Discovery's headquarters in Sandton, Johannesburg. Discovery's Medical Health Scheme maintained a solvency ratio at about 32,6% in 2025, well above the 25% regulatory requirement, with reserves of around R39bn.
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Discovery Health Medical Scheme (DHMS) says it remained financially resilient in 2025, while its members are living longer than they had ten years ago.
This emerged from South Africa’s largest open medical scheme of more than 2.7 million beneficiaries, at its annual general meeting held late last week. The scheme paid more than R89.4 billion in claims in 2025 from 64 million claims, reinforcing its role in enabling access to private healthcare at scale.
The recent HealthTrend26 report, based on more than 60 million life-years of Discovery Health Medical Scheme’s clinical, lifestyle and behavioural data, showed that earlier diagnosis, improved treatment pathways and sustained behaviour changes were contributing to better health outcomes.
Over the past decade, the overall mortality rate among its members has declined by 5,6%.
In cancer care, mortality among patients had declined by 48% over the past decade, while life expectancy for members living with cancer has increased by 7.1 years.
“The most sustainable way to keep healthcare affordable is to keep people healthier. By investing in innovation and personalised care, we are improving outcomes while addressing long-term sustainability,” said Discovery Health Medical Scheme principal officer, Charlotte Mbewu at the AGM.
She said the scheme, supported by Discovery Health as its administrator and managed care provider, invests in prevention, earlier detection and proactive care. Personalised, data-driven interventions help members to act sooner, thereby improving outcomes and reducing avoidable costs.
Mbewu said the scheme is focused on balancing affordability, access and quality in a challenging economic and healthcare environment.
“Healthcare affordability continues to place pressure on households. Our focus is on delivering real value to members – by improving health outcomes, managing risk responsibly and using the Scheme’s strength to support members when they need it most,” said Mbewu.
She said healthcare costs continued to outpace general economic growth in 2025, intensifying affordability pressures for members.
To provide relief, Discovery Health Medical Scheme implemented a three-month deferral of the 2026 contribution increase. This resulted in an effective annual increase of about 5.4%, compared with a weighted increase of 7.2%.
As a result of the deferral of contribution increase and other initiatives, 2026 contributions for Discovery Health Medical Scheme members were 17.7% lower - on a like-for-like basis - than those of the next seven largest open schemes.
“Affordability comes from carefully managing risk, improving health outcomes and ensuring sustainability over the long term,” said Mbewu.
The solvency ratio was maintained at about 32.6%, well above the 25% regulatory requirement, with reserves of around R39bn. In 2026, R1.5bn was returned to members through the deferral of the contribution increase.
“Our reserves are carefully managed to ensure sustainability and regulatory compliance, while continuing to deliver value back to members,” said Mbewu.
“The most sustainable way to keep healthcare affordable is to keep people healthier,” said Mbewu. “By investing in innovation and personalised care, we are improving outcomes while addressing long-term sustainability.”
The scheme’s approach balances immediate financial relief with long-term sustainability.
Benefit enhancements, expanded access to care and investment in innovation reflect the scheme’s response to members’ evolving needs.
“We also continue to proactively explore options for providing cover for new technologies and treatment innovations that can be prohibitively expensive. This includes ongoing engagement with manufacturers on pricing, alongside careful monitoring of emerging clinical evidence and budget implications,” she said.
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