Medical Aid Plan - Council for Medical Aids

Council for Medical Aids


Everybody wants access to good medical care, and the Council for Medical Schemes (CMS) regulates the medical schemes industry. People sometimes call this body the Council for Medical Aids.


They are essentially protecting the interests of the South African public and shielding them from bad medical aid governance. They will for instance advice the public on how to select the best medical scheme. They also advise customers to make sure that the scheme in registered in terms of the Medical Schemes Act 131 of 1998. 


Council for Medical Aids - Find Out More about your Medical Aid


Customers can find the names and contact details of all registered medical schemes on the website of the Council for Medical Schemes. Information about the benefits of a medical scheme, its premiums each months, its waiting periods, limitations and exclusions can be requested from your medical scheme.


If you do make use of the services of a broker, make sure that the broker is accredited by the Council for Medical Schemes. To make certain that a broker is accredited, members of a medical scheme can insist that the broker produce proof of accreditation with Council.


Council for Medical aids - Who are the Members of the Council?

 Council for Medical Aids

They are a legal body which was set up by the Medical Schemes Act. Their job is to provide  supervision of private health financing through these medical schemes. Council members are appointed for a period of up to 3 years and on a part-time basis.


Members of the Council have a number of skills between them and you’ll find experts among them with experience in the likes of law, medical sciences, consumer affairs, finance and economics.


They know about ICD-10 codes, codes which inform medical schemes about what conditions their members were treated for. This helps to settle claims correctly. It’s a coding system developed by the World Health Organisation (WHO) and they help the medical scheme to determine what benefits you are entitled to and how they’ll be paid.


In fact the Medical Schemes Act gives the Council a number of roles -


·         they monitor the financial stability of all the different medical schemes.

·         they co-ordinate the functioning of medical schemes to ensure they are
 complementary with the national health policy.

·         they collect information about private health care in the country.

·         They make recommendations to the Minister of Health about health
 services provided by medical schemes


The Council for Medical Schemes meets at least 4 times a year. However, special meetings can be called for the chairperson or the majority of members may request a meeting. The minister too, can request a meeting. The Council also has Subcommittees which also meet from time to time on a regular basis.


Council for Medical aids - Consumer Awareness Initiatives


If you’re interested, the Council for Medical Schemes also offers some programmes as part of Consumer Awareness and Education Initiatives. If you want to have questions on your medical aid answered by the Council for Medical Schemes they have a very comprehensive FAQ page.


The Council for Medical Schemes can’t just act freely, but acts in accordance with legislations drawn up by the Department of Health.


As a statutory body or ombudsman, it has an important role to keep an eye on private health financing through medical schemes, and to ensure that the South African public is on the receiving end of quality healthcare.



Please click on the Get a Quote link at the top (or the bottom) of this page to reach a form where you can apply for a comparative medical aid quotes online!



Medical Aid QuoteNOTES:

Your medical aid quote will include options to suit your pocket. Please ensure that the cover you select is exactly what you need and that you understand exactly what insurance you are buying. Do not hesitate to ask questions about the medical aid or hospital cover you choose.