Medical aid costs in South Africa have been rising consistently above inflation for several years, with 2024 being no exception. Here are key trends shaping the medical aid landscape:
- Above-Inflation Increases
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- Medical schemes in South Africa traditionally increase contributions at rates exceeding inflation by 2-3%. This is due to medical inflation—the rising cost of healthcare services, equipment, and treatments—which often outpaces consumer inflation. For 2024, weighted increases range from 6.9% to 12.85%, depending on the scheme and plan type. Discovery Health’s plans, for example, see variations in increases from 3% to 12.9%, depending on the coverage offered.
- Tightening Benefits and Higher Costs for Members
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- To manage these increases, many medical schemes have scaled back on benefits, tightened coverage limits, and introduced higher co-payments. Members must now navigate increased out-of-pocket expenses for hospital admissions, specialist visits, and specific treatments, which underscores the importance of gap cover to bridge these financial gaps.
- Economic Pressures on Consumers
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- South Africa’s challenging economic environment, marked by high interest rates, inflation, and stagnant economic growth, is making it difficult for households to afford medical aid contributions. The Council for Medical Schemes (CMS) has recommended that increases be kept at CPI plus a margin for healthcare service utilisation—around 5% plus adjustments. However, the final increases announced by some schemes still surpass these guidelines.
- Impact of Utilisation Trends
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- Post-pandemic, there is a gradual return to normal healthcare utilisation, which has added pressure on medical aids. Many schemes deferred increases during the pandemic years (2021 and 2022), leading to more significant adjustments now to recover costs.
- Outlook for 2025
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- Looking ahead, members should brace for continued above-inflation increases in 2025. Some schemes are already hinting at further price hikes to maintain operational sustainability amid rising healthcare demands and inflation.
In summary, medical aid costs are expected to remain high, and the landscape is becoming increasingly difficult for members to manage without additional financial planning. Members are advised to regularly compare plan benefits and costs and explore options like gap cover to manage rising co-payments and reduce financial strain.
Note: All material on this website is provided for your information only and may not be construed as medical advice or instruction. No action or inaction should be taken based solely on the contents of this information; instead, readers should consult appropriate health professionals on any matter relating to their health and well-being. The information and opinions expressed here are believed to be accurate, based on the best judgement available to the authors, and readers who fail to consult with appropriate health authorities assume the risk of any injuries. Errors and Omissions Excepted. Terms and Conditions Apply.
