Healthcare provider expands cover across everyday care, specialist gaps and major life events as rising costs reshape the private healthcare funding market
Seen Here: Healthcare cover is evolving — and so are the needs of South Africans. NetcarePlus is expanding its 2027 offering with greater choice across everyday healthcare, specialist gaps and major life events, including new Cancer and Funeral Cover, enhanced GapCare benefits and expanded PrimaryCare access. As healthcare costs rise and consumers seek more flexible ways to protect themselves and their families, NetcarePlus is putting the healthcare need first — building cover around real-life healthcare journeys, not one-size-fits-all product. .Photo Credit: Supplied
SANDTON, 9 September 2026 — South Africa’s changing healthcare landscape is prompting consumers to rethink how they access and fund private healthcare, with rising costs, diverse medical needs and growing gaps in traditional cover driving demand for greater choice and flexibility.
Against this backdrop, NetcarePlus has unveiled an expanded 2027 portfolio designed around a different starting point for healthcare cover: the healthcare need rather than the product.
The expanded offering was announced at the company’s annual NetcarePlus Product Launch in Sandton, as the healthcare sector grapples with global trends including ageing populations, the increasing burden of chronic disease and rapid advances in technology, data and artificial intelligence.
For South Africa, however, the challenge is particularly pronounced.
Only 14.6% of the population is currently covered by a medical scheme, leaving millions of income-earning households outside traditional medical scheme structures.
At the same time, even those with medical scheme membership can face significant financial exposure when healthcare costs fall outside their benefits.
Rising out-of-pocket costs reshape healthcare funding
NetcarePlus analysis shows that average out-of-pocket healthcare expenditure per beneficiary has tripled over the past 11 years, increasing at more than twice the rate of CPI over the same period.
The figures point to a healthcare funding environment that is becoming increasingly difficult to define through a simple distinction between comprehensive medical scheme membership and having no private healthcare cover.
Consumers can find themselves exposed at multiple points — from routine healthcare needs and emergency treatment to specialist shortfalls, co-payments and procedures excluded from their medical scheme benefits.
Teshlin Akaloo, Managing Director of NetcarePlus, says these realities require a more flexible approach to healthcare cover.
“South Africans have very different healthcare needs and increasingly need different ways to fund them.”
For some consumers, the priority may be affordable access to everyday private healthcare or protection against an unexpected emergency. For others, the challenge lies in filling specific gaps left by existing medical scheme cover.
“The question for us is not simply what product we can offer,” Akaloo says. “It is where people remain exposed when they need healthcare and how we can build cover around those needs.”
Building cover from inside the healthcare system
That philosophy is central to NetcarePlus’s positioning as health cover “built by healthcare experts”.
As part of the Netcare Group, NetcarePlus says it is able to draw insights directly from the healthcare environment, including healthcare utilisation patterns, costs, patient experiences and feedback from clients and financial advisers.
The company argues that this provides a different perspective on healthcare funding — one that begins with understanding how people actually experience the healthcare system.
“Being part of healthcare delivery gives us a different starting point,” says Akaloo.
“We see healthcare not simply as a claim or a transaction, but as a journey.”
The approach allows the business to identify where financial and access pressures emerge and design cover around those specific points of exposure.
A broader 2027 portfolio
The expanded 2027 offering introduces greater choice across healthcare access and financial protection.
Among the key additions are Cancer Cover and Funeral Cover, alongside a Scheme-Excluded Procedures benefit designed to provide additional financial protection for certain procedures not funded by a member’s medical scheme.
NetcarePlus has also strengthened its GapCare offering with additional benefits including:
- Expanded mental-health support
- A new optical repair benefit
- Contraceptive cover
The company’s PrimaryCare offering has also been enhanced, with selected options providing additional access to everyday healthcare services, including nurse-led and virtual consultations, flu vaccinations and specialist consultations.
The broader portfolio is aimed at giving individuals and families more flexibility to select cover according to their healthcare requirements, life stage and budget.
Employers gain more flexibility
The expansion also has implications for employers navigating increasingly diverse workforce needs.
For employer groups, the broader portfolio gives financial advisers greater scope to structure healthcare solutions around different employee requirements, participation models and budgets.
This flexibility could become increasingly important as employers contend with rising healthcare costs while seeking benefits that remain relevant to employees with very different personal and family circumstances.
Rather than assuming that one healthcare solution can serve an entire workforce equally, the expanded offering points towards a more modular approach to employee healthcare protection.
Healthcare cover becomes more personalised
The evolution of NetcarePlus comes at a time when personalisation is becoming a defining theme across healthcare.
Advances in data, digital technology and artificial intelligence are creating opportunities to make healthcare more connected, preventative and responsive.
At the same time, demographic changes and the increasing prevalence of chronic conditions are placing additional pressure on healthcare systems and household finances.
For South Africa, these pressures are compounded by the relatively limited penetration of medical scheme coverage and the growing financial burden faced by those accessing private healthcare.
NetcarePlus’s approach is therefore positioned around creating multiple layers of protection rather than expecting consumers to find all their healthcare needs in a single product.
Rapid growth reflects changing demand
The strategy comes as NetcarePlus continues to expand rapidly, recording a compound annual growth rate of 57% over the past three years.
The company sees this growth as evidence of an evolving healthcare funding market in which consumers increasingly want products that can respond to specific risks and healthcare requirements.
“The future of healthcare funding is not about finding one solution for every South African,” says Akaloo.
“It is about creating meaningful choice and building protection around different healthcare needs, life stages and budgets.”
That shift could signal a broader transformation in the private healthcare market.
As healthcare costs rise and traditional funding models leave consumers exposed in different ways, the competitive question may no longer be simply who offers the most comprehensive cover.
Instead, it may increasingly be about who can identify the gaps in a person’s healthcare journey and provide meaningful protection exactly where those gaps occur.
For NetcarePlus, the 2027 portfolio represents an attempt to build that proposition from the inside out — using its position within the healthcare ecosystem to move beyond conventional product design and towards a more needs-based approach to healthcare funding.
