Medical savings account (MSA) explained

On a saver or comprehensive plan your contribution has two parts. The risk portion pays for hospital admissions, chronic medicine and other big claims for everyone on the plan. The savings portion stays earmarked for you and your dependants.

Some schemes make the whole year's savings available on day one. Medihelp says its MedSaver plan makes the whole year's savings available upfront as a credit facility. That helps when you need care in January, but it means you can spend money you have not yet contributed, so ask the scheme what happens to an advance you have already used if you leave part way through the year.

Hospital plans and network plans usually have no savings account. Discovery Health Medical Scheme's Classic Core, Classic Smart and Active Smart plans, and Bankmed's Essential and Basic plans, are described as having no medical savings account.

These are plans that state a savings percentage. The rand figures are for the main member.

Discovery Health Medical Scheme states the savings in rand rather than as a percentage. From 1 April 2026 the main member's total monthly contribution and savings portion are:

A bigger savings share is not automatically better. Money in savings is money that is not in the risk pool, so a plan with a large savings account may have tighter hospital or chronic limits than one with a small account at the same price. Compare the whole benefit schedule, not only the percentage. Prices for each scheme are on its own page, for example Discovery Health and Medihelp.

The savings account pays for out-of-hospital, day-to-day care. LA Health's LA Active plan, for example, pairs a medical savings account with an Extended day-to-day benefit for GPs, specialists, acute medicine, radiology, pathology, dentistry and optical. GEMS Ruby pays day-to-day cover from the savings account and a block benefit.

Typical uses:

• GP and specialist consultations
• Acute medicine, such as antibiotics or pain medication
• Basic dentistry and optometry
• Radiology and pathology outside hospital

Exactly which items draw from savings, and at what rate, is set by each plan. Use our day-to-day benefits guide to see how savings sit alongside the other ways schemes fund everyday care.

Hospital admissions and Prescribed Minimum Benefits must be paid in full by the scheme without a co-payment when you follow its rules, so they belong to the risk pool, not to your savings. That includes emergency treatment and the chronic conditions on the Chronic Disease List when you use the designated provider. The PMB guide explains the rules.

If a claim that looks like a PMB is being taken out of your savings, ask the scheme why and in writing. If you are not satisfied, you can escalate to the Council for Medical Schemes.

If you spend the savings before the year ends, you may pay day-to-day costs yourself. What happens next depends on the plan.

• Comprehensive plans often add an Above Threshold Benefit. Once you have used your savings and reached a threshold, the scheme starts paying again from the risk pool up to a limit. Discovery describes the Executive plan as having an unlimited Above Threshold Benefit and Classic Comprehensive as having a limited one. Momentum's Extender plan adds an Extended Cover benefit once your threshold is reached. KeyHealth's Platinum plan is described as having a self-funding gap and a threshold.
• Some saver plans have no threshold. Medimed's Medisave Standard and Max pay an elective benefit once savings run out: R6 000 per beneficiary up to R12 000 per family on Standard, and R7 500 per beneficiary up to R15 000 per family on Max.
• Hospital and network plans have no savings to run out, but limit day-to-day cover in other ways.

The gap is the stretch between the money running out and the next benefit starting. Ask two questions before joining: how big is the savings account, and what pays after it is used up? Our guide to co-payments and sub-limits covers other limits that can catch you out.

On plans that keep a savings account, money you do not spend normally rolls over to the next year while you stay on a plan with savings. Bestmed says on its 2026 home page that unutilised savings on Beat3 Plus carry over and earn interest.

If you leave the scheme or move to a plan without a savings account, the balance is treated according to the scheme's rules, so confirm in writing how a balance is settled before you switch. That matters more if you have been advanced the year's savings and used them. The savings account claim refund letter can help if a scheme owes you money.

A plan with a savings account suits people who reliably use GPs, dentists, optometrists and acute medicine and would rather have a ring-fenced pot than pay for those visits out of pocket. It can also help you control spending because you can see the balance.

A hospital or network plan suits people who use little day-to-day care and want a lower monthly price. Genesis, for example, describes its MED-100 and MED-200 plans as mainly in-hospital cover with other day-to-day costs self-funded and no Self Managed Fund. You keep the difference in your own pocket.

Prices also move each year. Fedhealth's 2027 announcement raised risk-benefit limits and savings allocations by 3.9%, while the Council for Medical Schemes recommended that schemes anchor 2027 contribution increases at 3.8%. For 2026/27, the SARS medical scheme fees tax credit is R376 a month for the main member, R752 for the main member and one dependant and R254 for each additional dependant, whatever your savings share is. See medical aid tax credit and how medical aid works.