Scheme rules

2018 Scheme rules

These are the rules of the Scheme as registered with the Council for Medical Schemes (CMS). In an event of a dispute, the registered rules will apply. These rules will be effective from 1 January 2018.

• Table of Contents
• Rules 1 - 8.2
• Rules 8.3 - 13.6
• Rules 13.7 - 19.10.3.1   
• Rules 19.10.3.2 - 20.1  
• Rules 20.2 - 22.11  
• Rules 22.12 - 34.6 
• Annexure A  
• Annexure B  
• Annexure C - Sapphire  
• Annexure C - Beryl 
• Annexure C - Ruby 
• Annexure C - Emerald  
• Annexure C - Emerald Value  
• Annexure C - Onyx 
• Annexure D - Additional chronic disease list 
• Annexure E - Exclusions and limitations  
• Annexure F - Personal Medical Savings Accounts  
• Annexure G - Prescribed minimum benefits 

2017 Scheme rules

These are the rules of the Scheme as registered with the Council for Medical Schemes (CMS). In an event of a dispute, the registered rules will apply. 

• Table of Contents 
• Rules 1 - 7.7.5 
• Rules 8 - 13.5.2 
• Rules 13.6 - 19.10.3.1 
• Rules 19.10.3.2 - 20 
• Rules 20.1 - 22.10
• Rules 22.11 - 34.6 
• Annexure A
• Annexure B  
• Annexure C - Sapphire     
• Annexure C - Beryl    
• Annexure C - Ruby    
• Annexure C - Emerald     
• Annexure C - Emerald Value       
• Annexure C - Onyx    
• Annexure D - Additional chronic disease list
• Annexure E - Exclusions and limitations 
• Annexure F - Personal Medical Savings Accounts 
• Annexure G - Prescribed minimum benefits

Archive

• 2016 registered rules of the Scheme
• 2015 registered rules of the Scheme