A practical model for affordable, high-quality medical cover in 2026

As clients reassess medical aid in a constrained economic environment, affordability is often the starting point. However, the risk for advisers is that affordability discussions become too focused on contribution levels alone, without fully considering quality of cover, long-term value and risk.

Discovery Health Medical Scheme leads with an approach to affordability that does not rely on reducing benefits or shifting costs to members. The focus is on improving health outcomes, managing risk, and using financial strength to return value to members.

Supporting clients with real and immediate affordability

In 2026, members benefited from two forms of financial relief that improved overall affordability. The national budget increased medical scheme tax credits to R376 for the first two beneficiaries and R254 for each additional dependant, reducing the after-tax cost of cover for taxpayers and providing sustained monthly relief.

Discovery Health Medical Scheme also deferred its annual contribution increase by three months. While the weighted average increase for 2026 is 7.2%, the effective increase for the year is approximately 5.4%, because contributions remained at 2025 levels until April. This returned R1.5bn to members and positioned the Scheme’s increase among the lowest in the industry. 

Importantly, a deferral is a timing shift – not a reduction in contributions – but it provides measurable short-term affordability relief to members.

Stability that delivers greater member value

When advising clients who are considering medical aids, financial stability and sustainability are foundational. Discovery Health Medical Scheme reports solvency of approximately 32.6%, well above the statutory requirement of 25%, supporting long-term sustainability and claims certainty. 

Over the past five years, more than R11bn in excess reserves has been returned to members through contribution deferrals and additional day-to-day benefits, demonstrating a consistent track record of value being returned.

Innovation that improves outcomes and controls costs

Advisers are increasingly required to help clients understand how innovation affects affordability over time. Discovery Health Medical Scheme’s Personal Health Pathways reinforces the importance of the right health actions at the right time.

This highly tailored programme uses individual health profiles, including age, risk factors and clinical history, to prompt targeted actions such as screening, prevention, chronic condition management and exercise goals. Each recommendation is specific to the individual, helping members take practical steps to improve their health.

More than 670 000 members are already using the programme, completing over 1.2 million health actions since inception. This has driven a 20% increase in cancer screening rates, improving outcomes through earlier detection and treatment. In turn, this supports better health outcomes and more stable contributions for members.

Tangible day-to-day value for clients who engage in their health

The Personal Health Fund supports everyday healthcare expenses such as GP visits, medicine and optometry. 

Clients who engage in their Personal Health Pathways can unlock up to R7 000 in value in 2026, depending on their plan type, including a once-off R1 000 boost per beneficiary, up to R6 000 per policy. As family size increases, so does the available benefit. 

These benefits are unlocked through simple actions such as completing a Health Check and activating a personalised pathway, making them accessible and practical for members.

Supporting confident switching decisions

For advisers assisting clients with medical aid choices during 2026, the key consideration is whether a scheme can balance current affordability with long-term sustainability.

Discovery Health Medical Scheme demonstrates how pricing discipline, financial strength and proactive health management can work together to support consistent value and more predictable contributions over time.

Important disclaimers: This statement is issued by Discovery Health (Pty) Ltd, registration number 1997/013480/07, an authorised financial services provider and accredited administrator of medical schemes, on behalf of Discovery Health Medical Scheme, registration number 1125, which it administers. 2. Personal Health Pathways is brought to Discovery Health Medical Scheme members by Discovery Health (Pty) Ltd. Personal Health Pathways is enabled by the combination of Discovery Health’s healthcare capabilities and Vtality’s behaviour change expertise. Vitality is a separate wellness product, sold and administered by Discovery Vitality (Pty) Ltd. 3. The Personal Health Fund is a benefit offered by Discovery Health Medical Scheme.