Making sense of your medical aid review period

Just like every other year, in 2026, medical aid members all over South Africa will receive an updated set of benefits. Nearly all of these packs contain small, intricate changes that affect both your health and your wallet. Their fine print might be difficult to navigate, but here is some good news; understanding your review period for your medical aid does not have to be difficult. With the correct information, instead of making it stressful, this review period can be used to ensure that you are still receiving the best value for your money.

Why the review period matters

Think of the review period as your annual financial health check. It’s the moment when your medical aid scheme lays out what’s changing for the year ahead. Some changes will have little impact, while others could affect your household budget or even the doctor, you’re able to see.

Premium increases

The first thing most people notice is the higher monthly premium – a rise that’s almost inevitable, irrespective of any pay increase for the main member on the horizon.

Take this example: R200 a month may feel small, but over a year that’s R2,400. The real question is – does this extra cost add value to your future, or just drain your budget?

Benefit adjustments

Not all changes are bad news. Sometimes benefits improve, like more GP visits or higher allowances for specialist scans. Conversely, sometimes cover shrinks. Because of this, you’ll lose cover sooner and tiny changes end up accumulating. This is why you need to ensure that your plan suits your lifestyle and daily activities.

Provider network changes

This is one area where people often get caught off guard. You could find that your chosen clinic or MSP hospital is no longer in your plan’s network. When this happens, you might need to pay additional charges or change providers. Being informed of this enables you to prioritise what matters to you more, either continuing with your doctor or minimising expenses.

Out-of-pocket increases

Additional co-payments, new exclusions, or increased deductibles are all examples of concealed charges that can accumulate quietly over time. The problem is that you typically become aware of them during an emergency, when you do not expect to receive an additional bill. Fine-tuning your policy now can prevent those unpleasant surprises in the future.

Value-adds

Medical aid schemes love to talk about their “extras”: wellness apps, rewards programmes, or free preventative screenings. Some of these are genuinely useful, especially if they help you stay healthier for longer. Others might simply inflate your premiums without offering much day-to-day benefit. The key is to ask: Will I really use this?

 Time to reassess

Your 2026 benefit pack isn’t just paperwork: it’s a signal to pause and check if your medical aid plan still matches your lifestyle, health needs, and budget.

Don’t just accept the changes in your 2026 benefit pack. Compare your plan today with MedicalAid.co.za and find the option that truly fits your health and budget needs.

 

What the medical aid review period means for you (and why it starts before November)

Every year around this time, something big happens in the world of medical aid, and it’s not just in November.

If you currently hold medical cover under an open medical aid scheme or are thinking of subscribing to one, the time between September and December is your months of opportunity. This is when medical scheme administrators begin updating existing schemes upwards in premiums, tweaking benefits, changing provider networks, and changing cover limits, all meant to be effective from the following January.

The knowledge of the annual review schedule stands to benefit your decision-making when determining health cover for 2026. Here follows some information for you to know.

What is the medical aid review period (and when does it start)?

The medical aid review period generally runs from late September through to December, although exact dates vary between schemes. Most of the major schemes begin releasing information in late September or early October, first to brokers and then to the public.

During this time, you’ll start seeing:

  • Premium (monthly contribution) changes
  • Updated benefit limits
  • Network provider adjustments
  • Revised co-payments or exclusions
  • New wellness tools or added-value services

While many refer to it as the “November review period,” the process typically kicks off from September, with more schemes revealing their updates as the weeks progress.

Why do these changes matter?

Your medical aid plan is not static and neither are your healthcare needs. Schemes revise their options annually to:

  • Keep pace with medical inflation and provider fee increases
  • Align with updated industry regulations
  • Adjust for changes in member claims and utilisation patterns
  • Introduce new digital tools or services for better member support

Staying informed about these updates is essential. A plan that served you well this year might not suit your needs or budget in 2026.

What to look out for during review season

When your scheme’s updates become available, pay close attention to:

  • Premium increases: What’s your new monthly cost?
  • Benefit adjustments: Are limits going up or down?
  • Provider network changes: Will your current doctor or hospital still be covered?
  • Out-of-pocket increases: Are there new co-payments or exclusions?
  • Value-adds: Are there any new wellness tools, apps or rewards?

Doing a medical aid comparison helps you weigh up your current plan against what’s newly available across different schemes and options, without necessarily switching funds.

Should you switch funds or just change options?

In most cases, switching to a different option within your current fund is the safer, easier route, especially if your needs have changed. Switching to a different scheme entirely can trigger new waiting periods or exclusions for certain conditions.

Unless there is a compelling reason, it’s usually better to stay within your existing medical aid and look at more suitable options under that umbrella.

How MedicalAid.co.za can help

With dozens of schemes and hundreds of options available in South Africa, comparing medical aids can quickly become overwhelming. That’s where MedicalAid.co.za comes in.

We track benefit updates and provide easy-to-understand comparisons, so you can see what fits your needs best, all in one place. Just note: not all premiums and benefits are available at once. Our updates are added as schemes release them, so check back often or speak to one of our consultants for real-time advice.

How to Prepare for the Review Period

Here are 4 simple steps:

  1. Review your current plan: Know what you are paying for, and which benefits you primarily use.
  2. Assess your healthcare needs: What has changed this year? Are there new diagnoses, dependants, or budget changes?
  3. Stay informed: Watch for communication from your scheme and follow any pertinent updates posted on MedicalAid.co.za.
  4. Get expert guidance: Consult a specialist if you need clarification. An informed decision today saves frustration (and bills) later.

In conclusion

Updates aside, whether that will happen in September or October, being proactive is what truly matters. This review period presents the perfect opportunity to reassess, realign, and ensure that your medical aid covers your needs. In view of this, with such foresight and by utilising the right tools, you should be able to step into 2026 with a plan that fits just perfectly.