes to anchor contribution increases and cost assumptions at 3.8%, in line with the South African Reserve Bank's projected inflation, and to justify anything higher. The anchor excludes what the council calls "reasonable utilisation estimates": the extra cost of members using more healthcare from year to year. A scheme that only prices for inflation, and not for people going to hospital more often, is pricing a year the council itself says is incomplete.

The Board of Healthcare Funders, which represents schemes and administrators, says the council has not defined what "reasonable utilisation" means. It argues that increases close to 3.8% would need deeper reforms, including collective tariff negotiation with providers and changes to prescribed minimum benefits and low-cost benefit options. Business Day reported that challenge on 23 September. The board is not saying schemes should ignore inflation. It is saying a 3.8% ceiling, with utilisation left undefined, is not a number schemes can hit on the current rules.

Based on past council data showing utilisation adding about 3.5 percentage points a year, BusinessTech estimated that a "reasonable" increase for 2027 would fall between 5.8% and 7.3%. All five schemes sit above that range. Bestmed, at 7.35%, is the closest, and it is still just outside it.

The pattern is not new. For 2026 the council recommended 3.3%. The industry-weighted average increase it later recorded was about 8.10%, against consumer inflation of 3.0%. Guidance near inflation, and approved increases well above it, is what members have already lived through once. The 2027 announcements sit in that same gap.

Scheme by scheme

Discovery Health Medical Scheme has set a weighted average of 8.2%. Increases run from 7.4% on Active Smart to 8.9% on KeyCare, Priority, Comprehensive, Executive and Coastal Core. Discovery says two in three beneficiaries will see an increase below 8%. Its 2026 increase was 7.2%, and its 2025 increase was 9.3%. It is also launching a cheaper option, Active Core, at R1,700 a month for a principal member. The 2027 changes are subject to council approval.

Our responsibility is not simply to pass rising healthcare costs on to members.

That line is from Dr Ron Whelan, chief executive of Discovery Health, as reported by Moonstone on 5 October. The new option and the average are separate facts. Active Core is a product at a stated price. The 8.2% is a weighted average across options that already exist, and KeyCare is among those going up 8.9%.

Bonitas has set an average of 8.7%. The spread is wide. BonStart, BonStart Plus, BonFit and BonSave rise by 7.3%. Standard rises by 9.2%. BonComprehensive and BonClassic rise by 10.2%. Hospital Standard rises by 10.7%. The income-based BonCap option rises by 11.5%, the steepest figure Bonitas published. Bonitas says 60% of members will see increases below 8%. The scheme moved its administration from Medscheme to Momentum Health Solutions on 1 June 2026, a switch principal officer Lee Callakoppen said had been "taxing, to say the least".

Momentum Medical Scheme has set an average of 7.9%. Momentum Health's Damian McHugh said hospitalisation "remains the largest area of expenditure in the medical scheme market". That sentence, reported by BusinessTech on 30 September, is the scheme's explanation for why the average sits where it does. It is not a breakdown of which options rise by how much. Momentum did not publish an option-by-option table in the reports this piece used.

Bestmed has set a weighted average of 7.35%, the lowest of the five, and still just above the 5.8% to 7.3% band BusinessTech derived from past utilisation. Monthly increases for a principal member range from R130 on the lowest Rhythm1 income band to R1,069 on Pace4. The rand amounts matter more than the percentage for anyone comparing a payslip. Chief executive and principal officer Leo Dlamini pointed to continued pressure from healthcare use and treatment costs. Bestmed's 2027 contributions remain subject to approval by the Registrar.

Medihelp's 7.5% average is the figure Moonstone reported on 5 October. It is not repeated here from a Medihelp document this newsroom read. Anyone checking a Medihelp option should use the scheme's own 2027 table.

The Government Employees Medical Scheme, the largest restricted scheme, had not published a 2027 contribution figure in any source this newsroom could find. In December 2025 it said a corrective increase of 9.8% would be needed in 2027 and again in 2028. That is not a 2027 announcement. In June 2026 the council turned down the scheme's request to cut its 2026 increase from 9.5% to 7.5%, News24 reported on 30 June. GEMS members do not yet have a 2027 number to plan against.

What members can check

An average says little about a single household's bill. Increases differ by option, and on some schemes by income band, so the figure that matters is the one on your own option's 2027 rate table. Discovery's weighted 8.2% and Bonitas's 8.7% both hide options above and below the average. Two in three Discovery beneficiaries below 8%, and 60% of Bonitas members below 8%, are statements about how many people sit under the line. They are not a promise that your option does.

Cheaper options do not always rise least. Discovery's income-based KeyCare plans are among those going up 8.9%, and Bonitas's income-based BonCap rises by 11.5%, its steepest increase. A lower premium and a lower percentage increase are different things. Members who change options should compare what each covers, not only the price, because hospital networks, chronic medicine lists and day-to-day benefits differ.

The council's 3.8% anchor is the number schemes were asked to justify moving away from. All five open schemes named here have moved away from it. Discovery and Bestmed still need the council's approval. Medihelp's figure, in this piece, rests on Moonstone. GEMS has not announced.

Sources: Moonstone, 5 October 2026, on Discovery, Bonitas and Medihelp; Moonstone, 1 October 2026, on Bestmed; BusinessTech, 30 September 2026, on Momentum, and 22 September 2026 on the council's anchor and the utilisation estimate; Business Day, 23 September 2026, on the Board of Healthcare Funders; News24, 30 June 2026, on the council rejecting the GEMS request to lower its 2026 increase. The council's 2027 circular was not the document read for this piece.