The end of the year is the best time to review your health cover. Look back at what 2026 cost you in premiums and out-of-pocket medical bills, use any benefits you still have before they reset, and then plan for 2027: read your medical scheme’s increase notice for your own option, compare alternatives before the option-change deadline, factor in medical tax credits and build a realistic, above-inflation increase into next year’s budget.
As 2026 draws to a close, most households are thinking about festive spending, school fees and the January stretch. It is also the moment when medical schemes announce what cover will cost next year, and when the choices you make in the next few weeks will shape your healthcare costs for the whole of 2027.
This year gave South African budgets plenty to absorb, from a fuel-driven spike in inflation to another round of above-inflation medical aid increases. In this guide, Bloom uses 2026 as a starting point: what happened, what it means for your budget, and a practical process for planning your health cover for 2027. Whether you need affordable health insurance, medical aid or gap cover, the steps are the same.
Key takeaways
| • In 2026, fuel pushed inflation to a two-year high of 5.0% in June, and medical scheme increases averaged about 8.1% against projected inflation of 3.0%. |
| • Medical schemes announce 2027 contributions from October. The Council for Medical Schemes has recommended an anchor of 3.8%, but this is guidance, not a cap. |
| • Read your scheme’s notice for your own option, the effective date and any benefit changes, and compare options before the year-end deadline for option changes. |
| • The 2026/27 medical tax credits of R376 a month for the first two members and R254 for each additional dependant apply until 28 February 2027. Health insurance and gap cover premiums do not qualify. |
| • Before the year ends, use the benefits you have already paid for, then set a 2027 health budget that includes premiums, a realistic increase and a buffer for out-of-pocket costs. |
Looking back: what 2026 meant for healthcare budgets
Fuel pushed up the cost of living
Consumer inflation climbed from 3.1% in March to 5.0% in June 2026, its highest level in two years, as fuel prices rose by more than a third year on year, according to Statistics South Africa. Inflation eased to 4.4% by August, but annual fuel inflation was still 20%, as reported by Stats SA. Higher transport and food costs left many households with less room for health cover.
Medical scheme increases outpaced inflation again
According to the Council for Medical Schemes (CMS), as reported by BusinessTech, the industry’s average contribution increase assumption for 2026 was 8.1%, compared with projected inflation of 3.0%. The CMS acknowledges that private medical inflation generally runs two to three percentage points above CPI, driven by hospital, specialist and medicine costs, new technology and an ageing membership, as reported by IOL.
More people bought down or switched
Affordability pressure changed how South Africans buy cover. Alexforbes reported that many medical scheme members were buying down to cheaper options, according to BusinessTech, while health insurance grew faster than medical aid, according to EWN. Momentum Health cautioned that health insurance does not offer the same protection as comprehensive medical aid, which makes it essential to understand what any cheaper cover leaves out.
Your year-end health budget review
Before you plan for 2027, take stock of how your cover actually worked for you in 2026. Your answers to these questions will tell you whether to stay, switch, add or adjust:
| Question to ask | What it tells you |
|---|---|
| How much did we pay in premiums this year? | Your baseline. Next year’s cost will build on this figure. |
| How much did we pay out of pocket? | Large cash payments for GP visits, medicine, co-payments or specialist shortfalls suggest your cover may not match how your family uses healthcare. |
| Which benefits did we use, and which did we not? | Paying for benefits you never use may mean you can move to a lower option. Running out of benefits may mean you need more cover. |
| Did anything catch us off guard? | An unexpected hospital shortfall or casualty visit may point to a need for gap cover or accident and emergency cover. |
| Has anything changed at home? | A new baby, a new chronic diagnosis, a job change or a child leaving home can all change the cover you need. |
Before the year ends: make the most of your 2026 benefits
Many benefits are limited per year. Check your policy or scheme rules to see when your benefit year runs, and use what you have already paid for before it resets:
| • Book your health assessment. Every Health4Me option includes one health assessment per member per year, covering blood pressure, cholesterol and blood sugar finger-prick tests at a wellness day or pharmacy clinic. |
| • Schedule dental and eye checks. Health4Me Silver and Gold include basic dentistry and a basic optometry benefit every two years. Medical aid members should check their remaining day-to-day benefits. |
| • Renew chronic prescriptions. Make sure repeat scripts and chronic registrations are in order before the holiday period, when many practices close. |
| • Submit outstanding claims. Claims usually have submission deadlines. Bloom Gap Cover, for example, requires claims within four months of treatment. |
| • Save emergency numbers for the holidays. Save Hello Doctor on WhatsApp (+27 860 10 29 03) and, if you have accident and emergency cover, Netcare 911 on 082 911. |
Looking ahead: what to expect from 2027 increases
October is when medical schemes begin announcing what their options will cost from January, as noted by Moonstone. In its guidance for 2027, the CMS recommended that contribution increases be anchored at 3.8%, in line with the Reserve Bank’s inflation projection, and that schemes seeking more provide detailed financial and actuarial justification, as reported by IOL.
The anchor is a starting point, not a cap. Schemes also factor in how much healthcare members use, new treatments and the age profile of their members, as explained by FAnews, and the CMS itself acknowledges that medical costs rise faster than CPI. The first 2027 announcement, from Medshield, came in at a 7.9% weighted average increase, according to FAnews. It is safer to budget for an increase well above 3.8% than to assume the benchmark.
How to read your scheme’s 2027 notice
Look for three things: the increase on your own option rather than the weighted average quoted in the media, the date the new contribution applies from, and any benefit changes, which may take effect even if an increase is deferred, as Curemed advises. Then compare your option with the one above and below it. You can compare Momentum Medical Scheme options or ask a Bloom consultant to help.
Key dates for your 2027 health budget
| When | What happens | What to do |
|---|---|---|
| October to November | Medical schemes announce 2027 contributions and benefit changes. | Read your notice and note the rand increase on your own option. |
| Before year-end | Most schemes set a deadline for option changes that take effect in January. | Confirm your scheme’s deadline and submit any change in time. |
| 1 January | New contributions and benefits take effect on most schemes, and annual benefits usually reset. | Update your debit order and monthly budget. |
| February | The national Budget may adjust tax brackets and medical tax credits for the 2027/28 tax year. | Check whether your tax credit has changed. |
| 28 February | The 2026/27 tax year ends. | Keep medical receipts and your scheme tax certificate for filing season. |
Medical tax credits: what applies until February
The 2026 Budget increased the Medical Scheme Fees Tax Credit after two years without an inflation adjustment, as reported by Moonstone. For the 2026/27 tax year, which ends on 28 February 2027, the credits are:
| Who is covered | Monthly tax credit |
|---|---|
| Main member | R376 |
| First dependant | R376 |
| Each additional dependant | R254 |
The credit reduces the tax you pay and is usually applied through your payslip if your employer deducts your medical aid contributions. You may also qualify for the Additional Medical Expenses Tax Credit on qualifying out-of-pocket costs, so keep your receipts. The amounts for the 2027/28 tax year will be confirmed in the February Budget. See the SARS medical tax credit rates for details, or speak to a tax practitioner.
Not all cover qualifies
The Medical Scheme Fees Tax Credit applies only to contributions to a registered medical scheme. Health insurance premiums, such as Health4Me, and gap cover premiums do not qualify, so include this in your comparison when you work out the true monthly cost of each type of cover.
Which type of cover fits your 2027 budget?
Bloom offers three types of health cover. They do different jobs, and many households combine them:
| Type of cover | What it does | Who it suits | Medical tax credit |
|---|---|---|---|
| Health insurance (Health4Me) | Day-to-day care: unlimited Network GP and Hello Doctor consultations, acute medication, basic pathology and X-rays, an annual health assessment and a flu vaccination. Optional major medical event benefits add accident and emergency cover. | Individuals and families who find medical aid unaffordable and mainly need everyday care. | No |
| Medical aid | Broader cover, including hospital treatment and Prescribed Minimum Benefits, with day-to-day benefits depending on the option, such as Ingwe, Evolve or Custom. | People who need hospital cover for planned procedures, chronic conditions or pregnancy and birth. | Yes |
| Gap cover | Covers shortfalls between what specialists charge in hospital and what your medical scheme pays, plus qualifying co-payments, oncology shortfalls and casualty visits after accidents. See Gap Max. | Medical aid members, especially anyone moving to a lower option or a network option in 2027. | No |
Thinking of buying down for 2027?
Moving to a cheaper medical aid option can make sense if you are paying for benefits you do not use, but check what you would lose first, such as hospital networks, chronic cover or specialist rates. Pairing a lower option with gap cover can protect you against in-hospital shortfalls. If you are considering health insurance instead of medical aid, read our guide to medical insurance vs medical aid and how to access private healthcare without medical aid.
Who should review their cover before 2027
| • Families with young children. Unlimited GP and Hello Doctor access on Health4Me keeps routine visits affordable, and every option includes a yearly flu vaccination per member. |
| • People with chronic conditions. Health4Me Gold includes a chronic benefit for 27 conditions, while medical schemes must cover the Chronic Disease List conditions as Prescribed Minimum Benefits. |
| • People planning a pregnancy. Every Health4Me option includes a maternity benefit for antenatal care, but not hospital cover for the birth. If you want private hospital cover for delivery in 2027, medical aid is the better fit, and waiting periods may apply, so plan early. |
| • Students and young adults. Phone-first care through Hello Doctor suits busy schedules. Read more about Health4Me for students. |
| • Adults approaching 35 without medical aid. Medical schemes may apply late joiner penalties to people who join at 35 or older without previous cover, so delaying can cost more over time. |
| • Travellers with medical aid. Bloom Gap Cover pays the excess on your travel insurance for medical emergency claims abroad. Health4Me does not cover treatment outside South Africa. |
How to build health cover into your 2027 budget
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1
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Start with your 2026 numbers Add up what you paid this year in premiums and out-of-pocket medical costs. This is your real healthcare spend and the foundation for next year. |
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2
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Confirm your 2027 take-home pay Base your budget on what actually lands in your account each month, and account for any expected salary increase, tax changes or new debt repayments. |
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3
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Update your fixed costs Review housing, school fees, transport and insurance for January. With fuel still volatile, give your transport line some headroom. |
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Plug in next year’s premium Use your scheme’s 2027 notice for the rand increase on your own option. If it has not arrived yet, assume an increase well above the 3.8% CMS anchor. |
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Compare before the deadline If the new cost does not fit, compare your current option with the alternatives, including a lower option with gap cover or Health4Me options for everyday care, before your scheme’s option-change deadline. |
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Factor in tax credits If you are on medical aid, include the Medical Scheme Fees Tax Credit in your calculation, as it reduces your effective monthly cost. |
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Add a health buffer Set aside a modest amount each month for co-payments, medicine and costs your cover does not include, especially if you are moving to a lower option. |
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Diarise a mid-year check Look again at your health spending halfway through 2027 so there are no surprises when the next round of increases is announced. |
Get your cover right for 2027Before the new year’s contributions kick in, let a Bloom consultant help you compare health insurance, medical aid and gap cover, and find the combination that fits your needs and your budget. Leave your details and we will call you back. |
Frequently asked questions
What will medical aid increases be in 2027?
How much did medical aid increase in 2026?
When can I change my medical aid option for 2027?
What are the medical tax credits for 2026/27?
Do Health4Me or gap cover premiums qualify for the medical tax credit?
Should I downgrade my medical aid for 2027?
Is health insurance a good alternative to medical aid?
What should I do with my health benefits before the year ends?
Close out 2026, plan for 2027
This year showed how quickly rising living costs and above-inflation medical increases can squeeze a household budget. The good news is that a little planning now goes a long way: review what 2026 really cost you, use the benefits you have left, read your 2027 notice carefully and choose cover that fits both your health needs and your budget before January arrives.
Explore health insurance, medical aid and gap cover from Bloom, or leave your details and a Bloom consultant will help you plan your cover for 2027.
Please note: This article is for general information only and does not constitute financial or tax advice as defined by the Financial Advisory and Intermediary Services (FAIS) Act. Figures were correct at the time of writing and may change. Speak to a qualified adviser or tax practitioner about your personal circumstances.
