Choosing the right benefits

KEEP THIS IN MIND BEFORE MAKING YOUR MEDICAL SCHEME SELECTIONS FOR 2025

As living costs surge, health care can feel like a luxury.

There are important factors to keep in mind when you decide on 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, health care coverage can feel like a luxury, particularly for young, healthy South Africans. But amid policy debates on National Health Insurance and private health care, medical scheme membership remains essential and offers crucial financial protection against unpredictable medical costs, says Dr Rajesh Patel, head of health system strengthening at the Board of Healthcare Funders.

Medical scheme members feel the strain of recent premium increases, and many of them consider 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 reveal that South African medical schemes collected R232 billion in premiums and paid over R218 billion in claims for about nine million beneficiaries during the 2023-2024 period. These funds covered a wide range of health care needs, from hospital stays and advanced procedures to life-saving medications.

Patel identifies these main drivers behind increasing medical scheme premiums: