Medimed Medical Scheme: 2026 options, savings plans and who can join

Medimed suits Eastern Cape households, especially people who want either a savings-based plan or a low-cost plan where one GP manages their care. Most of its members are on Medisave Standard (8 442 beneficiaries) and Alpha (3 741).

It is less suited to people who want the scale of a national scheme. With about 14 000 beneficiaries, Medimed has a small risk pool. Its finances look sound: reserves were 87.84% of gross contributions at 31 December 2024, far above the 25% statutory minimum. Size still matters, because one bad year is harder for a small pool to absorb, and small schemes can be pushed to merge, as the Suremed case on this site shows.

• Medimed Medical Scheme is registered under the Medical Schemes Act as an open scheme, but focuses on members in the Eastern Cape; it is administered by Momentum Thebe Ya Bophelo (MomTYB). (medimed.co.za)
• Medimed is on the CMS register as an open scheme (as at 31 March 2025) and describes itself as registered open but focused on the Eastern Cape. (static.pmg.org.za)
• Medimed sells four options for 2026: Medisave Max, Medisave Standard, Medisave Essential and Alpha. (medimed.co.za)
• Contributions on the Medisave options are income-banded by the main member's income, with the top band at R23,001 plus. (medimed.co.za)
• Medisave Standard and Max put 25% of contributions into a Medical Savings Account and add an elective benefit once the account is depleted. (medimed.co.za)
• Medisave Essential is a capitation network: contracted providers manage care and are paid a capitation fee per beneficiary. (medimed.co.za)
• Alpha is described in the scheme's financial statements as cost-effective because members pay co-payments on all services except hospitalisation. (medimed.co.za)
• Medimed's solvency was far above the 25% statutory minimum at 31 December 2024 (87.84% reserves to gross contributions). (medimed.co.za)
• Medimed has about 14 000 beneficiaries, making it one of the smallest open schemes; most are on Standard (8 442) and Alpha (3 741). (medimed.co.za)

Medimed Medical Scheme publishes 4 benefit options for 2026. Prices are the monthly contribution for a main member as published by Medimed, and income-banded plans show the band. Adult and child dependants pay extra. Checked on 29 September 2026.

Sources: medimed.co.za/...ploads/Medisave-Max_2026.pdf, medimed.co.za/...s/Medisave-Standard_2026.pdf, medimed.co.za/.../Medisave-Essential_2026.pdf, medimed.co.za/...ntent/uploads/Alpha_2026.pdf.

Alpha has one adult rate and one child rate, with no income bands. The Medisave options are income-banded by the main member's income. Because Alpha charges co-payments on everything except hospitalisation, it is a cost-saving plan for people who rarely use day-to-day care. Our hospital plan vs comprehensive guide explains that trade-off.

Checked on 29 September 2026 against Medimed'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: medimed.co.za/...s/Medisave-Standard_2026.pdf. All schemes' numbers are on our medical aid contact numbers page.

Medisave Essential is a capitation network. Contracted providers, ECIPA and PEGP, manage your primary care and are paid a fixed fee per beneficiary, so you must start with your selected GP. Going outside the network without a referral may not be paid, so ask before you book a specialist.

On Max, Standard and Alpha, benefits are paid up to the Medimed Scheme Tariff. If a provider charges more than that tariff you may have to pay the difference, so ask your doctor what they charge before a planned procedure. Hospital and specialist admissions need clinical pre-authorisation: the number is in the contact table. Read the pre-authorisation guide for how it works.

For emergencies, the 2026 benefit brochures list Netcare 911 as the ambulance service. Older Medimed material named a different provider, so confirm the ambulance number with the scheme and save it in your phone.

On Standard and Max, 25% of your contribution is paid into your MSA. You spend it on day-to-day costs, and once it runs out an elective benefit kicks in. Standard's elective benefit is R6 000 per beneficiary up to R12 000 per family. Max's is R7 500 per beneficiary up to R15 000 per family. Because of the family cap, a family of two on Standard already reaches the R12 000 limit, and larger families share it.

Essential also has an MSA, set at 10% of annual contributions, with day-to-day care mainly through your network GP. Alpha has no savings account and instead uses co-payments. Our medical savings account guide shows how unspent savings are treated when you move scheme.

Medimed has a pharmacy benefit management line for chronic medicine, listed in the contact table. If you have a chronic condition, register it with the scheme early so your medicine is authorised and paid from the correct benefit.

On every Medimed option, PMBs must be paid in full, without co-payment or deductible, when treated at the scheme's designated service provider. That includes the conditions on the Chronic Disease List, which the CMS describes as 26 chronic conditions. Formulary and treatment protocols still apply, and refusing a formulary medicine can carry a co-payment. See prescribed minimum benefits and chronic disease benefits.

We could not confirm maternity limits from the documents we read, so we do not state them. If you are planning a pregnancy, ask Medimed in writing which option covers antenatal care and delivery, at which hospitals, and whether a waiting period applies. Our medical aid for pregnancy guide lists what to ask.

The 2026 line-up is four options. We found no published 2026 or 2027 average contribution increase for Medimed. An old homepage line about an earlier year is out of date and we do not rely on it, so ask the scheme for your specific rate.

For the industry, the CMS recommended in Circular 20 of 2026 that 2027 increases be anchored at 3.8%. That is a benchmark and not a hard cap, and it acknowledges private medical inflation typically runs 2 to 3 percentage points above CPI. See our 2027 increases page for schemes that have already announced.

• Suremed Health: also administered by Momentum Thebe Ya Bophelo and also very small, but with a merger planned for 1 January 2027. See Suremed.
• Makoti: a low-cost open scheme whose Primary option covers hospital care only as PMBs in state hospitals. See Makoti.
• Medihelp: a not-for-profit open scheme with a much wider range of options, from hospital plans to a student plan. See Medihelp.

Compare hospital access, savings and co-payments rather than headline price. Our network vs traditional plans guide and the list of medical aid schemes help you shortlist.

You can apply through the scheme's membership application form or a broker. As an open scheme Medimed cannot turn you away on age or health, but waiting periods can apply. The Medical Schemes Act sets the ceilings. If you have had no cover for 90 days or more, or have never had cover, a scheme may impose a general waiting period of up to three months and a condition-specific waiting period of up to 12 months. These are maximums, and a scheme may impose shorter periods or none. Switching within 90 days does not wipe waiting periods out: after up to 24 months of earlier cover the new scheme may still impose a condition-specific period of up to 12 months, and after more than 24 months it may still impose a general period of up to three months. Neither can be applied to treatment of Prescribed Minimum Benefits (PMBs). There is no waiting period when you move between options on the same scheme, or for a baby born while you are a member. Read more in waiting periods and exclusions.

Late-joiner penalties. A late joiner is someone aged 35 or older when they apply, without earlier cover. The loading is a percentage of that adult's own part of the contribution only, and the maximum depends on the years you were uncovered after 35, less any years of cover you can prove: 1 to 4 years is 5%, 5 to 14 years is 25%, 15 to 24 years is 50% and 25 years or more is 75%. Example: a 45-year-old with no proof of earlier cover has 10 years to count (45 minus 35), which falls in the 5 to 14 year band, so the maximum loading is 25%. A sworn affidavit can prove earlier cover if the documents are gone, and the penalty can follow you to another scheme. See the late joiner penalty guide.

Tax credit. For the 2026/27 tax year (1 March 2026 to 28 February 2027) the medical scheme fees tax credit is R376 a month for you, R752 a month for you and one dependant together, and R254 a month for each additional dependant. It only reduces the tax you owe and cannot be carried over. Details are in the medical aid tax credit guide.

Complaints. If something goes wrong, raise it with Medimed first and keep a written record. The scheme has an escalations email listed on its site, which is the natural next step after customer care. If you are not satisfied after using the scheme's own complaints process, you can complain to the Council for Medical Schemes (CMS), the regulator. Send a completed complaint form with proof that you took it up with the scheme to [email protected], or phone the CMS on 0861 123 267 (Monday to Friday, 08:00 to 16:30). The CMS acknowledges a complaint in writing within 6 working days, asks the scheme to comment, and aims to finish within 120 calendar days of receiving the scheme's response and documents. Clinically urgent complaints are handled urgently. Our CMS complaints guide explains each step.