LA Health medical aid in 2026: who can join, the six options, prices and how the Discovery link works

You must work for local government. The scheme is accredited by the SALGBC, and your employer's HR department can confirm whether you may join and which options you are offered. Dependants can be covered with you.

If you are not eligible, you cannot join, however good the plans look. Look at an open scheme instead, such as Discovery Health or Bonitas. KeyHealth is an open scheme that is also one of 4 schemes accredited to operate in local government, so it is worth comparing if you work in that sector.

LA Health is not the same as Discovery. It uses Discovery for administration, so you deal with Discovery's systems, but the scheme's board and rules are separate.

• LA Health (CMS registration number 1145) is a restricted scheme accredited by the South African Local Government Bargaining Council to cover people working for local government. (lahealth.co.za)
• 2026 contribution increase: 8.7% weighted average for 2026, with tailored increases across the five existing options. (lahealth.co.za)
• LA Health offers six options for 2026: LA Comprehensive, LA Core, LA Engage, LA Active, LA Focus and LA KeyPlus. (lahealth.co.za)
• LA Engage is new for 2026, aimed at young and growing families and priced between LA Active and LA Core. (lahealth.co.za)
• The 2026 weighted average contribution increase is 8.7%. (lahealth.co.za)
• The scheme says it now covers nearly 300 000 beneficiaries, with annual beneficiary growth of about 7% over several years. (lahealth.co.za)
• Solvency margin was 49.27% at 31 December 2025, against 52.21% a year earlier. (lahealth.co.za)
• Annual medical savings allocations for the member for 2026: LA Focus R10 200, LA Active R9 624, LA Engage R10 200, LA Core R14 496, LA Comprehensive R18 012. (lahealth.co.za)
• Employer subsidy illustration in the table assumes a 60% subsidy and the SALGBC maximum subsidy capping of R5 791.15 in effect until 30 June 2026. (lahealth.co.za)
• Failing to pre-authorise a planned admission at least 48 hours ahead means the scheme pays only 70% of the hospital cover, with the member paying the other 30% up to R1000 per case. (lahealth.co.za)

LA Health Medical Scheme publishes 6 benefit options for 2026. Prices are the monthly contribution for a main member as published by LA Health, and income-banded plans show the band. Adult and child dependants pay extra. Checked on 29 September 2026.

Sources: lahealth.co.za/...ealth-contribution-table.pdf.

Contributions in the plans and prices table are the total before the employer subsidy, so what you pay from your salary is lower. Only LA KeyPlus has income bands.

Checked on 29 September 2026 against LA Health's official website. Numbers change, so confirm on the linked page before you call. A scheme will not ask you to pay into a new bank account over the phone: hang up and call the official number if anything feels off.

Sources: lahealth.co.za/portal/la-health/contact-us, lahealth.co.za/...alth/healthcare-professional, lahealth.co.za/...h/what-to-do-in-an-emergency, lahealth.co.za/...hatsapp-infographic-2026.pdf. All schemes' numbers are on our medical aid contact numbers page.

The table on this page shows the total contribution before any employer subsidy. The scheme's own illustration assumes a 60% subsidy and the SALGBC maximum subsidy cap of R5 791.15, which applied until 30 June 2026. The cap after that date may differ, so your actual deduction can be different.

Ask your HR department for your subsidy and your payslip deduction for each option. Then add the cost of dependants and the cost of any co-payments you expect to pay. See how much medical aid costs.

The 2026/27 medical scheme fees tax credit is R376 a month for the main member, R752 for the member and one dependant, and R254 for each additional dependant. The credit is fixed per person and is not tied to the actual contribution. See the tax credit guide.

Planned hospital admissions must be pre-authorised at least 48 hours before you go in. If you skip this step, the scheme pays only 70% of the hospital cover, and you pay the other 30%, up to R1000 per case. The same number handles client services and pre-authorisation. See the pre-authorisation guide.

All emergency medical transport must be authorised through Discovery 911. In a genuine emergency you may go to the nearest facility.

Members use the Discovery app, where you can submit a claim by photographing it with your smartphone camera. There is also a WhatsApp service for a membership certificate, tax certificate, [medical savings account balance](/templates/savings-account-claim-refund-letter/), option type and contribution breakdown. The scheme gives a QR code for it rather than a number. To report fraud anonymously, use the fraud line in the contact table.

Every scheme must pay Prescribed Minimum Benefits (PMBs) in full, and the CMS says these cover 271 conditions and 26 chronic conditions. LA KeyPlus, LA Focus and LA Active cover chronic conditions at PMB level by formulary. LA Engage, LA Core and LA Comprehensive add cover for additional-disease-list conditions. Register your condition with the scheme so your medicine is paid from the right benefit.

The main change for 2026 was LA Engage, a new option for young and growing families, priced between LA Active and LA Core. The weighted average increase was 8.7%, with tailored increases across the five existing options.

The scheme says it now covers nearly 300 000 beneficiaries, with annual beneficiary growth of about 7% over several years. Its solvency margin of 49.27% at the end of 2025 was slightly lower than the 52.21% a year earlier but is far above the 25% legal minimum.

No 2027 announcement had been made when this page was updated. The CMS recommends anchoring 2027 increases at 3.8%, a benchmark rather than a cap. See 2027 medical aid increases.

Restricted schemes decide who can join, but waiting periods come from the Medical Schemes Act. With no scheme cover for at least 90 days, the maximum is a 3-month general and a 12-month condition-specific waiting period. After a shorter gap the rules are narrower, and PMB treatment is excluded. The Act bars waiting periods when you must switch because your employer changed or ended its scheme. A late-joiner penalty can apply from age 35 without earlier cover, with a maximum loading of 5% for 1 to 4 years of missing cover, 25% for 5 to 14 years, 50% for 15 to 24 years and 75% for 25 years or more. See the waiting periods guide and the late-joiner penalty guide.

To join, ask your employer's HR department and see lahealth.co.za. The medical aid contact numbers page also lists every scheme's official lines.

To complain, go to LA Health first, by the email address in the contact table, and keep reference numbers. If you are still not satisfied, refer it to the CMS at [email protected] with a completed complaint form and proof that you escalated to the scheme. The CMS acknowledges in writing within 6 working days and aims to finish within 120 calendar days. See the CMS complaints guide.