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​​Rand Water Medical Scheme is nonprofit restricted medical scheme catering specifically for the Rand Water employees and their immediate families. It was founded in 1918 and is registered (registration number 1201) in terms of the Medical Schemes Act 131 of 1998, as amended.

The Scheme offers 2 Benefit Options , namely Option A ( Comprehensive Product ) and Option B plus (Standard) .Both product offerings are very rich, i.e. benchmarked and competes comfortably against higher options of the Largest Open & Closed Medical Schemes in the Market. The solvency ratio has been well maintained above 25% of the statutory requirement by Council for Medical Schemes
 
Circular 73 of 2016: Human Immunodeficiency Virus (HI) as a PMB condition
The council for Medical Scheme (CMS) has previously published a CMScript (Issue 10 of 2014) on Human Immunodeficiency Viruss (HIV) as Prescribed Minimum Benefit (PMB) condition. In this article, guidance was provided indicating that all medical scheme are required by law to pay for diagnosis, treatment and care costs of the condition in full.
CMScript issue 5 of 2015
The Clinical Review Committee receives a wide variety of enquiries and complaints with regards to the physical rehabilitation of members who suffered a Prescribed Minimum Benefit (PMB) condition requiring therapy. In order to provide guidance on what treatment is included as PMB level of care, it is important to understand the definition of physical rehabilitation and the provisions in the Medical Scheme Act 131 of 1998.
CMScript issue 8 of 2016
Endometriosis is a condition which occurs when tissue that is normally found inside the womb, known as the endometrium or womb lining, grows in other parts of the body. The tissue may attach outside the womb, to the ovaries, fallopian tubes, the bowel or the bladder.
Circular 75 of 2016: Non-compliance  with protocols and recommended treatment by members
The Council for Medical Schemes (CMS) Previously informed all the medical schemes that non-compliace with specific clinical protocols and recommended treatment by members may not result in the non-payment of claims.
 
 
If you are a Member or a Service provider:
                                    
 
 
Contact Details
 
Rand Water Medical Scheme Call Centre
011 682 0985
Net Care 911 (Emergency Service):
082 911
 
 
 
 
 
Sanlam Health
 
Hospital Pre-Authorization
Pharmacy (Acute & Chronic)
0861 114 476 & Select Option 1
0861 114 476 & Select Option 2
Chronic Disease (HIV & Aids)
 
Council for Medical Schemes Contact Details:
Tel: 0861 123 267
Fax: 012 431 0608
E-mail: information@medicalschemes.com
Address: Private Bag X34, Hatfield, 0028
 
... Read more about the Council for Medical Scheme
 
0861 114 476 & Select Option 3
 
 
Sanlam Health Management will be responsible for the Hospital Management; Medicine Management and chronic Disease management effective 01 November 2014. Read more. To read more about Medical Schemes Click here.
 
For Emergencies: During the Week After Hours, Weekends and Public Holidays, please go to the nearest Hospital Emergency Department for medical attention, should you be admitted, the hospital authorisation number will be obtained on the first working day. 
 Rand Water Medical Scheme Forms:
 
Summary of Contribution increase for 2015 Benefits
The Trustees have adopted a change to the pricing philosophy applied historically. The pricing philosophy adopted for the 2015 benefit year is to break-even before investment income. The following contribution increases effective 1 January 2015 and was approved as such by the Council for Medical Schemes:
 
 
CMScript
Prescribed Minimum Benefits (PMBs) refer to the benefits contemplated in section 29 (1) (o) of the Medical Schemes Act (the Act) 131 of 1998, and consist of the provision of the diagnosis, treatment and care costs.
 
 

 

 
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