It’s that time of year again. With letters landing in inboxes, numbers shift on your premium notice and the benefits you thought you understood suddenly feel foggy.
The 2026 medical aid benefit and premium review period can feel overwhelming, but it doesn’t have to. With MedXpert, you don’t face this alone. We bring a sense of calm, clarity, and a guided path to the right plan for you and your family.
If you’d like a full overview of how the review period works, see our explainer here. Or if you’re ready to focus on how MedXpert walks with you through it, and see the official 2026 updates as they arrive, you’re in the right place.
Start here: Your guided review with MedXpert
Our consultants help you:
- Clarify your real needs based on past healthcare use and future plans.
- Shortlist options that fit your budget and lifestyle.
- Flag watchouts like hospital networks, specialist rates, or waiting periods before you commit.
Why trust MedXpert?
- 25 years’ experience in guiding South Africans through this process.
- Independent advice, with contracts across most large open schemes.
- Qualified consultants who pass annual product exams to stay sharp.
And once you’ve chosen, our help doesn’t stop. We assist with onboarding, benefit questions and advice, claims support, and option changes if we find a more suitable plan for your needs. You’re never left to decode fine print on your own.
What to bring to your review
Come prepared with a few essentials to make your consultation smooth and precise. Please note, additional information may be required besides the list below:
- Your current medical scheme and the specific option name.
- A snapshot of your needs from the past 12 months (GP visits, hospital admissions, major bills).
- Details of chronic medication.
- Preferred hospitals or doctors you’d like to keep seeing.
- Any planned life events (marriage, pregnancy, retirement).
- Your realistic budget band.
Common Updates from Medical Schemes
Medical schemes typically announce a combination of cost adjustments and benefit enhancements during the review period. Examples from recent years include:
- Enhanced benefits: Offerings for mental health cover were expanded, better maternity benefits were introduced, and the chronic care list was extended.
- Network and co-payment changes: Where necessary, changes to DSP networks or co-payment structures were made for procedures.
- New programmes: Adoption of various programmes such as geriatric care initiatives and enhanced rewards programmes.
Common Updates from Medical Schemes
Industry data shows contribution increases for 2026 are expected to land between 8.8% and 10.8%, after averaging 10.1% in 2025. – a steep climb compared to the Consumer Price Index (CPI). Rising costs are fuelled by stronger demand for healthcare: an aging population, chronic illness, specialist care, and hospital admissions. Added to this are industry pressures like advancing technology.
While policy prioritises primary care, in practice most spending still flows to costly specialist consultations and in-hospital services. Rising costs make this guided review essential: keeping schemes affordable, aligning benefits to your needs, and exploring options like gap cover or smarter plan structures.
2026 update hub: Top 4 schemes at a glance
- BestMed
- Bonitas Medical Aid
- Discovery
- Medihelp Medical Aid Scheme
- MedShield
- Momentum
BestMed
Status: Released
Average weight increase: 6.8%
What changed (official)
- General benefit increase of 4.6% across all plans.
- Colon cancer screening (faecal occult test): Added to all options, available once every 24 months for beneficiaries 40+.
- Adenoidectomy & Tonsillectomy cover: Now included for adults and children on Rhythm 1, enriching non-PMB coverage.
- Shoulder replacements: Now have their own benefit on Pace 2, 3, and 4 instead of sharing the hip/joint replacement limit.
- Take-home medicine from retail pharmacies: Increased significantly across all options (R450 – R700), with a minimum increase of 175%.
- A separate IUD limit under the female contraceptive benefit across all options has been introduced. Members now have a set rand value for oral contraceptives, ranging from R2 092 to R2 801, and a separate set rand value for IUD, ranging from R3 295 to R4 225.
- On Pace 3 and Pace 4, an all-inclusive maximum limit breast reduction surgery of R100 000 has been introduced. This benefit applies to medically necessary breast reduction surgery.
Bonitas Medical Fund
Status: Released
Average weight increase: 8.8%
What changed (official)
- New Plan: BonCore – From just R1 275 per month, tailored for 22 – 35-year-olds and young couples. Includes unlimited network hospital cover, unlimited virtual visits, 3 face-to-face GP consultations, 28 chronic conditions, screening benefits, and a R1 000 Benefit Booster.
- Increased Benefits – Oncology, MRIs, PET scans, mental health, alternatives to hospital, and take-home medicine (now up to R470) all see meaningful increases.
- Fresh Value Additions – The new B.Value & Wellbeing Programme rewards members with exclusive discounts, while the Benefit Booster can now grow to R5 000 (activated via wellness screening and online mental health assessment).
- Co-payment Adjustments – Updates across plans include higher co-payments for specialised radiology, cataracts, and non-DSP day surgeries (ranging from R1 500 to R9 800 depending on the plan).
Discovery Health Medical Scheme
Status: Released
Average weight increase: 7.2%
What changed (official)
- DEFERRED INCREASES: All increases will take effect from 1 Apr 2026 instead of 1 Jan 2026.
- NEW SERIES: The Smart Saver series, which will consist of the Classic Smart Saver and the Essential Smart Saver will launch from 1 Jan 2026. Key benefits include up to 200% Smart network in-hospital cover, a medical savings account, the Personal Health Fund, unlimited Smart GP visits, optometry and dental benefits, and acute and over-the-counter medication.
- NEW partnership with OURA, giving members access to fully-funded OURA Rings through Vitality. These rings offer precise sleep tracking, and advanced application of sleep data to reward health behaviour that impacts mortality and morbidity rates.
- NEW Vitality Sleep tracker: a new points system has been introduced for quality sleep. Points will be awarded for: Sleep well, Eat well, Get active, and Vitality Health Check and assessments.
- Personal Health Fund: Enhancements have been made to the Personal Health Fund which offers members up to R24 000 per annum. Adult members can receive an advance of R1 000 for 1 Jan, based on their engagement from 2025. Up to R12 000 per policy for completing recommended actions and up to R12 000 in additional value for completing Personal Health Challenges (up to R1 500 per challenge)
Medihelp
Status: Released
Average weight increase: 8.4%
What changed (official)
- A specific focus has been placed on improving the MedVital offering to ensure that members receive greater value.
- Previously MedElect, MedReach is a smart, comprehensive plan designed for professionals who value efficiency, achievement, and quality care. The plan offers network cover with a full basket of benefits, including annual day-to-day benefits, unlimited hospitalisation, the Care extender, specialised radiology, dentistry, and optometry.
- Unlimited wound care benefits are now available on all plans (except MedMove!) as an alternative to hospital admission. Pre-authorisation and clinical guidelines apply.
- Maternity Benefits: Antenatal iron and folic supplements are now available on MedAdd, MedSaver, and MedReach.
- Childcare benefits: Hearing screenings for newborns up on eight weeks, in- or out-of-hospital, are available on all plans, except MedMove!
Medshield Medical Scheme:
Status: Released
Average weight increase: 7,5%
What changed (official)
- NEW: Netcare 911 Life Saving Emergency Care.
- NEW: AI Optical Diabetic Screening.
- NEW: 24hr Glucose Monitoring from Birth – 18 years for specific options.
- Reduced Co-payments for Chronic Medicine. Applies to MediPlus, MediValue, MediCore, MediPhila, and MediCurve.
- All benefit limits have been boosted by an overall average of 4.5%
- Many enhancements have been made to the PremiumPlus option, including the removal of co-payments for select procedures and significant benefit increases ranging from 14.35% to 79.83%.
- Most plans now include Virtual GP and/or Specialist consultations (ranging from 3 to unlimited).
- Mental health benefits have been enhanced
Momentum Medical Scheme:
Status: Released
Average weight increase: 7,5%
What changed (official)
- NEW: Screening benefit available on all options except Ingwe: the FIT (Faecal Immunochemical testing) test will be available once a year to beneficiaries 45 to 80 years old.
- Ingwe income brackets have increased by 4.5% with the purpose of making it easier for all members to fall into a bracket.
- The rate for a full-time student and child-as-principal-member is R645.
Maternity Benefit: The provider for online antenatal and postnatal classes has changed from BellyBabies to ParentSense. - Health Platform: Preventative dental care benefit has increased to R500 per beneficiary at any dental provider.
- All co-payments have been increased by an average of 4%.
Work smarter, not harder – have MedXpert do the heavy lifting
When you compare medical aid options, don’t just look at the monthly debit order. Ask us questions; challenge our understanding for your benefit. Use this checklist:
- Look at the total annual cost: How much will this plan cost me across the year with contributions and expected out-of-pocket spend?
- Confirm hospital networks and specialist rates: Which service providers and hospitals can I use without penalties?
- Understand designated providers: How do DSPs affect my claims?
- Maternity planning: What waiting periods apply to maternity and when should I apply? (Tip: always join before you fall pregnant)
- Consider gap cover: If my hospital plan certain fees in full, how would gap cover protect me?
How we help you choose with confidence
When you choose your medical aid with MedXpert, we:
- Tailor your comparison based on your needs and budget.
- Explain the 2026 premium and benefit changes which we receive directly from the medical schemes.
- Help you do the heavy lifting on switching plans or joining a scheme for the first time.
- And much more.
FAQs
Can I switch to a different plan during review season and by when?
Yes, but timelines vary. Depending on the scheme, your application cut-off dates will be in November or December and your new option will be active from 1 January 2026.
How do waiting periods work for maternity?
All schemes apply waiting periods for new pregnancies. If you’re planning to start a family, look for a suitable plan early as each plan offers different maternity benefits.
Do I need gap cover if I have a hospital plan?
Yes, many hospital plans only pay specialists and hospital fees at agreed scheme tariff rates, leaving shortfalls. Gap cover can protect you from these bills.
What is the Above Threshold Benefit?
It’s a benefit, typically presented in a rand value, that members become eligible to access once your day-to-day benefits or savings have been depleted, but this Threshold will only become available once specific rules and criteria are met.
How does MedXpert get paid?
Our remuneration comes from the scheme, so we don’t charge consultation fees when advising you. Additionally, our advisor services come at no additional cost to you.
Final thoughts
Choosing a medical aid for 2026 doesn’t need to feel like navigating a maze or climbing a mountain. With MedXpert, you speak to a person who understands both the fine print and your life story. Let’s walk this journey together.