Council for Medical Schemes

The Council for Medical Schemes (CMS) is an autonomous statutory body established under South Africa’s Medical Schemes Act (131 of 1998). It regulates private health financing through medical schemes, with a mandate to protect the interests of scheme beneficiaries and provide regulatory supervision of the industry. The CMS is not a medical scheme or healthcare provider; its work centres on oversight, information, and consumer support.

The Council provides guidance on topics including Prescribed Minimum Benefits, chronic benefits, medical aid versus insurance, complaints procedures, and consumer rights. Beneficiaries can submit complaints about a medical scheme’s conduct, while regulated entities and other stakeholders can access circulars, legislation, application forms, portals, and statutory return services. The CMS also publishes rulings, industry reports, research, annual reports, and educational resources, and offers consumer education, conferences, training, and events. Through its website, contact channels, and information portals, the CMS helps the public and industry participants understand medical scheme requirements and access relevant regulatory information.