How to cancel or downgrade your medical aid in South Africa (2026)

Last checked: 1 November 2026 (SAST). Lines marked ⚠️ rely on an older rules PDF, a third-party host, or a scheme form rather than the regulator's own page, or on sources that disagree. Check those with your scheme or the CMS before you act.

Who this guide is for

Anyone in South Africa who belongs to a registered medical scheme ("medical aid") and wants to:

leave the scheme completely (cancel / resign),
move to a cheaper option on the same scheme (downgrade), or
move to a different scheme, without losing cover in between.

It's written to work for any scheme. Scheme-specific guides for Discovery, Momentum, Bonitas and Fedhealth are coming next. Your own scheme's registered rules always win over this general guide.

Disclaimer

This is general information, not legal, financial or medical advice. SA How-To is independent and is not linked to the Council for Medical Schemes (CMS), any medical scheme, administrator or broker. We don't recommend schemes or options. Whether to cancel or downgrade is a financial decision that depends on your health and your family's needs. If you want personal advice, speak to an FSCA-authorised financial adviser or to the scheme itself. Rules change, so check the linked sources before you act.

Before you do anything: three things that can cost you

Don't leave a gap if you might want cover again. If you go 90 days or more without being on any medical scheme, a new scheme may impose a 3-month general waiting period and a 12-month condition-specific waiting period, and during those waiting periods Prescribed Minimum Benefits (PMBs) are not protected. (Medical Schemes Act s29A(1), CMS copy, PDF)
Gaps after 35 can mean a permanent "late-joiner penalty". If you're 35 or older and rejoin later, the scheme can load your contribution by up to 5%, 25%, 50% or 75% depending on how many years you were not covered after 35. The penalty can follow you to other schemes. (Regulation 13, Acts Online; Discovery late-joiner explainer 2026, PDF)
You can't belong to two schemes at once. If you're moving, end the old membership the day before the new one starts. (Momentum Medical Scheme FAQ)

Cancel vs downgrade: what's the difference?

	Cancel (resign from the scheme)	Downgrade (change option, same scheme)
When	Any time, after giving notice	Usually only from 1 January. Some schemes allow other dates at the board's discretion
Notice	Usually one calendar month / 30 days in writing (check your rules)	Apply in writing before the year starts (often at least 30 days before 1 January). Most schemes run a year-end option-change window
Waiting periods	Apply at your next scheme, depending on how long you were covered and how long the gap is (see table below)	None, unless you're still serving one on your current option (the remainder can carry over) (s29A(4))
Savings account	Positive balance is paid out or transferred, often only after a few months. If you've overspent savings, you may owe it back	Stays with you
Employer scheme?	If membership is a condition of your job, you usually can't resign without your employer's written consent	Usually allowed in the normal window

What the schemes' own documents say (examples):

Discovery Health Medical Scheme rules: a member who isn't required to belong by their employer "may terminate his membership of the Scheme on giving 30 days written notice. All rights to benefits cease after the last day of membership" (rule 11.2.1). Option changes take effect "from 01 January of any financial year", with the written application lodged "at least 30 days prior" (rule 15.2). Members whose employment requires membership need the employer's prior written consent (rule 11.1.1). (DHMS main rules, 2023 version, PDF) ⚠️ The rules PDF linked here is the 2023 version. Check the current year's rules on the scheme's site.
Bonitas Medical Fund (2026 termination form): "One month's calendar notice period is required for membership termination (excluding PERSAL members – 60 days' notice period required)". Positive savings are paid out or transferred "after four (4) months from termination date", and spending your savings then leaving in the same year "can result in you owing the Scheme". (Bonitas termination of membership form 2026, PDF hosted by Aon) ⚠️ This is an employer-group copy hosted by a broker, not a form published on bonitas.co.za.
Momentum Medical Scheme FAQ: you can claim for treatment up to the last day of membership. Unused savings are paid out when you resign. (Momentum FAQ)

If you're moving to another scheme: which waiting periods can apply?

Your situation when you apply to the new scheme	What the new scheme may impose
No scheme cover for 90+ days before applying	3-month general waiting period and 12-month condition-specific waiting period
Covered for up to 24 months, gap of less than 90 days	12-month condition-specific waiting period, but not for PMBs (plus any unexpired waiting period from the old scheme)
Covered for more than 24 months, gap of less than 90 days	3-month general waiting period, but not for PMBs
Moving because you changed jobs or your employer changed schemes (gap under 90 days)	No new waiting periods (except any unexpired one from the old scheme)
Changing option on the same scheme	None (except any unexpired one)

Source: Medical Schemes Act s29A, checked against the CMS copy of the Act (PDF). ⚠️ Acts Online's text of section 29A(1)(b) says a condition-specific waiting period of "up to 11 months". The CMS PDF of the Act, and scheme FAQs, say 12 months. This guide follows the CMS copy: 12 months.

Exact steps

Find your documents. Membership number, ID number, your current option, and (if you can) your scheme's current rules and termination form. Most schemes publish these on their website under "documents" or "forms".
Check whether your employer requires membership. If you're on a company scheme, ask HR first. You may need a signed employer section on the form.
Decide the exact last day of cover.
- Cancelling: count your scheme's notice period (often one calendar month or 30 days) from the date the scheme receives your written notice. Schemes generally don't accept backdated changes.
- Moving schemes: make sure the new scheme's start date is the day after the old one ends, and keep the gap under 90 days.
- Downgrading: get your option-change request in before the deadline for the coming 1 January.
Give notice in writing using the scheme's termination / option-change form or a letter (template below). Send it to the address the form gives, and keep proof of sending.
Ask for written confirmation of the effective date, any final contribution, and what happens to your savings.
Ask for your certificate of membership. It proves your cover history, which matters for waiting periods and late-joiner penalties at your next scheme. Discovery's rules, for example, say the scheme must provide it on request within 30 days of termination (rule 9.3, DHMS rules PDF).
Sort the debit order last. Only after the scheme confirms the end date, check your bank statement. If a contribution is collected after the confirmed end date, take it up with the scheme in writing first, then your bank.

What to ask your scheme in writing (checklist)

What is my effective termination date (or option-change date)?
What is my final contribution, and on what date will it be collected?
What is my savings balance? When and how will it be paid out or transferred? Do I owe anything for overspent savings?
Please send my certificate of membership showing all periods of cover for me and each dependant.
Are any of my dependants still serving a waiting period, and when does it end?
(Downgrade) Will any chronic medicine approvals, authorisations or network/DSP arrangements change on the new option?

Copy-paste letter

To: [scheme's membership / termination address from its form]
Subject: [Termination of membership / Change of benefit option] – [Full name], membership no. [number]

Dear [Scheme name],

Please accept this as my written notice to [terminate my membership of the scheme / change my benefit option from [current option] to [new option]].

Main member: [Full name], ID [number]

Membership number: [number]

Dependants affected: [names, or "all"]

Requested effective date: [DD/MM/YYYY], in line with the scheme's [one calendar month / 30-day] notice period [or: from 1 January YYYY]

Please confirm in writing:

the effective date of [termination / the option change];

any final contribution due and the date it will be collected;

my savings balance and when and how it will be paid out or transferred, and whether anything is owed for overspent savings;

[termination only] please send my certificate of membership for me and each dependant.

Kind regards,
[Name] · [cell] · [email]

If something goes wrong: the complaint path (overview)

Complain to the scheme first, in writing, and keep the reference number. Many schemes have a formal disputes process (for example, Discovery's Application to investigate a dispute 2026, PDF, under scheme rule 27).
If it's still unresolved, complain to the Council for Medical Schemes. The CMS says you must first use the scheme's own complaints process. Then submit its complaint form with:
- a detailed account of the facts and what you want done,
- proof you escalated with the scheme first,
- a signed consent letter if someone else complains for you,
- statements or clinical reports if relevant.
Email it to [email protected] or post or hand-deliver it to the CMS. The CMS asks you to complain preferably within 3 years.
What happens next: the CMS aims to acknowledge complaints within its mandate in 6 working days, refers them to the scheme for a response within 30 days, and aims to resolve them within 120 calendar days of the scheme's response.

Source: CMS – The Complaints Procedure. CMS customer care: 0861 123 267 (as listed on Discovery's 2026 dispute form). ⚠️ This number is printed on a scheme form, not on the CMS complaints page. Confirm it on medicalschemes.co.za.

A full step-by-step CMS complaints guide is planned.

Sources (all checked 1 November 2026)

General information only, not legal, financial or medical advice. SA How-To is independent and not affiliated with the CMS or any medical scheme, administrator or broker. Your scheme's registered rules and your membership documents are what apply to you.