Profmed medical aid 2026

Profmed: a restricted scheme for professionals

The CMS register at 31 March 2026 lists Profmed as restricted (CMS Annual Report 2025/26). Under rule 6.1 of its rules, membership is restricted to a person "who is or was employed in a profession, or who is a Member of a profession, as recognised in Section 2 of the Occupational Classification of All Economic Activities as published by Statistics South Africa", and to the full-time staff of Profmed and PPS (scheme rules). Its 2026 summary puts it simply: if you have a tertiary qualification and relevant professional experience, you qualify (Benefits at a Glance 2026).

The administrator and managed care provider is Professional Provident Society Healthcare Administrators (PPSHA). The PPS Wallet is an optional savings account kept outside the options: none of the ten options includes a medical savings account (Benefits at a Glance 2026).

Profmed contributions 2026

Monthly contributions for 1 January to 31 December 2026, from the scheme's Schedule of Benefits 2026, p. 6. Each Premium option sits above its Savvy version. Adult dependant rates apply from 21; on ProSecure, ProSecure Plus and ProPinnacle (Premium and Savvy) you pay for at most three children.

Premium or Savvy: the hospital networks

The co-payments are "subject to PMB legislation" (2026 schedule, p. 4): see Prescribed Minimum Benefits.

Profmed in 2027

Profmed has published its 2027 schedule (1 January to 31 December 2027), "subject to ratification by the Council for Medical Schemes", with benefit limits up 4.25%; it states no average contribution increase (Profmed 2027).

Joining and claiming

Send the application form with proof of your degree or qualification and profession to [email protected], or apply online; join line 0800 334 733 (contact). The waiting periods of section 29A and late-joiner penalties apply as on any scheme: see medical aid in South Africa and the late-joiner penalty calculator.

Claims: e-mail the account to [email protected], upload it in the Profmed app or post it to Private Bag X1031, Lyttelton 0140. "Claims not submitted within 4 months of the date of service are considered stale and cannot be paid" (how to claim).

Complaints

1. Complain to Profmed first, in writing, and keep the reference number: call the contact centre on 0860 679 200 within six months, then write to the Principal Officer; the scheme aims to deal with it within 30 days, and its Dispute Committee hears what remains (rule 30, scheme rules).
2. If the answer does not settle it, use the scheme's internal dispute process (the scheme's rules require one, s 29(1)(j) of the Medical Schemes Act).
3. Then complain to the Council for Medical Schemes: e-mail [email protected] with the CMS complaint form, the scheme's reply and your accounts (CMS complaints procedure). Under section 47 the scheme has 30 days to answer the CMS; a ruling can be appealed within 3 months (s 48). How it works: Council for Medical Schemes.

Sources

1. Profmed — Schedule of Benefits 2026: contribution tables, benefits and contributions 1 January to 31 December 2026, networks (scheme's own PDF, pp. 4 and 6, seen 31 October 2026)
2. Profmed — Benefits at a Glance 2026: who qualifies, PPS Wallet (scheme's own PDF)
3. Profmed — Rules of Profmed Medical Scheme (registered 11 June 2025): rule 6.1 (eligibility), rule 30 (complaints and disputes)
4. Profmed — 2027 benefits and contributions (scheme's own page): benefit limits +4.25%, ProSelect Savvy income threshold R40,000
5. Profmed — How to claim: [email protected], app, post, four-month limit (seen 31 October 2026)
6. Profmed — Contact us: 0860 679 200, join line 0800 334 733 (seen 31 October 2026)
7. Council for Medical Schemes — Annual Report 2025/26 (copy tabled in Parliament, hosted by PMG): register of medical schemes at 31 March 2026, solvency, complaints
8. Council for Medical Schemes — Medical Schemes Act 131 of 1998 and Regulations (consolidated copy, Web Archive)
9. Council for Medical Schemes — The Complaints Procedure (Web Archive)