Profmed Medical Scheme
Restricted scheme · For graduate professionals · 33,800+ principal members · 70,500+ beneficiaries
Profmed 2027 contributions: what changed, option by option →
Overview
Profmed is a registered non-profit restricted medical scheme regulated by the Council for Medical Schemes. Membership is exclusively available to graduate professionals holding a recognised degree (typically a 4-year qualification or higher) and their dependants. Profmed is South Africa's largest restricted medical scheme for graduate professionals, and one of the highest-solvency schemes in the industry.
Source: Profmed website and 2026 plan announcement.
Membership Profile
Profmed serves over 33,800 principal members and 70,500+ beneficiaries. Because membership is restricted to graduate professionals and their dependants, the Scheme has a structurally healthier risk pool than open schemes — typically higher-income, younger, and with lower chronic-disease prevalence at entry.
Membership requirements
Eligibility requires a recognised graduate qualification (typically a four-year degree or equivalent professional qualification). Members can remain on Profmed throughout their career and into retirement. Standard Medical Schemes Act waiting periods apply.
Source: Profmed membership eligibility documentation.
Financial Health
Profmed's statutory solvency ratio exceeds the 25% minimum required by Regulation 29(2) of the Medical Schemes Act, and has consistently been among the higher solvency positions in the open and restricted scheme industry. The Scheme reports a strong financial position, having not faced regulatory solvency concerns.
Contribution position
Profmed's 2026 weighted average contribution increase of 6.76% — the lowest among South Africa's major medical schemes for the second consecutive year — reflects both the favourable restricted-scheme risk profile and conservative cost management.
Source: Profmed — 2026 Benefit Enhancements announcement; Profmed 2026 Compare Options.
Plans & Options
Profmed's plan architecture is built around 5 Premium options (any-hospital choice) each with a parallel Savvy version that restricts hospitalisation to the Savvy hospital network in exchange for a 10–20% contribution saving.
| Plan | Category | Day-to-day model | Premium variant | Savvy variant (10–20% less) |
|---|---|---|---|---|
| ProActive | Mid-tier hospital + chronic | Hospital plan | ProActive | ProActive Savvy |
| ProActive Plus | Hospital + day-to-day (most popular) | Insured day-to-day | ProActive Plus | ProActive Plus Savvy |
| ProSecure / ProSecure Plus | Mid–upper comprehensive | MSA + insured | ProSecure(+) | ProSecure(+) Savvy |
| ProSelect | Upper comprehensive | MSA + ATB | ProSelect | ProSelect Savvy |
| ProPinnacle | Top-tier comprehensive | MSA + unlimited ATB | ProPinnacle | ProPinnacle Savvy |
Source: Profmed 2026 Benefits and Contributions; Profmed Our Benefit Options.
Key Benefits & Differentiators
Mirror Savvy plans. Each Premium plan has a Savvy network version offering identical benefits at a 10–20% lower contribution. This dual structure lets professionals trade hospital choice for cost without changing benefit set — useful for members switching between phases of career or family life.
ProPinnacle — specialist 300% reimbursement, 27 chronic conditions unlimited. The top-tier ProPinnacle plan reimburses specialists at up to 300% of the scheme tariff and covers 27 chronic conditions without a benefit limit (above the PMB minimum of 26 conditions). This is among the most generous chronic and specialist cover in the SA medical scheme market.
Built for the professional lifecycle. The Scheme markets its plan range around career stages — ProActive Plus Savvy for young professionals, mid-tier plans for established families, ProPinnacle for high-utilisation households.
Mental health and prevention
All Profmed plans include mental health benefits beyond the PMB minimum on mid-tier and above, in recognition of the Graduate Professionals Stress Index findings the Scheme publishes annually.
Source: Profmed Benefit Options; ProPinnacle plan summary; 2024 Profmed Graduate Professionals Stress Index.
Wellness & Loyalty
Profmed offers a wellness benefit and preventive screenings on every plan as part of membership. The Scheme does not operate a separate points-based rewards programme; instead, members of the related PPS group (Profmed's affiliated professional financial services group) can access PPS Profit Share and other PPS group benefits.
Source: Profmed Members page; PPS group overview.
Claims & Service
Claims can be submitted via the Profmed member app, the online portal, email, or by provider direct-billing. Administration is run by PPS Healthcare Administrators.
Service details
Dispute resolution follows the CMS process: internal dispute committee → CMS adjudication.
How the Scheme Is Set Up
Profmed is designed around: graduate professionals (the eligibility requirement); those who want to trade hospital choice for cost via the Savvy network without losing benefit features; young professionals starting out (ProActive Plus Savvy with the 5.5% 2026 increase); and high-utilisation households who value 300%-of-tariff specialist reimbursement and 59-condition unlimited chronic cover (ProPinnacle).
The 2026 6.76% weighted increase is the lowest among major SA medical schemes, making Profmed particularly attractive for members focused on long-run contribution stability — though the eligibility requirement means it is not available to non-graduates.
Source: Profmed 2026 plan announcements.
Each plan in detail
One page per plan: contributions and what it covers, in Profmed’s own words, with the source for every line.
Programmes you have to ask for
11 of these 15 programmes do not start on their own. You have to register, apply or get authorisation before the benefit applies — and until you do, you are paying for cover you are not receiving.
Read from Profmed’s own documents. Each page quotes the wording and names the source. Compare programmes across every scheme →