Photo: Shade Schutze Photography, Wikimedia Commons, CC BY-SA 4.0Council for Medical Schemes (CMS)
What it does, how to complain and how to contact it
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What the CMS regulates
The CMS Annual Report 2025/26 gives the size of the industry it supervises at 31 March 2026:
| Regulated entities | Number |
|---|---|
| Registered medical schemes | 70 (16 open, 54 restricted) |
| Administrators | 36 |
| Managed care organisations | 42 |
| Brokers (individuals) | 7,793 |
| Brokerages | 2,182 |
In money terms, schemes collected R267.3 billion of gross contributions and paid R259.3 billion of benefits in 2024, of which R135.66 billion for Prescribed Minimum Benefits (CMS Annual Report 2025/26).
The CMS regulates medical schemes and the people the Act accredits; its complaints procedure also accepts complaints against exempted health insurance providers (CMS). Gap cover and hospital cash plans are short-term insurance under the Demarcation Regulations: complain to the insurer, then the National Financial Ombud — see complaints.
How to complain to the CMS about your medical aid
- Complain to your scheme first, in writing, and keep its answer. A complaint sent to the CMS before the scheme has had its chance is premature: in 2025/26 the CMS counted 859 written queries as premature complaints or dismissals (CMS Annual Report 2025/26, Table 62).
- Fill in the CMS complaint form and e-mail it to [email protected] with proof that you escalated to the scheme, the scheme's reply and the relevant accounts or statements (CMS complaints procedure).
- Complain in time: the CMS asks for complaints preferably within 3 years.
- The scheme must answer: under section 47 of the Medical Schemes Act, the Registrar sends your complaint to the scheme, which has 30 days to reply in writing.
- Appeal if you disagree: a ruling can be appealed to the Council's Appeals Committee within 3 months (section 48), and further to the Appeal Board.
In 2025/26 the CMS processed 10,818 e-mails in its complaints mailbox, registered 2,455 formal complaints (up 25.1%), resolved 1,879 and issued 602 clinical opinions (CMS Annual Report 2025/26).
Check a scheme or a broker
- A scheme: check that it is registered on the CMS list of regulated entities. The 16 open schemes are listed on our medical aid page.
- A broker: brokers who sell medical aid must be accredited by the CMS; check the person and the brokerage on the same regulated entities pages before you sign.
- A scheme's financial position: the CMS annual report names schemes below the 25% minimum solvency and schemes under curatorship (CMS Annual Report 2025/26).
CMS contact details
| Channel | Details |
|---|---|
| Telephone | +27 86 112 3267 and +27 12 431 0500 |
| Hours | Monday to Friday, 08:00–16:30 |
| General enquiries | [email protected] |
| Complaints | [email protected] (complaints procedure) |
| Address | Block A, Eco Glades 2 Office Park, 420 Witch-Hazel Avenue, Eco Park, Centurion, 0157 |
From the CMS home page (copy of 16 October 2026). The same page links the CMS online portals, including the Broker/Brokerage portal and the Demarcation portal.
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Frequently asked questions
What does the Council for Medical Schemes do?
It is the statutory regulator of medical schemes under section 3 of the Medical Schemes Act 131 of 1998. It registers schemes, accredits administrators, managed care organisations and brokers, supervises their finances and conduct, and handles complaints from members.
How do I lodge a complaint with the Council for Medical Schemes?
Complain to your scheme in writing first. Then e-mail the CMS complaint form to [email protected] with proof of your escalation to the scheme and the accounts. The scheme has 30 days to answer the Registrar (s 47); a ruling can be appealed within 3 months (s 48).
What is the CMS contact number?
+27 86 112 3267 or +27 12 431 0500, Monday to Friday 08:00–16:30; e-mail [email protected].
Does the CMS charge to handle a complaint?
No fee appears in the CMS complaints procedure: you send the form and documents by e-mail.
Can the CMS help with gap cover or a hospital cash plan?
Those are short-term insurance policies, not medical schemes: complain to the insurer first, then to the National Financial Ombud. The CMS accepts complaints about medical schemes, the entities it accredits and exempted health insurance providers.
How many medical schemes are there in South Africa?
70 registered at 31 March 2026 — 16 open and 54 restricted — according to the CMS Annual Report 2025/26.
Sources
- Council for Medical Schemes — Annual Report 2025/26 (copy tabled in Parliament, hosted by PMG): registered schemes at 31 March 2026, complaints, contributions (Tables 60–62)
- Council for Medical Schemes — The Complaints Procedure (Web Archive)
- Council for Medical Schemes — home page: hours, phone numbers, e-mail, address, portals (Web Archive copy of 16 October 2026)
- Council for Medical Schemes — Regulated entities (medical schemes, administrators, brokers) (Web Archive)
- Council for Medical Schemes — Medical Schemes Act 131 of 1998 and Regulations (consolidated copy, Web Archive)