Overall, the Cape Medical Plan Medical Aid is a trustworthy and comprehensive medical aid that offers 24/7 medical emergency assistance and chronic illness benefits to up to 3 Family Members. The Cape Medical Plan Medical Aid starts from R2,805 ZAR.
|👤 Average number of members||1,000+|
|1️⃣ Number of Markets||1|
|👥 Number of Employees||150+|
|📉 Average Customer Rating||3.9|
|🔟 Average Number of Reviews||10+|
|↪️ Market Share||<1%|
|3️⃣ The number of plans offered||3|
|➡️ Number of Hospitals in Network||150+|
|🟦 Medical Claims Portal||☑️ Yes|
|💙 Information Hub for COVID-19||☑️ Yes|
|🔵 Chronic Illness Benefits||☑️ Yes|
|☑️ Number of PMB Diagnoses||271|
|🔃 Number of PMB Chronic Conditions||28|
|🩺 Screening and Prevention offered||☑️ Yes|
|🍼 Maternity Benefit||☑️ Yes|
|💶 Medical Aid Contribution Range||R2,805 – R7,987 per month|
|⬇️ Average Waiting Period||12 months|
|⬆️ Late-joiner penalties charged||☑️ Yes|
Cape Medical Aid offers the following plans:
|🔎 Plan||💴 Contributions (Main)||💵 Contributions (+Adult)||💶 Contributions (+Child)|
|🥇 HealthPact Silver||R2,805||R2,805||R421|
|🥈 HealthPact Premium||R2,842||R2,842||R501|
|🥉 HealthPact Select||R7,987||R7,987||R1,290|
Medical Aid Cape Medical Plan offers a range of medical aid plans that cater to different needs and budgets. The plans provide comprehensive cover for hospitalization, chronic medication, and day-to-day benefits such as doctor consultations, dentistry, optometry, and maternity benefits. Other benefits include:
Cape Medical Plan is financially stable, with a strong financial rating from the Council for Medical Schemes.
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Cape Medical Plan is committed to making a positive difference in the communities it serves. The scheme partners with various organizations to provide healthcare services and support to those in need, including vulnerable groups such as children and the elderly.
Cape Medical Plan offers a Medical Savings Account on the HealthPact Silver and Select options.
|🔎 Plan||👤 Main Member||👥 Adult Dependent||🍼 Child Dependent|
|🥈 HealthPact Silver||R335 per month|
R4,020 per year
|R335 per month|
R4,020 per year
R600 per year
|☑️ HealthPact Select||R336 per month|
R4,032 per year
|R336 per month|
R4,032 per year
|R55 per month
R660 per year
To apply for Medical Aid through Cape Medical Plan, you must Visit the Cape Medical Plan website at https://www.cmp.co.za/ and complete the following steps.
Get a Cape Medical Plan Medical Aid quote from our Dedicated Medical Aid Specialists Broker
If your application is successful, you will receive your membership certificate and other necessary documentation. You can then start using your medical aid benefits immediately.
Read more: Medical aid certificate explained for beginners.
Here are the step-by-step instructions on how to submit a claim with Cape Medical Plan:
If your claim is not approved, you will receive a notification from Cape Medical Plan explaining the reason for the rejection.
READ more about Gap cover for medical aid
To submit a complaint, members must note the following:
Furthermore, if you are still dissatisfied with the outcome, you can follow these steps:
If you wish to take the matter further, you can follow these steps:
However, members are encouraged to explore Cape Medical Plan’s dispute resolution process before lodging complaints with the CMS. The Medical Schemes Act allows members to lodge complaints directly with the CMS.
If a complaint is lodged with the CMS, the Registrar will request the party complained against to provide written comments within 30 days or such further period as the Registrar may allow.
To switch from your present medical aid to Cape Medical Plan, notify your current medical aid of canceling coverage. After advising your current medical plan of your desire to quit cover, you can apply to Cape Medical Plan via their website or by completing the application procedures over the phone.
Also, take note of the Cape Medical Plan late joiner fee.
There are various elements to consider before switching medical aids, even though certain medical aids allow plan alterations throughout the year. Furthermore, switching plans within the same medical insurance rarely results in waiting periods or exclusions.
Even if you have studied price and vital features, you should be aware that there are enrollment requirements for medical aids.
Numerous scheme parameters require a set interval between notifications. This specifies the payment date and whether subsequent payments are required. The CMS website states that membership dues must be paid until the final effective date. Therefore, whether a member sends notice of termination, they must continue making payments in full until the end of the notice period.
As the CMS website mentions, medical plans may initiate legal action to collect delinquent payments or suspend service retroactively as of the last date a contribution was received. In such a scenario, the program may be obliged to reverse any claims paid within the notification period.
Suppose the member does not enroll in a new benefit plan with a savings account. In that case, the debt may be removed from the balance before it is transferred to the new medical plan or paid out to the member.
You may only need to make a phone call to cancel your medical plan and cover but remember that you may still be responsible for any outstanding charges linked to the current year or policy term. If you terminate your medical assistance plan during the period, you will be responsible for repaying these advance payments.
Depending on the terms of the agreement, the payments may be distributed in installments. Council of Medical Schemes (CMS) guidelines, medical plans may only impose a 12-month waiting period on new members or those who have left their previous plan during the previous 24 months.
Any individual enrolled in another medical insurance plan for longer than 24 months is permitted to switch plans at any time without incurring a waiting period. However, you may be compelled to wait up to three months before receiving benefits if you have a pre-existing condition.
Nevertheless, you will not be eligible for statutory minimum benefits if you have never belonged to another medical plan or were permitted a gap of more than three months after leaving a previous one. This might have severe consequences, as you would be uninsured in the event of a heart attack or automobile accident.
Under new schemes, as a new member without continuous cover, you may be unable to file a claim for a specific ailment for up to a year. Consequently, many clients are discouraged from declaring pre-existing problems at the commencement of cover.
Throughout the application procedure, all medical and health information must be supplied. Non-disclosure is a felony for which a financial adviser can never be held accountable. In addition, the member must be aware that failure to report any medical condition may result in permanent exclusion from medical aid.
Cape Medical Plan prides itself on providing excellent customer support to its members. The company understands that dealing with healthcare can be stressful and confusing. Hence, it aims to make the process as smooth and easy as possible. Here are some of the ways that Cape Medical Plan provides customer support:
Furthermore, Cape Medical Plan’s streamlined claims processing system makes it easy for members to submit claims and get reimbursed quickly. The company also has a claims inquiry service that allows members to check the status of their claims online or via the contact center.
|🔎 Medical Aid||🥇 Cape Medical Plan||🥈 Sizwe Hosmed||🥉 Medihelp|
|📌 Years in Operation||52 years||35 Years||118 years|
|📍 Average # Members||1,000+||172,000+||250,000+|
|☑️ GCR Rating||–||A+||AA-|
|✅ Number of Employees||150+||500 – 1,000||1,000|
|📈 Market Share||<1%||<5%||<5%|
|📉 Market Cover||South Africa||South Africa||South Africa|
|📊 Customer Rating||3.9||–||3.5|
|➡️ Number of reviews||10+||<1,000||1,000+|
|↪️ Mobile App||No||Yes||Yes|
|💶 Contribution Range (ZAR)||R2,805 – R7,987||405 – 7,320 ZAR||756 – 10,980 ZAR|
|🌎 International Travel Benefit (ZAR)||No||100% of the Scheme Rate||Scheme Tariff|
Exceptional, proficient, and well-informed service accompanied by minimal wait times and amiable representatives. – Catherine Snyman
Cape Medical Plan provides cover for Prescribed Minimum Benefit (PMB) conditions through state facilities or CMP-approved providers. Members only qualify for state rates at Preferred Partners after attempting state facility admission. Given NHI’s goal of reducing state hospital strain and enabling private facility access, CMP members might benefit more from NHI. – Lydia Janse van Rensburg
Superior medical services.
Superior medical services accompanied by cost-effective plans. – Dimakatso Kumalo
|✅ Pros||❎ Cons|
|Affordable healthcare plans||Plans may not cover all healthcare needs|
|Large network of healthcare providers||Limited options for choosing healthcare providers|
|Easy-to-use online member portal||The claims process may be confusing for some|
|Dedicated contact center||Premiums are much higher than other medical plans|
Cape Medical Plan is a South African medical scheme provider that offers affordable healthcare plans to suit different needs and budgets. Furthermore, CMP has a large network of healthcare providers and provides excellent customer support through its online member portal and dedicated contact center.
Members can easily access their healthcare information, submit claims, and get assistance when needed. However, some members may find that the plans might cover all their healthcare needs and the monthly contributions are higher than others.
However, despite this, Cape Medical Plan is a reputable choice for those seeking affordable healthcare in South Africa.
You might also consider reading the following topics:
Cape Medical Plan is a medical scheme provider in South Africa that offers affordable healthcare plans to suit different needs and budgets.
Cape Medical Plan offers a range of healthcare plans to suit different needs and budgets, including hospital plans, comprehensive plans, and network options.
Cape Medical Plan provides an online member portal that allows members to access their healthcare information, claims history, and other resources.
Yes, Cape Medical Plan has a large network of healthcare providers, including doctors, hospitals, and other healthcare professionals.
READ More: 5 Best GP Network Plans on Medical Aid
Cape Medical Plan provides excellent customer support through its dedicated contact center staffed by knowledgeable and friendly customer service representatives.
Cape Medical Plan’s streamlined claims processing system makes it easy for members to submit claims and get reimbursed quickly.
Yes, Cape Medical Plan is committed to providing affordable healthcare options to its members in South Africa.
While Cape Medical Plan offers a range of healthcare plans, some treatments or services may not be covered, and members may have limited options when choosing healthcare providers.
Log in to your Cape Medical Plan account on the website or mobile app. Click the “Profile” tab and select “Change my Plan.”
If you want to add a child or adult dependent, you can log into your Cape Medical Plan profile and click the “Profile” tab and select “Add a Beneficiary.
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