There are important factors to keep in mind when you make your medical scheme choices for next year, although it is difficult to keep up with the ever-increasing premiums that seem to be very high for 2025. As living costs surge, healthcare coverage can feel like a luxury, particularly for young, healthy South Africans. However, with policy debates on National Health Insurance (NHI) and private healthcare, medical scheme membership remains essential and offers crucial protection against unpredictable medical costs, Dr Rajesh Patel, head of health system strengthening at the Board of Healthcare Funders (BHF), says.
Medical scheme members are feeling the strain of recent premium increases and many of them may be considering downgrading their options or even opting out entirely. However, Patel warns, continuous medical scheme coverage is crucial for maintaining financial security and supporting your long-term health. Reports from the Council for Medical Schemes (CMS) reveal that South African medical schemes collected R232 billion in premiums and paid over R218 billion in claims for approximately 9 million beneficiaries during the 2023/2024 period.
These funds covered a wide range of healthcare needs, from hospital stays and advanced procedures to life-saving medications. ALSO READ: Watch out: medical aid scheme surprises that can cost you money This is why your premiums are increasing Patel identifies these main drivers behind increasing medical scheme premiums: Medical inflati.