Discovery Health Medical Scheme members will pay between 7.4% and 8.9% more for their cover from January 2027, the country’s largest open medical scheme said in an announcement first reported by BusinessTech, with a weighted average increase across all plans of 8.2%. The increases still need approval from the Council for Medical Schemes before they take effect.
Active Smart carries the lowest increase at 7.4%, taking its contribution to R1,450 per member per month. Smart, Smart Saver and most Core and Saver options rise 7.9%, while KeyCare, Coastal Core, Priority, Comprehensive and Executive rise 8.9%, and Coastal Saver rises 8.4%. The scheme said two out of every three beneficiaries will see an increase below 8%.
Still well above the regulator’s guidance figure
Every increase on Discovery’s list sits above the 3.8% anchor the Council for Medical Schemes set for 2027 contribution increases, a figure the Board of Healthcare Funders had already warned would be overshot by a wide margin. Discovery’s 8.2% weighted average lands close to where Momentum Health set its own 2027 increase at 7.9%, while smaller rival Medshield held its own rise more modest, suggesting the open-scheme market is converging on increases roughly double the regulator’s non-binding guidance.
“Responsible pricing gives members certainty by balancing affordability with the long-term sustainability of their healthcare funding,” said Dr Ron Whelan, CEO of Discovery Health, the administrator and managed care provider of the scheme. “Members need confidence not only in the value of their benefits today, but also in the stability of their contributions over time.” Discovery attributes the pressure to rising healthcare input costs, new treatments and technology, and growing demand for care as the population ages and chronic disease becomes more common.
The scheme says its own cost-containment work is already doing some of the heavy lifting: Discovery Health and the scheme’s managed care initiatives saved members R12.4 billion in 2025 through fraud and waste reduction and preventive healthcare, which it says limited the 2027 weighted average increase to 8.2% rather than roughly 2.5 percentage points higher.
A new entry-level plan aimed at the affordability gap
Discovery Health will also launch a new plan, Active Core, from 1 January 2027, pending regulatory approval. It will cost R1,700 a month for a principal member, R1,550 for an adult dependant and R500 for a child dependant, putting a family of three on R3,750 a month and a family of four on R4,250. Discovery says the R500 child rate is the lowest in the open medical scheme market. The plan offers unlimited private hospital cover through a network of more than 40 hospitals nationally, up to R8,000 in day-to-day benefits through a Personal Health Fund, and maternity and mental health benefits.
Active Core follows Active Smart, launched in 2025, and Essential Smart Saver, launched in 2026; Discovery says those two plans have together attracted more than 80,000 lives. The company says affordability remains a real constraint on scheme membership, pointing to more than a million South Africans in the relevant income segment who still face barriers to taking out medical cover at all.
Discovery is also expanding its Personal Health Pathways digital health-guidance service for 2027, which more than 750,000 adult members currently use, adding more clinically validated health actions and personalised recommendations through its Vitality AI partnership with Google. “What changes in 2027 is the depth, precision and relevance of that personalisation,” Whelan said.
Discovery Health Medical Scheme is the largest open scheme in the country, covering more than 2.7 million people, and funded R90 billion in healthcare claims in 2025 across 64 million individual claims processed. For an employer budgeting medical aid subsidies for the year ahead, or an individual member weighing whether to trade down a benefit option, the gap between the regulator’s 3.8% guidance and Discovery’s actual 7.4%-8.9% range is the number to plan around, not the anchor figure the industry itself has already said will not hold.
