On 20 February 2026, the Council for Medical Schemes (CMS) in South Africa confirmed the imposition of levies on medical schemes for the 2026/2027 financial year.
The levies will ultimately have a direct cost on the schemes, often passed on to members through contribution increases.
Experts have also raised concerns that the increases will add to the already above-inflation contribution hikes experienced each year.
Finance Minister Enoch Godongwana’s 2026 Budget presented some relief to medical aid members by giving an CPI-linked increase to the medical aid tax credit.
However, medical aid contributions are currently rising by CPI plus 4 to 5 percentage points, completely offsetting any benefit.
While the levies have not yet been finalised, the CMS said it is awaiting approval of the new levy proposed for the 2026/2027 financial year.
CMS Chairperson Thandi Mabeba confirmed that the levy will be imposed at the 2025/2026 financial year approved rate.
The mandatory financial contributions that all registered medical schemes in South Africa are required to pay for the 2026 financial year are R51.49, which is effective from April 1, 2026.
This levy is to be paid by each medical scheme for each primary member listed in its official records.
The levy, which applies to medical schemes registered in terms of section 20 of the Medical Schemes Act, 1998 (Act No. 131 of 1998), will be adjusted once the new levy has been approved.
According to the notice posted in the Government Gazette, the levy should be paid in two equal instalments, the first of which is to be paid by April 30 at the latest.
The second levy payment should be paid by June 30 (of the levy year) at the latest.
According to CMS, the levy is calculated based on the number of principal members submitted to the Registrar by the medical scheme.
“If a transfer of principal members is in process and not finalised on 31 December 2025, the transferor must pay the levy in respect of the principal members to be transferred,” said the CMS.
For overdue levies, the CMS said that interest will be charged at a rate that will be determined by the Minister of Finance in terms of section 80(1) (b) of the Public Finance Management Act.
What this means for members
Manage All medical scheme brokers CEO Rudolph Ackermann said that the imposition of levies for medical schemes in 2025/26 will primarily affect medical scheme members through the increased costs of maintaining their cover.
“This is because the levies, which are used to fund the CMS and other regulatory functions, are ultimately factored into the scheme’s overall costs, which are then passed on to members through higher contributions or reduced benefits,” he said.
According to the broker, some medical schemes may choose to reduce benefits for members or even limit access to certain services to offset the impact of the imposed levy on their finances.
The result could be that members of the medical schemes would need to pay higher out-of-pocket costs.
“Medical scheme contributions are generally eligible for tax credits, which can help offset the cost of the levy,” said Ackermann.
“However, any future changes to tax credits could affect the net cost of medical scheme cover.”
While tax credits are still being implemented and even increased, the National Health Insurance (NHI) Act codefies their eventual removal to fund the NHI.
Although the levy could increase members’ costs, Ackermann suggests it plays a vital role in ensuring that medical schemes remain sustainable in the long term.
“By funding the regulatory oversight and other functions, the levy helps to maintain the integrity of the scheme and protect members’ interests,” said Ackermann.
The CMS emphasises the importance of transparency between medical schemes and its members when communicating any levy changes and the impact it will have on members.
The CMS advises medical schemes not only to notify members of levy changes but also to explain the reasons for contribution increases and ensure that members are fully aware of their rights and options.
