Bestmed unveils 2026 benefits with stronger preventative care and competitive contributions
Bestmed Medical Scheme has announced its 2026 benefits, reinforcing its focus on sustainability, affordability, and member-first healthcare under its Personally Yours promise.
Despite economic pressures, Bestmed is the only top open medical scheme in South Africa to achieve six consecutive years of positive membership growth. Over the past five years, principal membership has risen 28.1%, with a sustainable claims ratio of 86.1% (YTD July 2025) and a 13.83% increase in net contribution income.
“Healthcare inflation remains one of the biggest challenges facing households,” said Leo Dlamini, CEO and Principal Officer. “Our responsibility is clear: to safeguard the depth of our benefits while keeping contributions competitive. For 2026, we’re not only protecting existing benefits but adding new preventative care benefits too.”
Expanded preventative benefits
From 2026, Bestmed will introduce:
- Colon cancer screening (faecal occult test) on all options.
- HIV rapid test on all options.
- Prostate-specific antigen (PSA) screening from age 45 (previously 50), expanded to Beat1 and Rhythm1.
- Intrauterine device (IUD) covers as an added female contraceptive benefit.
These will be funded from the Scheme’s risk pool, not members’ day-to-day benefits. “Preventative interventions save lives and reduce costs long-term,” added Dlamini.
Other 2026 enhancements include:
- Higher take-home medicine benefit (R700, up from R450).
- Cover for adenoidectomy (with tonsillectomy) on Rhythm1.
- Increased limits for cochlear implants and bone-anchored hearing aids on Beat4 and Pace options.
- Shoulder prostheses funded from a combined knee/shoulder benefit.
- Expanded breast reduction cover on Pace3 and Pace4, with an R100 000 benefit.
Meeting rising healthcare needs
In 2024, Bestmed processed 33.9 million claims, paying out R7.8 billion. From January to July 2025, claims reached R5 billion. Hospital costs made up 43% of claims, followed by medicines and specialists (16% each). Breast and prostate cancers remain the most prevalent.
Dlamini noted rising trends in hospital stays, diagnostic testing, and mental health services, adding: “Our figures reflect the reality of increasing complexity in members’ healthcare needs.”
Sustainable growth and affordability
Bestmed will implement an average weighted contribution increase of 6.8% in 2026, with some options rising as little as 5.1%.
“Our members entrust us with both their health and financial well-being,” concluded Dlamini. “We remain focused on sustainable growth, enhanced benefits, and delivering the Personally Yours experience that sets us apart.”
Disclaimer: Benefits and contributions are subject to Council for Medical Schemes approval.
