The Top 10 Medical Schemes in South Africa (2024/2025): What You Need to Know Before Choosing Cover

Choosing the right medical scheme is one of the most important financial and healthcare decisions you’ll make. With rising medical costs and annual contribution increases, having the right cover in place is no longer optional — it’s essential.

South Africa currently has 71 registered medical schemes, serving more than 9.13 million beneficiaries according to the Council for Medical Schemes (CMS) Annual Report 2024/25.

While there are many options available, a small group of schemes dominate the market due to their size, stability, and comprehensive benefits.

As an independent medical scheme brokerage, Proper Group works with most open medical schemes and provides unbiased, personalised advice — helping you choose the best option for your needs, without favouring any one provider.

Below is an overview of the top 10 medical schemes in South Africa, based on the latest CMS data.

1. Discovery Health (Open Scheme)

Discovery Health is the largest medical scheme in South Africa and covers the greatest share of beneficiaries among open schemes. It is well known for its extensive hospital networks, strong digital tools, and integrated wellness programmes.

2. GEMS – Government Employees Medical Scheme (Restricted Scheme)

GEMS is the largest restricted medical scheme in the country, serving government employees across all sectors. With over two million beneficiaries, its size allows for strong negotiating power, although membership is limited to qualifying public-sector employees.

3. Bonitas Medical Fund (Open Scheme)

Bonitas is one of South Africa’s most trusted open medical schemes. It consistently ranks among the largest by membership and appeals to families seeking value, simplicity, and dependable benefits.

4. Momentum Medical Scheme (Open Scheme)

Momentum Medical Scheme is a major national provider offering flexible hospital options, rewards programmes, and growing digital healthcare initiatives. Its scale places it firmly among the top open schemes.

5. POLMED – SAPS Medical Scheme (Restricted Scheme)

POLMED serves members of the South African Police Service and their dependants. It is one of the largest restricted schemes in South Africa, offering benefits tailored to its specific membership base.

6. Medshield (Open Scheme)

Medshield remains a strong contender among open medical schemes, offering a wide range of benefit options and solid hospital cover for individuals and families.

7. Bestmed (Open Scheme)

Bestmed is known for its strong focus on preventative care and transparent benefits. Its steady growth in membership places it confidently among South Africa’s top-tier open medical schemes.

8. Fedhealth (Open Scheme)

Fedhealth offers flexible hospital plans and innovative savings structures, making it a popular choice for professionals and families seeking adaptability in their medical cover.

9. Profmed (Restricted Scheme)

Profmed is a restricted medical scheme designed for professionals and continues to rank among the largest restricted schemes nationally.

10. Medihelp (Open Scheme)

Medihelp completes the top 10 as a long-established open medical scheme, serving a diverse range of members across South Africa with stable and reliable benefits.

What This Means for You as a Consumer

South Africa’s medical aid market is highly concentrated, confirmed by a high Herfindahl-Hirschman Index (HHI > 2500). While larger schemes may offer stability, size alone doesn’t guarantee the best value or fit for your needs.

Key considerations include:

• Bigger isn’t always better for your personal health profile

• Prices, benefits, and hospital networks vary widely

• Many schemes are designed for specific lifestyles or demographics

• The best plan is one that aligns with your medical needs and your budget

This is where independent advice makes a real difference.

Independent Advice That Puts Your Needs First

As an independent medical scheme brokerage, Proper Group is not tied to any specific provider. This means:

1. We compare relevant medical schemes on your behalf

2. You receive unbiased recommendations based on your needs

3. We explain benefits, exclusions, and provider networks clearly

4. We assist with plan selection, upgrades, downgrades, and claim escalations

5. Our services come at no additional cost to you (regulated by the CMS)

Whether you’re choosing medical aid for the first time, considering a switch, or looking to manage rising contributions, we’re here to help you make an informed decision.

Looking for the Right Medical Aid for 2026?

Understanding the top medical schemes is just the starting point. The right plan depends on your:

• Health needs

• Family situation

• Budget

• Lifestyle

• Preferred doctors and hospitals

If you’d like professional, independent guidance, Proper Group is ready to assist.

Get in touch today for personalised medical aid advice you can trust.