Discovery Health Medical Scheme 2026: Benefit and Contribution Changes
- Albert Johnson
- 2 days ago
- 3 min read
As we move into 2026, Discovery Health Medical Scheme has announced several key updates to contributions, new plan options, and enhanced benefits to help members make informed healthcare decisions.
If you’re reviewing your medical aid for 2026, here’s a summary of the most important changes.
Contribution Increases Effective 1 April 2026
Discovery Health will implement contribution increases from 1 April 2026 and NOT on 1 January 2026, after deferring them for the first three months of the year. The scheme expects to end 2025 with a healthy solvency level of 31.6%, well above regulatory requirements.
Increases are as follows:
7.9%Â for KeyCare, Coastal, Comprehensive (including Classic Smart Comprehensive), and Executive plans.
6.9%Â for Smart, Core, Saver, and Priority plans (excluding Coastal and Active Smart options).
No increase for the Active Smart plan.
Discovery continues to charge for a maximum of three children under 21 per membership.
Introducing the Smart Saver Series – January 2026
A major highlight for 2026 is the launch of the Smart Saver Series, offering members flexible, risk-funded day-to-day benefits and an annual Medical Savings Account (MSA).
Key features include:
Unlimited hospital cover within the Smart Hospital Network.
Full chronic medicine cover when using network pharmacies.
Unlimited GP visits with a small co-payment, plus optometry and dental check-ups.
Over-the-counter and prescribed acute medicine benefits.
Personal Health Fund rewards of up to R10,000 per family for Classic Smart Saver and R6,000 per family for Essential Smart Saver members.
New Support Programs for Families
Discovery introduces two new support benefits in 2026:
Nurture at Home:Â Assists parents with premature or medically fragile babies discharged from NICU. Includes virtual health coaching, home nurse visits, and mental health support.
Perinatal Bereavement Counselling: Provides compassionate counselling for families who experience pregnancy loss or stillbirth, accessible through the Women’s Health Hub.
KeyCare Enhancements
The KeyCare Series is being expanded with new healthcare delivery systems in Potchefstroom, Welkom, and Kimberley, bringing the total to 24 across South Africa. Members with chronic conditions are encouraged to register on Discovery’s Care Programs, as coordinated care reduces hospital admissions by up to 24%. Registered members receive full cover for approved chronic care services, while unregistered members are covered up to 80% of the Discovery Health Rate.
Oncology Innovation Benefit Updates
Discovery’s Oncology Innovation Benefit continues to provide access to advanced cancer treatments such as immunotherapies and targeted therapies. From 2026, co-payments will apply to all new treatment plans:
30%Â co-payment for Executive plan members.
50%Â co-payment for Comprehensive plan members. Existing treatment plans remain unaffected.
Surgical Benefit and Device Limits
Discovery has updated several surgical and device limits for 2026, including:
Cochlear processor upgrades up to R190,000 (excludes Smart and KeyCare plans).
Bone-anchored hearing aids up to R150,000 when using network suppliers.
Drug-eluting balloons covered in full through network hospitals.
Shoulder joint prostheses fully covered at network suppliers.
Personal Health Pathways and Vitality Updates
Discovery’s Personal Health Pathways will now include Sleep Tracking and Personal Health Challenges to promote better rest and daily wellness. Members can earn Discovery Miles or boost their Personal Health Fund by up to R3,000 per year through healthy actions.
In 2026, Vitality members will also benefit from more free gym visits — up to 8 per month for Gold and Diamond members — and can earn or fully fund a Garmin fitness device through consistent activity goals.
Maximize Your Benefits in 2026
To make the most of your Discovery Health plan in 2026:
Activate your Personal Health Pathways and complete your annual Health Check.
Participate in Personal Health Challenges to earn rewards.
Use the Vitality Fitness Network for discounted workouts and benefits.
Stay within Discovery’s provider networks for optimal cover and lower co-payments.
Here are the summaries of the various DHMS options and pricing for 2026.
Discovery Health’s 2026 updates reflect a strong focus on personalized healthcare, family support, and rewarding healthy living. With the introduction of the Smart Saver Series and expanded wellness pathways, members have more control and flexibility than ever before.
If you’re unsure which Discovery Medical Aid plan best fits your lifestyle and budget, speak to your financial or healthcare advisor before the new plan year begins.