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:
- Review your current plan: Know what you are paying for, and which benefits you primarily use.
- Assess your healthcare needs: What has changed this year? Are there new diagnoses, dependants, or budget changes?
- Stay informed: Watch for communication from your scheme and follow any pertinent updates posted on MedicalAid.co.za.
- 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.