Who can complain to the Registrar’s Office?
Any beneficiary or any person who is aggrieved with the conduct of a medical scheme can submit a complaint.
It is however very important to note that a prospective complainant should always first seek to resolve complaints through the complaints mechanisms in place at the respective medical scheme before approaching the Council for assistance.
Complaints can be submitted by any reasonable means such as a letter, fax, e-mail or in person at our Offices from Mondays to Fridays during 08:00 – 17:00.
The Council for Medical Schemes is a statutory body established in terms of the Medical Schemes Act to provide regulatory oversight to the medical schemes industry. As part of their mission, the Council serves to act in an administratively fair and transparent manner, to:
- Inform the public of their rights and duties
- Ensure that all entities conducting the business of a medical scheme comply with the Medical Schemes act
- Ensure that complaints raised by members and the public are handled appropriately and speedily
Patient Rights Information
from the Council For Medical Schemes
What are PMBs?
Prescribed Minimum Benefits (PMB) is a set of defined benefits to ensure that all medical scheme members have access to certain minimum health services, regardless of the benefit option they have selected. The aim is to provide people with continuous care to improve their health and well-being and to make healthcare more affordable.
PMBs are a feature of the Medical Schemes Act, in terms of which medical schemes have to cover the costs related to the diagnosis, treatment and care of:
When deciding whether a condition is a PMB, the doctor should only look at the symptoms and not at any other factors, such as how the injury or condition was contracted. This approach is called diagnosis-based. Once the diagnosis has been made, the appropriate treatment and care is decided upon as well as where the patient should receive the treatment (at a hospital, as an outpatient or at a doctor's rooms).
Download 10 things no one tells you about PMB's