1. No category

Circular 68 of 2014: Medical Scheme benefit options for open and restricted schemes approved for 2015
1. The Council for Medical Schemes (CMS) would like to share the status of benefit options in open schemes for the 2015 calendar year.
Name of medical scheme
BESTMED MEDICAL SCHEME
Name of benefit option
PACE 4
APPROVED
PACE 3
PACE 2
PACE 1
BEAT 4
APPROVED
APPROVED
APPROVED
BEAT 4 NETWORK
BEAT 3
BEAT 3 NETWORK
BEAT 2
BEAT 2 NETWORK
BEAT 1
BEAT 1 NETWORK
BONITAS MEDICAL FUND
Decision
APPROVED
APPROVED
APPROVED
APPROVED
PULSE 2
PULSE 1
APPROVED
APPROVED
BONCAP
BONCOMPREHENSIVE
BONSAVE
APPROVED
APPROVED
APPROVED
Basis for the decision
NETWORK OPTION – pending exemption
NETWORK OPTION – pending exemption
NETWORK OPTION – pending exemption
NETWORK OPTION – pending exemption
Name of medical scheme
CAPE MEDICAL PLAN
COMMUNITY MEDICAL AID
SCHEME (COMMED)
COMPCARE WELLNESS MEDICAL
SCHEME
DISCOVERY HEALTH MEDICAL
SCHEME
Name of benefit option
Decision
PRIMARY
STANDARD
APPROVED
APPROVED
BONESSENTIAL
APPROVED
BONCLASSIC
APPROVED
HEALTHPACT PREMIUM
APPROVED
HEALTHPACT SILVER
HEALTHPACT SELECT
APPROVED
APPROVED
FUNDAMENTAL
DISCONTINUED
DELUXE
STANDARD
APPROVED
APPROVED
ROOTS
APPROVED
DYNAMIX
DSP NETWORK
PINNACLE
DSP NETWORK
MUMED
DSP NETWORK
SYMMETRY
DSP NETWORK
AXIS
DSP NETWORK
NETWORX
DSP NETWORK
CLASSIC COMPREHENSIVE
CLASSIC DELTA
COMPREHENSIVE
CLASSIC CORE
CLASSIC DELTA CORE
CLASSIC PRIORITY
CLASSIC SAVER
CLASSIC DELTA SAVER
COASTAL CORE
COASTAL SAVER
ESSENTIAL COMPREHENSIVE
ESSENTIAL DELTA
COMPREHENSIVE
APPROVED
APPROVED
APPROVED
APPROVED
APPROVED
APPROVED
APPROVED
APPROVED
APPROVED
APPROVED
APPROVED
APPROVED
APPROVED
Basis for the decision
Discontinued with effect from 31 December 2014
New with effect from 1 January 2015
Name of medical scheme
Name of benefit option
ESSENTIAL CORE
ESSENTIAL DELTA CORE
ESSENTIAL PRIORITY
ESSENTIAL SAVER
ESSENTIAL DELTA SAVER
EXECUTIVE
KEYCARE CORE
KEYCARE PLUS
KEYCARE ACCESS
CLASSIC COMPREHENSIVE ZERO MSA
FEDHEALTH MEDICAL SCHEME
GENESIS MEDICAL SCHEME
HOSMED MEDICAL AID SCHEME
Basis for the decision
APPROVED
APPROVED
APPROVED
APPROVED
APPROVED
APPROVED
APPROVED
APPROVED
MAXIMA BASIS
APPROVED
MAXIMA CORE
MAXIMA PLUS
MAXIMA STANDARD
MAXIMA STANDARD NET
MAXIMA ENTRYZONE
MAXIMA EXECUTIVE
APPROVED
APPROVED
ULTIMA 200
APPROVED
ULTIMAX
APPROVED
BLUE DOOR PLUS
APPROVED
MAXIMA SAVER
APPROVED
MAXIMA ENTRYSAVER
APPROVED
PRIVATE
APPROVED
PRIVATE PLUS
PRIVATE COMPREHENSIVE
APPROVED
APPROVED
PRIVATE CHOICE
APPROVED
PLUS
APPROVED
ESSENTIAL (was Step Medium)
STEP CORE
VALUE
KEYHEALTH
Decision
APPROVED
APPROVED
APPROVED
APPROVED
DISCONTINUED
APPROVED
PLATINUM
APPROVED
GOLD
APPROVED
SILVER
APPROVED
Re-named with effect from 1 January 2015
Renamed “Essential” with effect from 1 January 2015
Discontinued with effect from 31 December 2014
Name of medical scheme
Name of benefit option
Decision
EQUILIBRIUM
ESSENCE
ORIGIN
APPROVED
APPROVED
APPROVED
TRADITIONAL ULTIMATE
HOSPITAL STANDARD
HOSPITAL SELECT
SAVER STANDARD
SAVER SELECT
COMPLETE PLUS
HOSPITAL PLUS
SAVER PLUS
APPROVED
TRADITIONAL STANDARD
COMPLETE STANDARD
COMPLETE SELECT
TRADITIONAL BASIC
APPROVED
COMPREHENSIVE
APPROVED
PRIMARY
APPROVED
DIMENSION ELITE
DIMENSION PRIME 1
DIMENSION PRIME 1 NETWORK
DIMENSION PRIME 2
DIMENSION PRIME 2 NETWORK
DIMENSION PRIME 3
DIMENSION PRIME 3 NETWORK
MEDIHELP PLUS
NECESSE
UNIFY
APPROVED
MEDIMED MEDICAL SCHEME
ALPHA
MEDISAVE ESSENTIAL
MEDISAVE - MAX
MEDISAVE - STANDARD
APPROVED
APPROVED
APPROVED
APPROVED
MEDSHIELD MEDICAL SCHEME
MEDIBONUS
APPROVED
MEDIPLUS
APPROVED
LIBERTY HEALTH MEDICAL
SCHEME
MAKOTI MEDICAL SCHEME
MEDIHELP
APPROVED
APPROVED
APPROVED
APPROVED
APPROVED
APPROVED
APPROVED
APPROVED
APPROVED
APPROVED
APPROVED
APPROVED
APPROVED
Basis for the decision
Name of medical scheme
MOMENTUM HEALTH MEDICAL
SCHEME
Name of benefit option
Decision
MEDIVALUE
APPROVED
80% OPTION
DISCONTINUED
CORE PLUS
APPROVED
PREMIUM PLUS
APPROVED
STANDARD
APPROVED
MEDIPHILA
APPROVED
INGWE
PRIMARY CARE/STATE
HOSPITAL NETWORK
PRIMARY CARE/INGWE
HOSPITAL NETWORK
ACTIVE NETWORK/INGWE ANY
OPTION
APPROVED
CUSTOM
STATE/ASSOCIATED
HOSPITALS
STATE/ANY HOSPITAL
ASSOC GP & PHARM/ASSOC
HOSPITALS
ASSOC GP & PHARM/ANY
HOSPITAL
ANY GP & PHARM/ASSOC
HOSPITALS
ANY GP & PHARM/ANY
HOSPITAL
INCENTIVE
STATE/ASSOCIATED
HOSPITALS
STATE/ANY HOSPITAL
ASSOC GP & PHARM/ASSOC
HOSPITALS
ASSOC GP & PHARM/ANY
HOSPITAL
ANY GP & PHARM/ASSOC
HOSPITALS
ANY GP & PHARM/ANY
HOSPITAL
EXTENDER
APPROVED
APPROVED
APPROVED
Basis for the decision
Discontinued with effect from 31 December 2014
Name of medical scheme
Name of benefit option
Decision
Basis for the decision
STATE/ASSOC HOSPITALS
STATE/ANY HOSPITAL
ASSOC GP & PHARM/ASSOC
HOSPITALS
ASSOC GP & PHARM/ANY
HOSPITAL
ANY GP & PHARM/ASSOC
HOSPITALS
ANY GP & PHARM/ANY
HOSPITAL
RESOLUTION HEALTH MEDICAL
SCHEME
SELFMED MEDICAL SCHEME
SIZWE MEDICAL FUND
SPECTRAMED
ACCESS
SUMMIT
APPROVED
APPROVED
HOSPITAL
APPROVED
PROGRESSIVE FLEX
CLASSIC
SUPREME
MILLENNIUM
APPROVED
PENDING
APPROVED
APPROVED
FOUNDATION
APPROVED
MEDXXI
APPROVED
MED ELITE
SELFMED 80%
SELFSURE
SELFNET
APPROVED
APPROVED
APPROVED
APPROVED
SIZWE AFFORDABLE CARE
APPROVED
SIZWE FULL CARE
SIZWE PRIMARY CARE
APPROVED
APPROVED
SIZWE SAVINGS CARE
SIZWE GOMOMO CARE
APPROVED
APPROVED
CYAN
APPROVED
AZURE
AQUA
COBALT
APPROVED
APPROVED
APPROVED
CAPRI
APPROVED
New with effect from 1 January 2015
New with effect from 1 January 2015
New with effect from 1 January 2015
Name of medical scheme
SUREMED HEALTH
THEBEMED
TOPMED MEDICAL SCHEME
Name of benefit option
Decision
CHALLENGER
APPROVED
NAVIGATOR
SHUTTLE
EXPLORER
APPROVED
APPROVED
APPROVED
ENERGY
CORE
MEDIUM
OPEN
UNIVERSAL
APPROVED
APPROVED
RAINBOW COMPREHENSIVE
APPROVED
PALADIN COMPREHENSIVE
APPROVED
PROFESSIONAL
APPROVED
SAVINGS
APPROVED
ACTIVE SAVER
APPROVED
HOSPITAL
APPROVED
NETWORK
LIMITED (WAS METHCARE)
APPROVED
APPROVED
Basis for the decision
2. The Council for Medical Schemes (CMS) would like to share the status of benefit options in restricted schemes for the 2015 calendar
year.
Name of medical scheme
AECI MEDICAL AID SOCIETY
AFROX MEDICAL AID SOCIETY
ALLIANCE-MIDMED MEDICAL
SCHEME
ANGLO MEDICAL SCHEME
Name of benefit option
VALUE OPTION
COMPREHENSIVE OPTION (WAS
COMPREHENSIVE PLAN)
BASE PLAN
Decision
Basis for the decision
APPROVED
APPROVED
DISCONTINUED
ALLIANCE-MIDMED
APPROVED
MANAGED CARE PLAN
STANDARD CARE PLAN
VALUE CARE PLAN
APPROVED
APPROVED
APPROVED
ANGLOVAAL GROUP MEDICAL
SCHEME
ANGLOVAAL GROUP MEDICAL
SCHEME
APPROVED
BANKMED
BANKMED BASIC PLAN
BANKMED COMPREHENSIVE PLAN
BANKMED CORE SAVER PLAN
BANKMED PLUS PLAN
BANKMED TRADITIONAL PLAN
BANKMED PMB PLAN
APPROVED
APPROVED
APPROVED
APPROVED
APPROVED
APPROVED
BARLOWORLD MEDICAL SCHEME
BARLOWORLD MEDICAL SCHEME
APPROVED
BMW EMPLOYEES MEDICAL AID
SOCIETY
BMW EMPLOYEES MEDICAL AID
SOCIETY
APPROVED
BP MEDICAL AID SOCIETY
BP MEDICAL SOCIETY
APPROVED
BUILDING &CONSTRUCTION
INDUSTRY MEDICAL SCHEME
CHARTERED ACCOUNTANTS (SA)
BASIC OPTION
APPROVED
ALLIANCE BENEFIT OPTION
APPROVED
Amalgamated with Discovery Health Medical Scheme; with
effect from 1 May 2014
Mid-year contribution increases and annual benefit changes
Name of medical scheme
Name of benefit option
Decision
MEDICAL AID FUND (CAMAF)
DOUBLE PLUS BENEFIT OPTION
FIRST CHOICE BENEFIT OPTION
VITAL BENEFIT OPTION
NETWORK CHOICE BENEFIT OPTION
ESSENTIAL PLUS BENEFIT OPTION
APPROVED
APPROVED
APPROVED
APPROVED
APPROVED
DE BEERS BENEFIT SOCIETY
DE BEERS BENEFIT SOCIETY
APPROVED
ENGEN MEDICAL BENEFIT FUND
ENGEN MEDICAL BENEFIT FUND
APPROVED
FISHING INDUSTRY MEDICAL
SCHEME (FISH-MED)
PRIMARY
STANDARD
APPROVED
APPROVED
FOOD WORKERS MEDICAL
BENEFIT FUND
FOOD WORKERS MEDICAL BENEFIT
FUND
GLENCORE MEDICAL SCHEME
GLENCORE MEDICAL SCHEME
APPROVED
GOLDEN ARROWS EMPLOYEES
MEDICAL BENEFIT FUND
ADVANCE
PRIMARY
STANDARD
APPROVED
APPROVED
APPROVED
GOVERNMENT EMPLOYEES
MEDICAL SCHEME (GEMS)
ONYX
EMERALD
RUBY
SAPPHIRE
BERYL
APPROVED
APPROVED
APPROVED
APPROVED
APPROVED
GRINTEK ELECTRONICS MEDICAL
AID SCHEME
GRINTEK ELECTRONIC MEDICAL AID
SCHEME
APPROVED
HORIZON MEDICAL SCHEME
HOSPITAL PLAN
MAJOR MEDICAL PLAN
MAJOR MEDICAL PLUS CARECROSS
APPROVED
APPROVED
APPROVED
IMPALA MEDICAL PLAN
IMPALA MEDICAL PLAN
APPROVED
N/A
Basis for the decision
Mid-year contribution increases and annual benefit changes
No changes for 2015
Name of medical scheme
Name of benefit option
Decision
IMPERIAL GROUP MEDICAL
SCHEME
IMPERIALMED HEALTH PLAN
IMPERIALMED BUDGET PLAN
APPROVED
APPROVED
LA-HEALTH
ACTIVE
COMPREHENSIVE
CORE
FOCUS
KEYPLUS
APPROVED
APPROVED
APPROVED
APPROVED
APPROVED
LIBCARE MEDICAL SCHEME
LIBCARE
APPROVED
LONMIN MEDICAL SCHEME
LONMIN MEDICAL SCHEME
APPROVED
MALCOR MEDICAL SCHEME
PLAN A
PLAN B
PLAN C
PLAN D
APPROVED
APPROVED
APPROVED
APPROVED
MASSMART HEALTH PLAN
CHOICE OPTION
NETWORK OPTION
ESSENTIAL OPTION
APPROVED
APPROVED
APPROVED
MBMED MEDICAL AID FUND
PLAN A
APPROVED
MEDIPOS MEDICAL SCHEME
OPTION A
OPTION B
OPTION C
APPROVED
APPROVED
APPROVED
METROPOLITAN MEDICAL SCHEME
CLASSIC
PREMIER
APPROVED
APPROVED
MOTO HEALTHCARE
OPTMUM
CLASSIC
HOSPICARE
CUSTOM
ESSENTIAL
APPROVED
APPROVED
APPROVED
APPROVED
APPROVED
Basis for the decision
Mid-year contribution increases and annual benefit changes.
Mid-year contribution increases and annual benefit changes.
New with effect from 1 January 2015
Name of medical scheme
NASPERS MEDICAL FUND
Name of benefit option
Decision
M-MED OPTION
APPROVED
N OPTION BASIC
N OPTION PLUS
APPROVED
APPROVED
NEDGROUP MEDICAL AID SCHEME
PLATINUM PLAN
TRADITIONAL PLAN
TRADITIONAL PLUS PLAN
SAVINGS PLAN
HOSPITAL PLAN
APPROVED
APPROVED
APPROVED
APPROVED
APPROVED
NETCARE MEDICAL SCHEME
NETCARE SAVINGS OPTION
APPROVED
OLD MUTUAL STAFF MEDICAL AID
FUND
TRADITIONAL PLUS PLAN
TRADITIONAL PLAN
SAVINGS PLAN
NETWORK PLAN
HOSPITAL PLAN
APPROVED
APPROVED
APPROVED
APPROVED
APPROVED
PARMED MEDICAL AID SCHEME
PARMED MEDICAL AID SCHEME
APPROVED
PG GROUP MEDICAL SCHEME
PG GROUP MEDICAL SCHEME
APPROVED
PICK & PAY MEDICAL SCHEME
PICK N PAY MEDICAL SCHEME
APPROVED
PLATINUM HEALTH
PLATCOMPREHENSIVE
PLATCAP
PLATSAVE
APPROVED
APPROVED
APPROVED
PROFMED
PRO ACTIVE
PRO ACTIVE PLUS
PRO PINNACLE
PRO SECURE
PRO SECURE PLUS
APPROVED
APPROVED
APPROVED
APPROVED
APPROVED
QUANTUM MEDICAL AID SOCIETY
ESSENTIAL COMPREHENSIVE
ESSENTIAL SAVER
KEYCARE PLUS
APPROVED
APPROVED
APPROVED
Basis for the decision
Mid-year contribution increases
Mid-year contribution increases
Mid-year contribution increases
Mid-year contribution increases
Mid-year contribution increases
and benefit changes
and benefit changes
and benefit changes
and benefit changes
and benefit changes
Name of medical scheme
Name of benefit option
Decision
RAND WATER MEDICAL SCHEME
OPTION A
OPTION B
APPROVED
APPROVED
REMEDI MEDICAL AID SCHEME
CLASSIC
COMPREHENSIVE
STANDARD
APPROVED
APPROVED
APPROVED
RETAIL MEDICAL SCHEME
ESSENTIAL OPTION
ESSENTIAL PLUS OPTION
APPROVED
APPROVED
RHODES UNIVERSITY MEDICAL
SCHEME
S A BREWERIES MEDICAL AID
SOCIETY
RUMED
APPROVED
ESSENTIAL
COMPREHENSIVE
APPROVED
APPROVED
SABC MEDICAL AID SCHEME
SABC PLAN 009
APPROVED
SOUTH AFRICAN MUNICIPAL
UNION NATIONAL MEDICAL
SCHEME (SAMWUMED)
SASOLMED
OPTION A
OPTION B
APPROVED
APPROVED
SASOLMED
APPROVED
SEDMED
SEDMED
APPROVED
SISONKE HEALTH MEDICAL
SCHEME
HERITAGE PLAN
PRIDE PLAN
APPROVED
APPROVED
SOUTH AFRICAN POLICE SERVICE
MEDICAL SCHEME (POLMED)
HIGHER PLAN
LOWER PLAN
APPROVED
APPROVED
TFG MEDICAL SCHEME
PLAN A
PLAN B
APPROVED
APPROVED
TIGER BRANDS MEDICAL SCHEME
OPTION 1
MZANSI NETWORK OPTION
APPROVED
APPROVED
Basis for the decision
Mid-year contribution increases and annual benefit changes
Mid-year contribution increases and annual benefit changes
Mid-year contribution increases and annual benefit changes
Name of medical scheme
Name of benefit option
Decision
TRANSMED MEDICAL FUND
GUARDIAN
STATE PLUS NETWORK
STATE PLUS OWN CHOICE
PRIVATE NETWORK
APPROVED
APPROVED
APPROVED
APPROVED
TSOGO SUN GROUP MEDICAL
SCHEME
CLASSIC COMPREHENSIVE
CLASSIC SAVER
APPROVED
APPROVED
UMVUZO HEALTH MEDICAL
SCHEME
STANDARD
SUPREME
ULTRA AFFORDABLE
EXTREME
APPROVED
APPROVED
APPROVED
APPROVED
UNIVERSITY OF KWAZULU-NATAL
MEDICAL SCHEME
STANDARD PLAN
KEYPLUS PLAN
UNIVERSITY OF THE
WITWATERSRAND,
JOHANNESBURG STAFF MEDICAL
AID SCHEME
WITBANK COALFIELDS MEDICAL
AID SCHEME
UNIVERSITY OF WITWATERSRAND
STAFF MEDICAL AID
APPROVED
COMPREHENSIVE OPTION
YEBOMED
APPROVED
APPROVED
WOOLTRU HEALTHCARE FUND
CORE OPTION
EXTENDED OPTION
PLUS OPTION
APPROVED
APPROVED
APPROVED
APPROVED
DISCONTINUED
Basis for the decision
New with effect from 1 January 2015