Discovery Health Medical Scheme contributions increase between 7.4% and 8.9% for 2027; new Active Core plan delivers the most affordable family cover in the market at R500 per child dependant

Disclaimers

1. This press 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. Note: The Discovery Health Medical Scheme contribution increases, launch of the Active Core benefit plan and benefit updates for 2027 have been submitted to the Council for Medical Schemes for approval. Contribution increases, the Active Core plan and benefit updates will be effective from 1 January 2027, subject to approval by the Council for Medical Schemes.
3. Personal Health Pathways is brought to Discovery Health Medical Scheme members by Discovery Health (Pty) Ltd, registration number 1997/013480/07. Vitality is a separate wellness product, sold and administered by Discovery Vitality (Pty) Ltd, registration number 1999/007736/07. Limits, terms and conditions apply.
4. The Personal Health Fund is a benefit offered by Discovery Health Medical Scheme in accordance with its Scheme Rules.

Highlights – Discovery Health Medical Scheme

• Discovery Health Medical Scheme contributions increase by between 7.4% and 8.9% for 2027, effective 1 January 2027.
• Cumulative contribution increases for Discovery Health Medical Scheme over the past three years have been 5.1% lower than the weighted average increases across the next six largest open medical schemes in the market.
• Contributions for Active Smart – Discovery Health Medical Scheme’s plan designed to meet the healthcare needs of young, healthier individuals and couples, will increase by 7.4%, offering unlimited hospital and some day-to-day benefits at R1,450 per member per month in 2027.
• Discovery Health Medical Scheme will introduce a new plan, Active Core, on 1 January 2027. Active Core offers core medical scheme cover from R3,750 a month for a family of three, with a child dependant rate of R500 - the most affordable child dependant rate in the market. This new plan is subject to approval and registration by the Council for Medical Schemes.

Johannesburg, 1 October 2026: Contributions for members of Discovery Health Medical Scheme ("the Scheme") will increase by between 7.4% and 8.9% from 1 January 2027, in line with medical inflation. Two out of every three beneficiaries will have an increase below 8%.

The Scheme announced it is introducing Active Core, a new core medical scheme plan which provides unlimited hospital benefits within the respective hospital network from R3,750 a month for a family of three, one of the lowest rates in the market for families. Also, at R500 per child dependant, the new plan offers the most affordable child dependant contribution in the open medical scheme market.

Responsible pricing, and the levers that bring the increase down

Discovery Health Medical Scheme is the largest open medical scheme in South Africa. Six out of every ten open medical scheme members choose to belong to the Scheme, which covers more than 2.7 million South Africans. It is also the only open scheme in the industry with a AAA credit rating, the highest possible rating for medical schemes.

In 2025 alone, the Scheme funded R90 billion in healthcare claims, with 64 million individual claims processed, demonstrating the scale of operations and the volume of claims processed annually.

“Responsible pricing gives members certainty by balancing affordability with the long-term sustainability of their healthcare funding,” says Dr Ron Whelan, CEO of Discovery Health, the administrator and managed care provider of Discovery Health Medical Scheme. “Members need confidence not only in the value of their benefits today, but also in the stability of their contributions over time. The Scheme’s focus is to avoid price shocks, protect benefits into the future and provide predictable, sustainable increases that remain materially below those seen across the broader medical scheme industry.”

Medical inflation is driven by both the cost of healthcare services, and the demand for and supply of care. The cost of healthcare continues to rise each year, reflecting increasing input costs as well as the ongoing introduction of new treatments, medicines and technologies. At the same time, demand for healthcare is growing as populations age and the prevalence of chronic disease increases, resulting in higher utilisation of healthcare services.

“Medical inflation is a challenge affecting health systems globally, not only medical schemes in South Africa,” says Dr Whelan. “What matters is how effectively a scheme manages those pressures. Discovery Health Medical Scheme has consistently contained contribution increases within a medical inflation corridor of CPI plus 3% to 4%, reflecting a disciplined approach to balancing affordability with long-term sustainability.

“We are acutely aware of the financial pressure facing South African households. Every rand matters and healthcare is one of the expenses families are most concerned about. Our responsibility is not simply to pass rising healthcare costs on to members. Instead, we focus on removing as much cost and inefficiency from the healthcare system as possible before it reaches members' monthly contributions, while continuing to protect access to quality healthcare and the value of their benefits.”

“The Scheme works to curb rising healthcare costs in two ways. The first is through the way it funds and manages healthcare. Discovery Health Medical Scheme promotes quality and health outcomes rather than volume only, supports care in the most appropriate setting, and remains relentless in reducing fraud, waste and inefficiency. In 2025, Discovery Health and the Scheme’s managed care initiatives saved members R12.4 billion that would otherwise have been paid out of their own pockets.

“The second is a long-standing commitment to helping members become healthier and stay healthier. Better health reduces the risk of serious illness and helps avoid the costs associated with preventable disease. Personal Health Pathways and Vitality are globally recognised innovations that support healthier behaviours and better health outcomes over time. They also help the Scheme attract younger, healthier members, strengthening the sustainability of the risk pool. More than 70% of new members that joined the Scheme during the past two years were younger than 40 years old.”

Together, these interventions have enabled Discovery Health Medical Scheme to limit its weighted average contribution increase for 2027 to 8.2%, approximately 2.5 percentage points lower than would otherwise have been required.

“Discovery Health Medical Scheme has consistently delivered exceptional value for members. On a weighted average basis, its contribution increases have been 5.1 percentage points lower than those implemented by the next six largest open medical schemes over the past three years. This reflects a sustained focus on managing healthcare inflation, improving the efficiency of healthcare delivery and maintaining a healthy, sustainable risk pool.” Dr Whelan adds.

Active Core extends access for young and healthy South Africans

Over the past three years, Discovery Health Medical Scheme has expanded its product offering to better meet the needs of younger, healthier individuals and families, priced to take into account utilisation experience. Active Smart, launched in January 2025, and Essential Smart Saver, launched in January 2026, have attracted more than 80,000 lives, making them the fastest-growing plans in both the Scheme's history and the broader medical scheme industry.

Despite this progress, affordability remains a significant challenge. More than one million South Africans in this market segment continue to face barriers to accessing medical scheme cover. Over the past six years, membership in this segment has declined by 8%, while the average number of lives covered per membership has fallen by 15%.

These trends underscore the need for continued innovation in healthcare funding. In addition to Active Smart and Smart Saver introduced in 2025 and 2026 respectively, expanding access to lower-cost, high-value cover is critical to improving affordability, attracting younger members and ensuring the long-term sustainability of medical scheme cover in South Africa.

Active Core, Discovery Health Medical Scheme’s new benefit plan, has been designed specifically for families seeking valuable private healthcare cover at a lower cost. Launching on 1 January 2027, contributions start at R1,700 for a principal member, R1,550 for an adult dependant and R500 per child dependant, the lowest child dependant contribution in the open medical scheme market.

A family of three will pay R3,750 per month, at least 26% less than the average contribution of the seven closest comparable plans. This provides a meaningful step towards improving affordability for families who have increasingly found medical scheme cover to be beyond their reach financially.

Active Core offers unlimited private hospital cover through the new Active Hospital Network, which includes more than 40 strategically selected hospitals across South Africa, ensuring access to high-quality care with national coverage.

In addition, members have access to up to R8,000 in day-to-day healthcare benefits through the Personal Health Fund, complemented by dedicated maternity and mental health benefits. Together, these benefits provide a balance of affordability, valuable cover and meaningful day-to-day value for families.

“Families in this segment are looking for healthcare cover that they can afford, that meets their day-to-day healthcare needs and that protects them against the significant costs of serious illness,” says Dr Whelan. “Active Core has been designed to meet those needs. It brings valuable private healthcare funding within reach for more families by offering a level of affordability that has not previously been available in this segment of the open medical scheme market.”

Personal Health Pathways takes a significant step forward in 2027

More than 750,000 adult Discovery Health Medical Scheme members already receive fully personalised health guidance through Personal Health Pathways. Collectively, they have completed more than 12 million personalised health actions and unlocked over R1 billion in additional healthcare benefits through the Scheme’s Personal Health Fund enabling the funding of day-to-day healthcare needs.

From 1 January 2027, Personal Health Pathways will be enhanced to provide members with deeper health insights and a broader range of personalised recommendations designed to support better health outcomes.

These enhancements to Discovery Health’s Personal Health Pathways are powered by Vitality AI and Discovery’s global partnership with Google,” says Dr Whelan. “This allows us to expand to more than 8,000 clinically validated health actions and over 41,000 personalised next best actions, reflecting the platform’s growing ability to tailor recommendations to each member's own health history and circumstances.”

Participating members will also gain access to Personal Health Insights, a dynamic and integrated view of their health that brings together clinical history, claims information, screening results and lifestyle data in one place. The platform will provide a clear picture of how a member’s health is evolving, identify patterns that may require attention and connect those insights directly to personalised, clinically relevant actions that can help improve health outcomes.

“Personalisation has been central to Personal Health Pathways since its launch. What changes in 2027 is the depth, precision and relevance of that personalisation,” says Dr Whelan. “We can now guide members towards the appropriate health action at the right time, while helping them understand how each action contributes to their own health journey. Our experience shows that when guidance is personalised, timely and supported by meaningful context, members in partnership with their primary care doctors are more likely to take action and improve their health.”

Building a healthcare system that delivers better health and better value

“When illness strikes, families should be focused on getting well, not on financial uncertainty,” says Dr Whelan. “A medical scheme exists to provide that peace of mind. Yet the only sustainable way to contain healthcare costs over time is to improve health itself.”

“That belief sits at the heart of everything we are doing in 2027. From more affordable healthcare funding , to highly personalised health guidance powered by new technology, our focus is on creating better health, better health outcomes, enhanced member experiences and greater value for our members. That is how we make healthcare more sustainable and within reach of more South Africans,” he concludes.

To access the detailed Discovery Health Medical Scheme plan comparison guide for 2027, please click here.

To review the detailed 2027 contribution table for all Discovery Health Medical Scheme plans please click here.

ENDS

Notes to editors:

The benefit changes to Discovery Health Medical Scheme outlined in this announcement are not exhaustive and reflect only key benefit updates.

Discovery Health Medical Scheme gross contribution increases for 2027 by benefit option: