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Major medical schemes have announced contribution increases of between 7.35% and 8.9% for 2027 as ageing membership bases, rising rates of chronic illness, and advances in medical technology and medicines push up healthcare costs. Medical aid schemes operate on a shared-pool model, similar to a stokvel, with members’ contributions used to pay for eligible healthcare claims. Data from the Council for Medical Schemes, the industry regulator, shows that as much as R96 of every R100 paid into a scheme goes towards healthcare costs. Moneyweb asked Momentum Health, Discovery Health Medical Scheme, the Health Funders Association (HFA) and the Board of Healthcare Funders (BHF) why contributions increase above inflation every year. The short answer is that as healthcare expenditure increases, so do contributions. 1. Members are using more healthcare services Increased use of healthcare services, known as utilisation, is adding to medical scheme costs. According to HFA chief executive Thoneshan Naidoo, utilisation is adding about 4% to the estimated 3.8% consumer price inflation (CPI) rate for healthcare provision in 2027. Deon Kotze, chief commercial officer at Discovery Health, says Discovery Health Medical Scheme (DHMS) has recorded increased utilisation across doctors and other healthcare professionals, diagnostic services, medicines and hospital admissions. An ageing membership and the growing prevalence of chronic conditions are among the factors driving this trend. “The number of members on the [DHMS] that are registered for the treatment of a chronic illness rose from 27.8% to 33.6% between 2019 and 2026,” he says. Kotze says members with chronic illnesses, including mental health and lifestyle-related conditions, incur healthcare costs three times higher than those of other members. Momentum Health chief marketing officer Damian McHugh says hospitalisation remains one of the largest areas of medical scheme expenditure. Meanwhile, almost one in six members costs more than they pay in. The HFA’s State of Medical Schemes report, based on data covering 62% of medical scheme beneficiaries, found that nearly 35 000 beneficiaries in the study had claims exceeding R500 000 in 2025, while more than 10 000 had claims of over R1 million. A further 975 528 beneficiaries – 17% of the population surveyed – incurred healthcare costs exceeding their annual contributions, Naidoo says. 2. Modern medicines cost more Medical advances have brought new treatments and therapies, but many come at a high cost. Kotze says medicine costs funded by DHMS, excluding members’ discretionary day-to-day benefits, increased by an average of 6.2% a year between 2016 and 2026, despite savings from generic medicines and patent expiries. “High-cost new medicines have been a major driver of this trend,” he says. “Spending on these drugs grew by an average of 9.7% a year over the same period and had a disproportionate impact on medical inflation.” 3. Medical scheme members are ageing Older people generally have greater healthcare needs, which can lead to higher claims costs. McHugh says the average age of beneficiaries in the Momentum medical scheme increased from 32 to 34.2 years between 2019 and 2024. The average age in open schemes (not linked to a specific employee) is 36.4 years. Discovery Health Medical Scheme’s claims data shows that its average beneficiary age rose by 3.1 years, from 35.3 to 38.4, between 2019 and 2026. This reflects both existing members ageing and people joining at older ages. 4. Fewer younger people are joining Low economic growth and high unemployment make medical scheme membership unaffordable for many people. Those who do join may also be older. Paresh Prema, branch head of technical and actuarial consulting solutions for healthcare at Alexforbes, says medical schemes rely on cross-subsidisation: younger, healthier members help fund the higher expected healthcare costs of older members and those with greater medical needs. When fewer younger people join or remain in schemes, the average age of the membership and expected claims costs can rise. McHugh says attracting and retaining younger members is a key challenge for the industry. “The medical scheme market is actually shrinking and that is one of the key challenges to resolve.” Schemes are trying to attract younger members through more affordable options. DHMS, for example, has added more than 80 000 members since 2025 through newer options. 5. Prescribed minimum benefits add to costs To protect members, the law requires medical schemes to cover the full cost of treating specified prescribed minimum benefit (PMB) conditions, subject to applicable rules. These include 271 specified conditions, such as cancer and medical emergencies, as well as 26 chronic illnesses. The HFA says the cost of providing PMBs continues to rise. Between 2014 and 2024, PMB costs increased at twice the rate of CPI and now account for about 52% of total benefits paid, up from 43% in 2014. 6. Don’t just cancel your cover BHF managing director Dr Katlego Mothudi advises members to speak to their scheme about a more affordable benefit option before cancelling their cover. Network options may reduce contributions, but members should check whether designated doctors and hospitals are accessible to them. They should also understand specialist referral rules, medicine formularies – which determine which drugs are covered – and potential co-payments. Members should compare the likely overall cost of healthcare, rather than focusing only on monthly contributions, Mothudi says. They should also consider the implications of a break in membership, including possible waiting periods when rejoining. Mothudi warns that health insurance products, which can cost as little as R400 a month, offer different benefits and protections. They should not be assumed to provide cover equivalent to that of a medical scheme. This article was republished from Moneyweb. Read the original here.

New recruit Bongi Mbonambi has been included in the Stormers team to face Ulster in a United Rugby Championship encounter at Cape Town Stadium on Saturday, after being released by the Sharks earlier in the day Wednesday. Mbonambi, who played for the Stormers and Western Province previously, will play from the bench. Vernon Paulo will start at hooker in the absence of several unavailable players. There are 10 changes in total to the matchday squad from the side that featufred last week. Ruhan Nel returns to lead the side from outside centre and will link up in midfield with Jonathan Roche, who has recovered from concussion. Warrick Gelant, Hacjivah Dayimani and Lukhanyo Vokozela have all been ruled out due to concussion protocols this week. Damian Willemse starts at fullback in place of Gelant, while in the loose trio Evan Roos shifts from blindside flank to the back of the scrum, with Louw Nel coming into the starting line-up. The halfback pairing of Cobus Reinach and Yaqeen Ahmed that finished the win against Scarlets so strongly last weekend will start on Saturday, with Sacha Feinberg-Mngomezulu being rested and Haashim Pead among the replacements. JD Schickerling and Adré Smith start in the second row, with Riley Norton and Connor Evans set for impact roles, along with explosive loose forward Wandile Mlaba. In the front row Wilco Louw and Paulo join Ntuthuko Mchunu, with André-Hugo Venter unavailable through injury and JJ Kotzé serving a suspension. Director of Rugby John Dobson said that it will be important for the new combinations to click against a dangerous Ulster team. “There are many changes, but every player coming in bar the vastly experienced Bongi Mbonambi has already played an important role for us this season. “It will take a big effort to end this phase of the season with a fourth straight win at home and everyone is determined to give our fans another win at Cape Town Stadium. “After this match we go into a four-week break, so you can expect to see them leave it all out there on Saturday,” he said. Stormers: Damian Willemse, Seabelo Senatla, Ruhan Nel (capt), Jonathan Roche, Leolin Zas, Yaqeen Ahmed, Cobus Reinach, Evan Roos, Louw Nel, Paul de Villiers, JD Schickerling, Adré Smith, Wilco Louw, Vernon Paulo, Ntuthuko Mchunu. Bench: Bongi Mbonambi, Vernon Matongo, Neethling Fouché, Riley Norton, Connor Evans, Wandile Mlaba, Haashim Pead, Wandisile Simelane.

One of the biggest questions the Springboks need to answer when looking to the future revolves around who can take over from Eben Etzebeth when he eventually hangs up his boots. It’s largely been a year to forget for Etzebeth as he’s battled with injuries, while also needing to sit out a large part of action at the start of the year while serving a lengthy ban for an eye gouge. The 34-year-old has 147 Test caps to his name, and has become such a mainstay in the Springbok team that it has started to feel like he’s become almost irreplaceable. However, the Springboks will very quickly need to find a solution as Etzebeth will miss the next four Tests in November at a time when RG Snyman is also unavailable. What options could the Springboks consider to replace Etzebeth? The Springboks will head on tour with five specialist locks, although Riley Norton is uncapped and unlikely to feature in the high-pressure games against Ireland and France. Erasmus could view Norton as a long-term successor to Etzebeth, but the 20-year-old does still need time to be gradually integrated at international level. Looking short term, other locks touring with the Springboks are Ruan Nortje and Franco Mostert. However, both are out-and-out No 5 locks. That leaves Lood de Jager and Salmaan Moerat in the travelling group, and it’s this duo who will have a big job to do in trying to fill the boots left behind by Etzebeth. One wonders whether the Springbok coaches may have given any consideration to calling up giant lock JJ van der Mescht after he was on the national radar earlier this year, but that does seem to be a project delayed for now. For now, it’s over to De Jager and Moerat to prove the Springboks do have capable options beyond Etzebeth. nd-of-year fixtures (SA kick off times) Saturday 7 November:Italy v Boks Venue: Allianz Stadium, Turin Kick off: 13:40 Friday 13 November: France v Boks Venue: Stade de France, Paris Kick off: 22:10 Saturday 21 November: Ireland v Boks Venue: Aviva Stadium, Dublin Kick off: 18:40 27–29 November: Finals Weekend Venue: Twickenham Stadium, London Kick off: TBC

Gauteng has the largest registered voting population in South Africa, accounting for nearly a quarter of all registered voters, according to the latest statistics published by the Electoral Commission of South Africa (IEC). The IEC’s voter registration statistics put the national total at 29 230 808 registered voters ahead of Wednesday, 4 November’s Local Government Elections. READ | Elections 2026: What is a spoilt vote? Here are 7 examples [photos] Gauteng accounts for 6 751 064 of those voters, representing 23.1% of the national total. KwaZulu-Natal follows with 6 030 969 registered voters, or 20.63%. The Eastern Cape has the third-largest registered voting population, with 3 628 934 voters (12.41%), followed by the Western Cape, with 3 457 253 (11.83%). Registered voters by province The IEC’s figures show the distribution of registered voters across South Africa’s nine provinces. ProvinceRegistered votersShare of national totalGauteng6,751,06423.1%KwaZulu-Natal6,030,96920.63%Eastern Cape3,628,93412.41%Western Cape3,457,25311.83%Limpopo3,037,38710.39%Mpumalanga2,170,1397.42%North West1,907,6236.53%Free State1,533,5705.25%Northern Cape713,8692.44%Total29,230,808100% Gauteng and KwaZulu-Natal together account for more than 12.7 million registered voters, representing approximately 43.7% of the national total. At the other end of the table, the Northern Cape has the smallest registered voting population, with 713,869 voters, accounting for 2.44% of the total. Women make up 55% of registered voters The IEC’s demographic figures also show that women account for a larger share of South Africa’s registered voters than men. Of the 29,230,808 people on the voters’ roll, 16,155,730 are women, representing 55.27%. Men account for 13,075,078 registered voters, or 44.73%. The difference between the two groups is more than 3.08 million voters. Voters aged 30 to 39 form the largest age group The statistics show substantial representation across the adult age groups, with registered voters aged 30 to 39 forming the largest group overall. This age category includes 6,775,584 registered voters when the male and female figures are combined. The 40-to-49 age group is the next largest, with 6,317,631 registered voters, followed by those aged 20 to 29, with 4,838,960. The figures also show that women outnumber men in every age category listed by the IEC. Among voters aged 18 to 19, there are 693,913 registered voters. This represents 2.37% of the national total. Are you registered to vote – and will you be doing so? Let us know by clicking on the comment banner below …

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