Discovery Health Medical Scheme
South Africa's largest open medical scheme — and one of its most controversial. Founded in 1992 with FNB/RMB backing, Discovery now covers 2.7 million beneficiaries across 20 schemes. Its Vitality programme and Personal Health Pathways are industry-leading, but its size means complexity. Understanding which plan series suits you can save — or cost — you thousands.
Momentum Health Medical Scheme
Momentum Health traces its roots back through multiple scheme mergers to 2004, now covering around 300,000 beneficiaries. Its Multiply rewards programme is one of the most comprehensive wellness offerings in the industry. From 2026, Momentum also takes over administration of Bonitas — making it one of the most significant players in the country.
Fedhealth Medical Scheme
Founded in 1936 as the Reef Medical Scheme, Fedhealth covers around 100,000 lives. Its 2026 joint venture with Sanlam gives members access to gap cover, short-term insurance and investments — a direct response to what Discovery and Momentum have long offered. With an average member age of 44, there are important dynamics prospective members should understand before joining.
Medihelp Medical Scheme
One of the oldest medical schemes in South Africa, founded in 1905 as the Civil Service Medical Benefits Association. Medihelp now covers approximately 200,000 beneficiaries and is the 5th largest scheme in the country. Members and prospective members should be aware of its current solvency position and the CMS-approved recovery plan in place.
Bestmed Medical Scheme
Originally founded in 1964 as a closed scheme, Bestmed became an open scheme in 1990 and has grown to become the 4th largest open scheme in South Africa, covering 250,000 lives across 13 plan options. Notably, it is the largest self-administered scheme in the country — meaning no external administrator takes a cut. Its Tempo Wellness Programme is free to all members with no points system or weekly fitness targets, making it a refreshingly straightforward alternative to the rewards-heavy programmes of larger schemes.
Bonitas Medical Fund
The second-largest open scheme in South Africa, Bonitas was founded in 1982 and originally targeted black civil servants. It now covers approximately 700,000 lives and has grown significantly through mergers — absorbing Pro-Sono (2012), Liberty Medical Scheme (2017) and Nedgroup Medical Scheme (2022). With an average member age of 35.9, it has one of the youngest membership profiles of any major scheme. From 2026, administration moves from Medscheme to Momentum Health Solutions.