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Information information@medicalschemes.co.za
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Understanding your medical scheme

Navigating your medical scheme in 2025

It’s the 2025 benefit year, and your medical scheme benefits for 2025 are now available*. But where do you start? We’ve compiled an easy guide to navigate your medical scheme benefits, rights, responsibilities, and other key aspects of being a member.

  • Your Prescribed Minimum Benefits (PMBs) are a baseline for your healthcare cover.

Did you know that your scheme is required to cover a set list of 271 medical conditions and 26 chronic conditions, regardless of your benefit option? Click here to learn more about the prescribed minimum benefits that protect you as a member.

  • We’ve unpacked PMBs in our CMScript newsletter.

We want to help you understand your guaranteed benefits through our condition-specific newsletter, CMScript. Whether it’s diabetes, burns, or bulimia, we have put these topics together in an easy-to-read format here.

  • Should things not go as planned, here’s our complaints procedure.

If you have an issue with your medical scheme, we encourage you to first raise it through the scheme’s channels. If you are unsatisfied with the outcome, you may lodge a complaint with the CMS.

  • Empower yourself with knowledge.

Our consumer education material is designed to empower you about your rights and responsibilities as a medical scheme member. Download our comprehensive guides, available in English, Afrikaans, Tswana, and Zulu, here.

  • Our regulated and accredited entities all in one place.

Looking for important information such as your medical scheme’s contact details? Visit our list of regulated entities here.

  • Annual & Industry Reports

We uphold transparency by publishing annual reports on CMS operations and finances, and industry reports with key data and trends on medical schemes. Access the reports here.

  • For you, for health, for life.

Our main order of business is safeguarding the interests of medical scheme members.

Feel free to contact us at information@medicalschemes.co.za or call our Customer Care Centre on 0861 123 CMS (267), and one of our friendly agents will gladly assist you.

*subject to applicable waiting periods.

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