Territory planning inputs
What does medical aid coverage mean for pharmaceutical territory planning?
Medical aid coverage tells us what share of a province's population has private healthcare funding, so we weigh it when we design pharmaceutical territories. In 2025, 15.5% of the population of South Africa was covered by a medical aid scheme, unchanged from 2024, and the provincial range ran from 25.9% in the Western Cape to 8.2% in Limpopo.Source: Statistics South Africa, General Household Survey 2025 (statistical release P0318, 26 May 2026), Table 5.1 and page 21.
Last verified 10 October 2026 against the Statistics South Africa P0318 PDF; the 2024 figure was corrected on that date.
The figure and the numbers behind it
15.5%
Covered by a medical aid scheme, 2025
Table 5.1, page 21
15.5%
Same measure, 2024
Table 5.1, page 21, 2024 column
| Measure | Year | Value | Unit |
|---|---|---|---|
| Covered by a medical aid scheme | 2025 | 9,960 | thousands |
| Not covered | 2025 | 53,972 | thousands |
| Subtotal | 2025 | 63,932 | thousands |
| Percentage covered by a medical aid scheme | 2025 | 15.5 | percent |
| Total population | 2025 | 64,071 | thousands |
| Percentage covered by a medical aid scheme | 2024 | 15.5 | percent |
Source: Statistics South Africa, Statistical release P0318, General Household Survey 2025, Table 5.1 and text, page 21. Stats SA prints a decimal comma (for example "15,5%") and space-separated thousands; the site's convention is shown here. Figures are quoted as printed and are not recomputed.
Provincial values
The same release gives provincial values on page 21. We quote four provinces and leave the others out.
| Province | Percent covered |
|---|---|
| Western Cape | 25.9% |
| Gauteng | 22.1% |
| KwaZulu-Natal | 9.5% |
| Limpopo | 8.2% |
What this figure measures
The General Household Survey is a household survey: it records medical aid coverage as reported to the survey. Medical schemes keep registers of their beneficiaries, and the Council for Medical Schemes publishes beneficiary counts from those registers in its annual industry report. A survey estimate and a register count measure different things, so the two differ by design. Cite each for what it is.
For the register side, see the Council for Medical Schemes. We quote no Council figure on this page.
How we use it when we plan territories
Medical aid coverage is one of the inputs we weigh when we design pharmaceutical territories, beside socioeconomic profile, disease burden, healthcare infrastructure and population density. It tells us what share of a province's population has private healthcare funding, so it shapes how we weight customer potential and how a value proposition is aligned to what customers can access and afford. The national figure is a reference point, not a forecast: the same release puts the Western Cape at 25.9% and Limpopo at 8.2%, more than three times apart, so a territory planned on the national average misreads both. How this input enters territory design is set out under territory optimisation.
Common questions
How many people in South Africa have medical aid?
Statistics South Africa's General Household Survey 2025 (release P0318, Table 5.1, page 21) reports 9,960 (thousands) people covered by a medical aid scheme in 2025, against a total population of 64,071 (thousands). The release prints the percentage covered as 15,5, shown on this page as 15.5%.
Is medical aid coverage in South Africa rising or falling?
Statistics South Africa reports that coverage changed very little between 2002 and 2025, declining only slightly from 15.9% to 15.5% (General Household Survey 2025, page 21). The 2024 and 2025 figures are both 15.5% (Table 5.1). This page quotes those points and does not show the full series.
Does medical aid coverage differ by province?
Yes. In the General Household Survey 2025 (page 21), coverage is 25.9% in the Western Cape, 22.1% in Gauteng, 9.5% in KwaZulu-Natal and 8.2% in Limpopo. This page quotes those four provinces only.
Source and reuse
Source of the basic data: Statistics South Africa (Stats SA), Statistical release P0318, General Household Survey 2025, 26 May 2026 (PDF). The survey was conducted between January and December 2025. Stats SA has copyright on the publication. The relevant application and analysis on this page result from our own processing of the data.