Medihelp rules
medihelp rules
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The Medical Schemes Act, 1998 governs medical schemes in South Africa. Amongst other things, the Act makes provision for the registration of medical schemes as well as controlling their activities, and to protect the interests of members of medical schemes.

The Council for Medical Schemes (CMS) is a statutory body established by the Medical Schemes Act, to provide regulatory supervision of brokers, administrators, healthcare management organisations and private health financing through medical schemes. 

In compliance with the Act, Medihelp’s Rules are registered with the Registrar of Medical Schemes. According to the CMS, a member is entitled, on request, to copies of a medical scheme’s rules, financial statements and financial reports upon payment of a reasonable fee.

New members joining Medihelp receive a welcome pack with their membership card(s), a schedule containing the membership conditions, a member information guide and a summary of the member’s chosen benefit option rules in the form of a benefit brochure. 

Medihelp’s Rules are available on the Medihelp website to inform members of their rights, the obligations of the medical scheme and the relevant contributions and benefits to which members are entitled.  

To ensure that you know how Medihelp is managed and to which benefits you’re entitled, please download and read Medihelp’s Rules.

Rules for 2014

The Rules for 2014 will be released in due course.

Rules for 2013

*Services that are excluded from benefits, are set out in the Rules of Medihelp.

Medihelp Rules - 2013
Schedule B1 Medihelp Plus - 2013
Schedule B2 Dimension Elite - 2013
Schedule B3 Dimension Prime 3 - 2013
Schedule B4 Dimension Prime 2 - 2013
Schedule B5 Dimension Prime 1 - 2013
Schedule B6 Necesse - 2013
Schedule B7 Unify - 2013