Medihelp medical aid: 2026 plans, network rules, increases and how to join

Medihelp suits people who want a self-administered scheme with a clear ladder of plans, from hospital-only cover to top-of-the-range comprehensive cover.

• Students can use MedMove!, a hospital plan on a national network of private hospitals and GPs, where the main member, dependant and child all pay the same flat rate.
• Young families on a budget can look at MedAdd Elect and MedPrime Elect, where you pay for only two children under 18.
• People who mainly want hospital cover can use MedVital Elect or MedVital, with limited day-to-day benefits.
• Professionals can look at MedReach, an affordable comprehensive plan on a network of private hospitals and GPs, with child rates until 26.
• Members who want extensive day-to-day cover can look at MedElite or MedPlus.

It suits you less if you want the cheapest cover and are not a student: the entry plan for everyone else is a network hospital plan with limited day-to-day. It also suits you less if you dislike hospital networks, because the Elect versions and MedReach use one.

Medihelp's solvency is above the legal minimum but not by a wide margin, so it is worth reading the scheme's latest financial statements before you decide.

• Medihelp is a not-for-profit open medical scheme registered with the Council for Medical Schemes under reference number 1149; anyone may join. (medihelp.co.za)
• 2026 contribution increase: 8,46% weighted average (lowest increase across selected plans 6%). (fanews.co.za)
• Medihelp's solvency ratio was 27,01% at year end 2025, back above the 25% statutory minimum, a year ahead of its three-year restoration plan. It had been marginally below 25% when the 2026 increases were announced in October 2025. (medihelp.co.za)
• Membership at year end 2025: 193 744 beneficiaries including 89 836 main members. (medihelp.co.za)
• 2026 contribution increase was 8,46% weighted average, with most members seeing 7,5% or less. (medihelp.co.za)
• From 2026, savings-plan members can change at any point in the year whether co-payments are paid from their savings account. (fanews.co.za)
• From 2026 only the single highest procedure-specific co-payment per admission applies. (fanews.co.za)
• Members who complete a combo health screening unlock R1 000 in over-the-counter medicine benefits per family per year plus one additional GP visit (care extender benefit, 2026). (fanews.co.za)
• Members on MedVital Elect, MedAdd Elect and MedReach no longer need a GP referral to see a specialist, and the 35% co-payment for not having one was removed (2026 member guide). (medihelp.co.za)
• Chronic medication members can choose home or workplace delivery; Medihelp members also get the Omnihelp wellbeing rewards programme. (fanews.co.za)
• Medihelp says it was voted number one medical aid client care contact centre in the CE Index. (medihelp.co.za)
• Medihelp offers 11 plans in total for 2026 (MedMove! student, MedVital and MedVital Elect, MedAdd and MedAdd Elect, MedSaver, MedReach, MedPrime and MedPrime Elect, MedElite, MedPlus). (medihelp.co.za)

Medihelp Medical Scheme publishes 11 benefit options for 2026. Prices are the monthly contribution for a main member as published by Medihelp. Adult and child dependants pay extra. Checked on 29 September 2026.

Sources: medihelp.co.za/plans/student-plan, medihelp.co.za/plans/vital-plans, medihelp.co.za/plans/savings-plans/medadd, medihelp.co.za/plans/savings-plans/medsaver, medihelp.co.za/...comprehensive-plans/medreach, medihelp.co.za/...comprehensive-plans/medprime, medihelp.co.za/...comprehensive-plans/medelite, medihelp.co.za/.../comprehensive-plans/medplus.

Plans with "Elect" in the name are the network versions. The prices are in the plans and prices table on this page.

The hospital plan guide explains what a hospital plan covers and what it leaves to your own pocket. For how cost varies by plan type, see how much medical aid costs.

Checked on 29 September 2026 against Medihelp'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: medihelp.co.za/contact-us. All schemes' numbers are on our medical aid contact numbers page.

A few rules changed for 2026, and they matter if you use your benefits a lot:

• Members on MedVital Elect, MedAdd Elect and MedReach no longer need a GP referral to see a specialist, and the 35% co-payment for not having one was removed.
• On savings plans you can change, at any point in the year, whether co-payments are paid from your savings account.
• Only the single highest procedure-specific co-payment applies per hospital admission.
• If you complete a combo health screening, you earn R1 000 in over-the-counter medicine benefits per family a year plus one extra GP visit.

Medihelp also runs the Omnihelp wellbeing rewards programme. You manage your cover on the Member Zone web portal or the Medihelp app, where you can authorise hospital admissions, submit and track claims, track your benefits and show a digital membership card.

If you use a hospital outside your network by choice, scheme rules can add a co-payment.

Every scheme must pay Prescribed Minimum Benefits (PMBs) in full, and the CMS says these cover 271 conditions and 26 chronic conditions. For chronic medicine, Medihelp members can choose home or workplace delivery.

The MedVital hospital plans include maternity cover. Dental and optical benefits are handled by the Dental Risk Company and Opticlear, and there is an HIV and Aids programme with PEP through LifeSense. All the numbers are in the contact table on this page.

For emergencies, Medihelp uses Netcare 911 as its emergency medical transport partner. Medihelp also says it was voted number one medical aid client care contact centre in the CE Index, which is the scheme's own claim.

For 2026, Medihelp raised contributions by 8,46% on a weighted average, with the lowest increase across selected plans at 6%. Most members saw 7,5% or less. Solvency was restored above 25% at the end of 2025.

Medihelp has not announced 2027 contributions. The CMS recommends that 2027 increases be anchored at 3.8%, which is a benchmark rather than a hard cap. Fedhealth and Medshield have already announced theirs, and other schemes usually follow in October and November. Follow 2027 medical aid increases for updates.

Whatever the increase, your own bill depends on your plan and how many dependants you have. Check the new rates before the CMS Open Season deadline, which is usually late November or early December.

Reported 2026 average increases, from an Alexforbes analysis: Momentum 9.9%, Fedhealth 9.6%, Bonitas 8.88%, Medihelp 8.46%, Discovery 7.2% and Bestmed 6.8%. Discovery's increase was deferred to April, so its effective increase for the year was lower.

• Bonitas is another open scheme, with a reported 2026 increase of 8.88%. See the Bonitas page.
• Bestmed is an open scheme with the lowest reported 2026 increase of this group.
• Discovery Health Medical Scheme deferred its 2026 increase to April.

A lower increase does not mean lower cost. Compare the plan you would actually buy, at today's price, on hospital choice, day-to-day limits and co-payments.

Medihelp must accept anyone who applies and can pay, but it can apply waiting periods. With no scheme cover for at least 90 days, the maximum is a 3-month general waiting period and a 12-month condition-specific waiting period. After a shorter gap the rules are narrower, and PMB treatment is excluded. Read the waiting periods guide.

A late-joiner penalty can apply from age 35 if you have no earlier cover. The maximum loading is 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 late-joiner penalty guide.

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. See the tax credit guide.

Apply on medihelp.co.za or through a broker; the contact table lists the adviser lines. The medical aid contact numbers page also lists every scheme's official lines. Have your ID, proof of earlier cover and dependant details ready.

If something goes wrong, complain to Medihelp first and keep the reference numbers. If you are still not satisfied, refer the complaint 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 of receiving the scheme's response and documents. See the CMS complaints guide.

Gap cover and hospital cash plans are not medical schemes. They are health insurance products, and complaints about them go to the National Financial Ombud, not the CMS.