Circular 41 of 2025: Open and restricted medical schemes – approved benefit options and contribution adjustments effective from 01 January 2026

The Council for Medical Schemes (CMS) hereby publishes the status of benefit options applicable to open and restricted schemes for the 2026 benefit year.

Section 31(1) of the Medical Schemes Act (131 of 1998) (MSA) provides that a medical scheme may, in the manner prescribed in its registered rules, amend or rescind any such rules or make any additional rules.

Section 31(2) states that no amendment, rescission, or addition of any rule shall be valid unless it has been approved by the Registrar. Section 31(3) further states that the Registrar shall approve if he is satisfied that the change will not be unfair to members or will not render the rules inconsistent with the MSA. The requirement to only approve amendments, rescissions, or additions which are fair to members is in line with one of the functions of the Council, which is to protect the interest of beneficiaries at all times.

Accordingly, and amongst other reasons, this publication seeks to provide members and potential members of medical schemes with information to enable them to exercise informed choices.

Download the full Circular here.