Medical aid templates & tools
Practical, free help for medical aid admin: resignation and cancellation letters, complaint letters to your scheme and the CMS, PMB and claim letters you can copy, and plain-language guides to contributions, savings and gap cover.
Letters
Medical aid resignation and cancellation letter template
A free medical aid cancellation letter template for South Africa, plus the notice period, refund rules and steps to cancel without leaving a gap in cover.
Medical aid complaint letter and CMS escalation template
Free medical aid complaint letter template for South Africa, plus how to escalate to the Council for Medical Schemes (CMS) if your scheme stalls.
PMB application and motivation letter template
Free prescribed minimum benefit (PMB) application and motivation letter template for South Africa, with the ICD-10 code, treatment plan and DSP details.
Appeal a rejected claim or DSP co-payment letter template
Free letter to appeal a rejected medical aid claim or dispute a DSP co-payment in South Africa, with the grounds schemes accept and how to escalate.
Chronic medication (CDL) application letter template
Free chronic medication and CDL application letter template for South Africa, with the ICD-10 code, script and details to register chronic cover.
Medical aid claim submission letter template
Free medical aid claim submission letter template for South Africa, with the account, proof of payment and codes your scheme needs to refund you.
Switch medical aid transfer letter template
Free template to switch medical aid schemes in South Africa without a gap, using your membership certificate to waive waiting periods and keep chronic cover.
Letter to add or remove a dependant template
Free template to add or remove a dependant on your South African medical aid, with the documents, timing and waiting-period rules for newborns.
Hospital pre-authorisation request letter template
Free hospital pre-authorisation request template for South Africa, with the procedure, ICD-10 and tariff codes your scheme needs to approve cover.
Medical savings account refund request letter
Free letter to request a medical savings account refund or correct a misallocated day-to-day claim in South Africa, with claim and banking details.
Calculators & guides
How to compare medical aid plans: a checklist
A checklist to compare medical aid plans in South Africa: contributions, hospital cover, day-to-day benefits, networks and co-payments side by side.
Hospital plan vs medical aid: which should you choose?
Hospital plan vs full medical aid in South Africa compared: what each covers, the cost difference, day-to-day benefits, and who each option suits best.
Medical aid contribution calculator guide
How a medical aid contribution calculator works in South Africa: how dependants, plan type and tax credits affect what you pay, and how to estimate it.
How much medical aid do you need?
Work out how much medical aid you need in South Africa based on your age, family, health and budget, and choose a hospital or comprehensive plan.
Medical tax credit guide: how to claim it from SARS
How the SARS medical tax credit works in South Africa: the monthly scheme fees credit, the additional credit for high expenses, and how to claim it.
How to read a medical aid plan and benefit schedule
Learn how to read a South African medical aid benefit schedule: scheme rate, savings, thresholds, sub-limits, co-payments and networks explained simply.
Medical aid vs health insurance: the difference
Medical aid vs health insurance in South Africa explained: how cover, regulation, PMBs and payouts differ, and which protects you against hospital costs.
Medical aid for pensioners: what to know
A guide to medical aid for pensioners in South Africa: late-joiner penalties, chronic cover, the bigger tax credit for over-65s, and keeping it affordable.
Checklists
Gap cover buying checklist for South Africa
A checklist for buying gap cover in South Africa: what it covers, shortfall multiples, sub-limits and waiting periods, and how to choose the best one.
Questions to ask before joining a medical aid scheme
Key questions to ask before joining a medical aid scheme in South Africa: waiting periods, late-joiner penalties, hospital rates, networks and co-payments.
Waiting periods and late-joiner penalties explained
How medical aid waiting periods and late-joiner penalties work in South Africa: the 3-month and 12-month rules, when they apply, and how to reduce them.
Maternity benefits checklist for medical aid
A maternity benefits checklist for South African medical aid: antenatal visits, scans, the birth as a PMB, waiting periods and registering a newborn.
Documents you need to join a medical aid
A checklist of documents to join a medical aid in South Africa: ID, proof of income, banking details, dependant and membership certificates.