Netcare Medical Scheme
Restricted scheme · For Netcare employees and their dependants · DSP-network design
Overview
Netcare Medical Scheme is a registered non-profit restricted medical scheme regulated by the Council for Medical Schemes. Membership is exclusive to employees of Netcare Limited (the JSE-listed private hospital and healthcare group) and their qualifying dependants.
The Scheme should not be confused with NetcarePlus, Netcare's separately marketed retail healthcare and gap-cover product line — these are distinct offerings.
Source: Netcare Medical Scheme portal; Netcare Medical Scheme 2026 Brochure.
Membership Profile
Netcare Medical Scheme covers Netcare employees and their qualifying dependants. Granular member counts published in the Scheme's annual report.
Financial Health
Netcare Medical Scheme reports a solvency ratio above the 25% statutory minimum. Cost-containment through DSP arrangements and managed care has been a stated priority through 2024 into 2026 as the Scheme adjusted benefit structures in response to industry-wide cost pressures.
Plans & Options
Plan information for 2026 is published in the Scheme's annual brochure. Members must use designated service providers (DSPs) for both Prescribed Minimum Benefits (PMBs) and non-PMB situations — a network-led design that supports the affordability-focused contribution structure.
Source: Netcare Medical Scheme 2026 Brochure.
Key Benefits & Differentiators
DSP-network design for both PMB and non-PMB. Members must use designated service providers across the board — a stricter network model than most open schemes but supports lower contributions.
Netcare hospital integration. As an employee scheme of South Africa's second-largest private hospital group, Netcare Medical Scheme has natural alignment with Netcare hospital network access.
All plans cover the 27 PMB Chronic Disease List conditions.
Wellness & Loyalty
Standard preventive-care benefits included; the Scheme integrates with Netcare's workplace wellness initiatives for employees.
Claims & Service
Claims via member portal, email, and provider direct-billing. Netcare's own healthcare infrastructure provides natural DSP access.
How the Scheme Is Set Up
Structurally suited only to Netcare employees and their dependants. The DSP-led design means members who can comfortably use the Netcare network of facilities (which is geographically broad in SA's major metros) get the most value.
Eligibility & Continuation
Who can join: Employees of Netcare Limited and qualifying subsidiaries, plus qualifying dependants.
On leaving Netcare: Continuation rules apply for retirees. Non-retiring leavers generally need to transfer to another scheme.