South Africa’s private healthcare sector is currently releasing its premium increases for 2026, with most major schemes announcing modest adjustments generally below 10%. However, the medical scheme Sizwe Hosmed has announced a steep average premium increase of 19.15%, effective November 1, 2025. This steep rise significantly exceeds the guideline of CPI (3.3%) plus utilization estimates (recommended at up to 6.8%) set by the Council for Medical Schemes, and adds intense financial pressure on households already struggling with rising living costs.
Sizwe Hosmed’s high increase is attributed to the fact that the scheme was recently placed under curatorship in September 2025 after its reserves plummeted well below the mandatory 25% minimum required by the regulator. The hike is necessary to stabilize the scheme and bring its reserve levels back into compliance. Other major open schemes like Discovery Health (7.2% weighted average, deferred until April 2026) and Bonitas (8.8%) have kept increases below double digits, although these too remain above general consumer inflation, reflecting the ongoing challenge of medical inflation.This divergence in rates highlights the increasing debate around affordability and access to private healthcare in South Africa, where rising costs are forcing members to downgrade their plans or drop coverage entirely. Consumers are strongly advised to meticulously check their renewal notices, understand the specific price hike for their individual plan option, and verify their benefits before the new rates take effect in 2026.
