Discovery Health announces 7.2% increase in 2026 contributions: What you need to know
If you’re a Discovery Health Medical Scheme member, brace for some contribution increase news. The scheme is raising the weighted average contribution by 7.2% for 2026. However, only 65% of members will experience only a 6.9% increase, while contributions for members on Active Smartplans will remain unchanged from 2025.
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According to a statement, Discovery Health Medical Scheme’s weighted average contribution increase of 7.2% for 2026 reflects the expected rise in both the cost of healthcare products and services as well as their utilisation.
Contribution increase
While the cost of healthcare services is expected to rise in line with CPI, utilisation of healthcare services is expected to drive an additional 3% to 4% increase in claims paid by the scheme.
“Medical inflation is a global challenge affecting all health systems - not just medical schemes in South Africa,” Dr Ron Whelan, CEO of Discovery Health, the administrator of Discovery Health Medical Scheme.
Together with the scheme, we are deeply committed to improving the efficiency and cost-effectiveness of healthcare while delivering exceptional value and quality care.”
No need to start panicking now, as Discovery will defer all contribution increases to 1 April 2026.
“This strategic use of excess solvency enables the scheme to offer members meaningful financial relief without compromising its long-term sustainability,” explains Whelan.
“Contribution increases remain accurately priced, in line with medical inflation, ensuring affordability and long-term stability.
“This approach reflects Discovery Health Medical Scheme’s commitment to using every lever available to enhance member value.”
“The scheme remains acutely aware of the affordability pressures facing South African households.
“By deferring the 2026 contribution increase to 1 April 2026, the scheme provides significant financial relief while continuing to deliver industry-leading healthcare benefits.”
Affordable option
Moreover, in its emphasis on affordability, the scheme is introducing two major enhancements for 2026: Smart Saver Series and Enhanced Personal Health Fund Benefits.
Launching on 1 January 2026, the new Smart Saver plans are tailored to meet the health and financial needs of young families.
Smart Saver offers comprehensive protection against large, unexpected healthcare costs, guaranteed cover for predictable needs, and flexible benefits for family-specific healthcare needs – all while rewarding families for prioritising their health through Personal Health Pathways.
“Discovery Health Medical Scheme data shows that certain primary healthcare needs among young families are universal — over 92% claim for GP consultations and medicine each year,” says Dr Ron Whelan.
“At the same time, broader day-to-day needs are unique in terms of specialised care.
“This insight shaped the Smart Saver Series: guaranteed risk-funded benefits for universal needs, and flexible, innovative benefits for the more unique ones.”
Smart Saver provides guaranteed cover for the healthcare services families use most – including GP consultations, optometry, dentistry, prescribed and over-the-counter medicine, and contraceptives.
These are complemented by comprehensive hospital cover, maternity benefits, mental health support, and oncology treatment within the Smart Network.
Within the new Smart Saver series, there are two plan options available: Classic Smart Saver and Essential Smart Saver.
The Classic Smart Saver option offers up to 200% in-hospital specialist cover, while the Essential Smart Saver provides up to 100% in-hospital specialist cover.
Enhanched benefits
Members will also get enhanced personal health fund benefits.
Discovery Health’s Personal Health Pathways programme is proving to be a powerful catalyst for positive behaviour change – with a nearly four-fold increase in completion rates and a five-fold increase in total health actions completed from 2024 to 2025.
Adult members accumulate funds into their Personal Health Fund by completing "next best actions" in their Personal Health Pathways, which can be used to finance their day-to-day benefits.
“Rewarding scheme members for completing recommended health actions is driving meaningful habit formation,” says Whelan.
“Beyond the individual health benefits, it is also helping to contain medical inflation by reducing avoidable healthcare costs.”
“In 2025, members completed significantly more high-impact health actions; from GP visits and mental wellbeing assessments to cancer screenings, medication collection, and other vital checks.
“Over 27,000 members achieved weekly physical activity goals for the first time, marking a major milestone in preventative care.
By completing personalised health actions within their pathway, members earn funds into their Personal Health Fund, which can be used to cover day-to-day medical expenses.
By September 2025, members had earned over R200m in additional healthcare benefits through this mechanism.
“The power of Personal Health Pathways lies in delivering timely, personalised actions tailored to each member’s unique needs,” says Whelan.
“Combined with the Scheme’s Personal Health Fund, it gives members the opportunity to unlock real financial value by engaging in their health.”
In 2026, members will benefit from:
- More than double the earning limits available in 2025.
- R1,000 opening balances for engaged members.
- New personalised health challenges to support members in improving their long-term health and wellness.
“These enhancements are designed to help members in achieve targeted breakthroughs in their health and build longer-term habits,” says Whelan.
“Together, Personal Health Pathways and the Personal Health Fund form a powerful behavioural change ecosystem – offering precise and personalised recommendations, motivating long-term health improvements and recognising members more meaningfully than ever for engaging in their health.”