In 2019 Fedhealth merged with Topmed, absorbing its membership base. A proposed merger with Medshield in 2025 was approved by the Competition Commission but was ultimately called off by the two schemes — likely because the combined average member age of both schemes would have exceeded 41, raising concerns about long-term financial sustainability.

In 2025 Fedhealth entered into a joint venture with Sanlam, which officially launched in 2026 under the banner of Sanlam Health Solutions. The partnership gives Fedhealth members access to Sanlam products — including gap cover at a discount, short-term insurance, long-term assurance and investment products. In return, Sanlam customers gain access to the Fedhealth Medical Scheme. This was a strategic move to help Fedhealth compete against Momentum and Discovery Health, both of which have long offered integrated financial and wellness products to their members.