Peter MokoenaChoosing the right medical aid scheme is one of the most important financial decisions you can make. South Africa has several well-established open medical schemes, each with its own strengths, benefit options, and contribution structures. Based on membership size, financial stability, and market reputation, the top five open medical schemes in South Africa for 2026 are:
Top 5 Medical Aid Schemes in South Africa (2026)
| Rank | Scheme | Membership (Beneficiaries) | 2026 Avg Contribution Increase | Key Strength |
|---|---|---|---|---|
| 1 | Discovery Health | Largest in SA (over 2.8 million) | 7.2% (effective 1 April 2026) | Market leader; innovative wellness programmes; Personal Health Fund |
| 2 | Bonitas | 731,576 as of Dec 2024 | 8.8% | Second-largest open scheme; affordable entry options; R9 billion reserves |
| 3 | Momentum Health | Top 5 open scheme | 9.9% | HealthReturns rewards; Health4Me insurance product; Multiply wellness |
| 4 | Fedhealth | Over 250,000 beneficiaries | 9.6% | Built Different offering; Sanlam partnership; lowest increase on flexiFED 1 (5%) |
| 5 | Bestmed | Over 250,000 members | 6.8% (lowest among top 5) | Member-focused; no self-payment gaps; Tempo wellness programme free |
1. Discovery Health Medical Scheme
Discovery Health remains South Africa’s largest open medical scheme by a significant margin, with over 2.8 million members. The scheme is known for its comprehensive plan range, innovative wellness programmes, and integration with the Vitality rewards platform.
Key 2026 Features
Average contribution increase of 7.2% effective 1 April 2026, with increases per plan ranging from 0.0% to 7.9%. The effective annual increase is approximately 5.4%, the lowest among the top five schemes.
Personal Health Fund: New for 2026, this benefit rewards members for completing health actions. Members can earn up to R500 for each recommended action completed, up to a maximum annual limit depending on plan choice (ranging from R2,000 to R12,000 per policy).
Once-off boost: New members joining in 2026 can unlock an additional R1,000 per beneficiary (up to R6,000 per membership) by activating Personal Health Pathways and enabling tracking features.
Vitality programme: The wellness rewards programme continues to encourage healthy behaviour with benefits across gym, healthy food, and travel.
Plan Range
Discovery offers plans across all price points, from the affordable KeyCare and Active Smart options to the comprehensive Executive and Classic plans.
Best For
Individuals and families seeking a market-leading scheme with extensive network access and reward-based wellness programmes. The Personal Health Fund provides significant value for members who engage with their health proactively.
2. Bonitas Medical Fund
Bonitas is the second-largest open medical scheme in South Africa, with 731,576 beneficiaries as of December 2024. The scheme has maintained an AA+ credit rating and won the BHF Titanium Award for Operational Performance for the fourth consecutive year. It holds reserves of R9 billion, providing strong financial stability.
Key 2026 Features
Average contribution increase of 8.8%, with increases per plan ranging from 6.9% to 11.3%.
BonCore: A new digitally enabled hospital plan launching in 2026, designed for younger, price-sensitive members aged 22-35. It offers unlimited hospital cover at a defined network of hospitals, virtual-first primary care, limited face-to-face GP visits, and a R1,000 Benefit Booster. The option is priced at just R1,275 per beneficiary, with equal contributions for principal and adult dependants.
BonPrime: Converted from the Primary Select option, this savings plan offers a 16% medical savings account while retaining its existing hospital network structure.
Benefit Booster: Enhanced for 2026, offering up to R5,000 in extra benefits. To unlock these benefits, members must complete a wellness screening through a preferred partner and an online mental health assessment.
Plan Range
Bonitas offers plans across all market segments, from the new affordable BonCore to comprehensive options with savings accounts.
Best For
Members seeking a stable, well-established scheme with strong reserves and a focus on affordability. The new BonCore option is particularly attractive for young professionals entering their peak earning years.
3. Momentum Health
Momentum Medical Scheme is part of the Momentum Group, offering flexible plan options and integrated wellness rewards. For 2026, the scheme is focused on empowering members to take proactive ownership of their health.
Key 2026 Features
Average contribution increase of 9.9%, reflecting industry-wide trends such as medical inflation and rising utilisation. Members have the ability to earn more than R1,000 per adult per month through HealthReturns, reducing their total spend significantly.
HealthReturns: Members can earn up to R1,000 per month for engaging in healthy behaviours such as fitness assessments and activity goals. Rewards are paid into HealthSaver accounts and can be used for medical scheme contributions, gym memberships, or healthcare provider fees.
Health4Me: Momentum’s health insurance product has grown by 20% in the past year, now covering over 200,000 members. For 2026, it will introduce AI-driven digital triage via Hello Doctor and a virtual assistant with a 90-second symptom checker.
Multiply Wellness Programme: The incentivised health programme focuses on improving quality of life. The Wellness Booster targets older members within employer groups, combining digital health assessments, personalised coaching, and gamified incentives. Members can earn up to 75% back from Multiply partners.
Plan Range
Momentum offers a range of medical scheme options as well as the Health4Me insurance product for those seeking more affordable primary care.
Best For
Members who value reward-based wellness programmes and digital health tools. HealthReturns provides a tangible incentive for proactive health management.
4. Fedhealth Medical Scheme
Fedhealth has reimagined its offering for 2026 under the “Built Different” theme, in partnership with Sanlam. The scheme is in the process of amalgamating with Medshield, which will place the combined scheme among South Africa’s top four open medical schemes, with over 250,000 beneficiaries and reserves of R3.3 billion.
Key 2026 Features
Average contribution increase of 9.6%, the lowest average weighted increase in years. Popular options such as flexiFED 1 will rise by only 5% (R125 per month for a main member), and flexiFED Savvy will increase by R100 per month.
Five core values: Affordability, customisation, inclusivity, simplicity, and trust shape the 2026 benefit enhancements.
New benefits for 2026 include:
– Expanded maternity benefits on flexiFED 1 (additional scans, antenatal consultations, classes, amniocentesis)
– Stronger mental health support, with funded depression medication extended to entry-level options (Savvy, flexiFED 1, flexiFED 2)
– Emergency contraception added as a covered benefit across all options
– Additional pneumococcal vaccine for members aged 65 and older
– Day-to-Day Plus (D2D+), rewarding members who complete a health risk assessment with up to R4,500 in additional cover
Sanlam partnership: Members have access to Sanlam Gap Cover (30% discount), Sanlam Primary Care, oncology solutions (up to R6 million cover), and Sanlam Health Rewards.
Plan Range
Fedhealth offers plans from the affordable myFED and flexiFED Savvy to more comprehensive options.
Best For
Members seeking value for money with low contribution increases and a strong partnership with Sanlam for integrated health and financial planning.
5. Bestmed Medical Scheme
Bestmed is a member-focused, not-for-profit medical scheme that has been serving South Africans for over 60 years. With over 250,000 members, it prides itself on being “by members, for members”.
Key 2026 Features
Lowest average contribution increase among top 5 open schemes at 6.8%.
BEAT3 Plus: A new plan offering a 25% annual savings account, comprehensive in-hospital cover, and out-of-hospital and preventative care benefits. Unutilised savings are carried over to the next year and earn interest.
No automatic self-payment gaps on any option, providing members with predictable costs.
Tempo wellness programme: Available at no extra cost on all 13 options. Members can now do their Tempo Health Assessment and Emotional Wellbeing-related Assessments online.
Preventative care benefits include pneumonia and flu vaccines, travel vaccines, female contraceptives, paediatric immunisations, a back and neck preventative programme, HPV vaccinations for females aged 9-26, and mammograms every 24 months for females over 40.
Disease management support: Programmes for diabetes, oncology, and HIV/AIDS are available to members.
Plan Range
Bestmed offers four plan categories: Hospital (from R2,269), Network (from R1,736), Savings (from R2,775), and Comprehensive (from R5,936).
Best For
Members seeking the lowest contribution increases, strong preventative care benefits, and a member-focused, not-for-profit scheme with no unexpected out-of-pocket costs.
Key Comparison Table
| Feature | Discovery | Bonitas | Momentum | Fedhealth | Bestmed |
|---|---|---|---|---|---|
| 2026 Avg Increase | 7.2% (5.4% effective) | 8.8% | 9.9% | 9.6% | 6.8% |
| Entry-Level Plan | KeyCare, Active Smart | BonCore (R1,275 per person) | Health4Me (insurance) | myFED, flexiFED Savvy | Network Plans (from R1,736) |
| Wellness/Rewards | Vitality, Personal Health Fund | B Value & Wellbeing | Multiply, HealthReturns | Sanlam Health Rewards | Tempo (free) |
| Unique 2026 Feature | Personal Health Fund (up to R12,000) | BonCore digital hospital plan | AI-powered digital triage | Day-to-Day Plus (R4,500 extra) | BEAT3 Plus (25% savings) |
| Reserves | Largest | R9 billion | – | R3.3 billion | – |
How to Choose the Right Scheme for You
1. Consider Your Healthcare Needs
– Do you have chronic conditions requiring ongoing medication?
– Do you plan to start a family in the coming year?
– How often do you visit GPs and specialists?
– Do you need dental, optometry, or physiotherapy cover?
2. Evaluate Affordability
– Look beyond the monthly premium to out-of-pocket costs (co-payments, deductibles)
– Consider the total value of rewards and wellness programmes
– Compare the effective increase rate rather than just the headline figure
3. Check Network Restrictions
– Some affordable plans (BonCore, Network options) require you to use designated providers
– If you have preferred doctors or hospitals, ensure they are in-network
4. Review Preventative and Wellness Benefits
– Regular health screenings, vaccinations, and wellness support can reduce long-term costs
– Schemes like Bestmed and Discovery offer extensive preventative care
5. Consider Additional Products
– Gap cover can protect you against shortfalls in private hospital rates
– Primary care insurance (like Health4Me) may be a cost-effective alternative for healthy individuals
Frequently Asked Questions
Which medical aid scheme is the biggest in South Africa?
Discovery Health Medical Scheme is the largest open medical scheme in South Africa, with over 2.8 million members.
What is the cheapest medical aid option for 2026?
Bonitas has launched BonCore at R1,275 per beneficiary, designed for young, price-sensitive professionals. Bestmed’s Network plans start from R1,736 per month, while Discovery’s KeyCare and Active Smart options offer affordable entry-level cover.
Why are medical aid contribution increases lower in 2026?
2026 increases are generally more moderate than previous years due to a drop in CPI and the fact that schemes recovered deferred contributions from the COVID-19 period in prior years. However, healthcare cost inflation remains at 4.7%, exceeding overall CPI.
What is the difference between a medical scheme and health insurance?
Medical schemes are regulated by the Medical Schemes Act, offer prescribed minimum benefits (PMBs), and cover hospitalisation. Health insurance products (like Momentum Health4Me) are not registered medical schemes and typically only cover primary care, not hospital procedures.
Do I need gap cover?
Gap cover is recommended for members on medical schemes with rate-limitation provisions. It protects against shortfalls between what your scheme pays and what private specialists charge. Fedhealth offers an exclusive 30% discount on Sanlam Gap Cover for its members.
What is the National Health Insurance (NHI) and how will it affect medical aids?
The NHI Act is currently being challenged in the Constitutional Court. Until legal clarity is achieved, medical schemes will continue operating in their current form. The phasing out of medical aid tax credits (worth approximately R34 billion annually) could make private cover more expensive for middle- and lower-income earners in the future.
Conclusion
The top five medical aid schemes in South Africa for 2026 each offer distinct advantages:
– Discovery Health leads in innovation with the new Personal Health Fund and extensive network access
– Bonitas provides strong financial stability and the affordable new BonCore entry plan
– Momentum Health excels in reward-based wellness with HealthReturns and digital health tools
– Fedhealth offers low contribution increases on key options and a strong Sanlam partnership
– Bestmed delivers the lowest average increase among top schemes and no unexpected out-of-pocket costs
The best choice depends on your individual healthcare needs, budget, and whether you value rewards programmes, digital tools, or low contribution increases. Consider consulting an independent financial advisor or medical aid broker to find the option that best suits your circumstances.
Note: All information is current as at time of publishing. Contribution increases, plan details, and benefits are subject to change. Always verify details on the official scheme websites or with accredited advisors before making decisions.