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Brochures 2021

Brochures 2020

Forms 2021

Applying to become a member
Applying to join DHMS when moving from another medical scheme
Applying to join the DHMS as part of an employer group
Add dependant application form
Advanced illness benefit application form
Affidavit addition of a minor dependant
Affidavit to confirm adoption proceeding for addition of minor dependant
Allied therapeutic and psychology extender benefit application form
Application to join Vitality Purple
Registration of newborn baby
Application to change main member
Application to transfer an existing member to an employer group
Application for additional allied therapeutic and psychology benefits
Application for out of hospital management of PMB condition
Application to join Vitality
Applying to become a member
Applying to join DHMS when moving from another medical scheme
Applying to join the DHMS as part of an employer group (KC-UW)
Applying to join the DHMS as part of an employer group
Bariatric surgery application form
Chronic Illness Benefit (CIB) application form
Declaration of medical scheme membership
Disputes investigation form
Employer application form
External medical items extender application form
Flexicare confirmation of employer debit order banking details form
Flexicare permission to change banking details form for claims purposes
Health declaration form
HIVcare programme application form
International travel benefit claim form
Keycare application for chronic renal dialysis
Keycare application form
Keycare income verification existing members
Keycare income verification for new members
Lymphoedema application form
Mamma Print application form for breast cancer pilot programme
Oncotype Dx test application form
Overseas treatment benefit
Overseas treatment benefit claim form
PMB appeals form
Priority downgrade form
Request for additional cover chronic illness benefit
Request for additional cover for Covid-19 testing.pdf
Request for additional PMB cover for HIV
Request for extended supply of medicine
Request for Pre-exposure Prophylaxis
The non-functional and/or reconstructive treatment and surgery pilot application form


Forms 2020

Membership Applications
Applying to become a member
Applying to join when moving from another medical scheme
Applying to join as part of an employer group
Employer Application
KeyCare Beneficiary Nomination Form
KeyCare Funeral Plan Claim Form
Application for special payments from the MSA
Ex Gratia Application Form
Permission to make certain information available to a third party
Settlement agreement for an amount owing to DHMS
Transfer to individual capacity form
Allied therapeutic and- psychology extender benefit application form
Advanced illness benefit application form
Application for additional allied therapeutic and psychology benefits
Application for out of hospital management of PMB condition
CIB application form
HIV care programme application form
International travel benefit claim form
KeyCare application for chronic renal dialysis
Overseas treatment benefit claim form
Overseas treatment benefit
PMB appeals form
Request for additional cover chronic illness benefit
Request for additional PMB cover for HIV
Request for extended supply of medicine
Request for pre-exposure prophylaxis
Add dependant application form
Affidavit addition of a minor dependant
App to change main member continuation form
App to transfer an existing member to an employer group
Application for registration of newborn baby
Applying to become a member
Applying to join when moving from another medical scheme
Applying to join as part of an employer group Keycare essential
Applying to join as part of an employer group
Becoming an employer contact
Declaration of medical scheme membership
Disputes investigation form
Employer application to join
Health declaration form
KeyCare application form
KeyCare GP to Specialist referral
KeyCare income verification existing members
KeyCare income verification for new members
KeyCare specialist referral form
Priority downgrade form
Pre-assessment request

Contact Details

14/2 Midas Ave, Olympus, Pretoria East, 0043

  • dummy086 010 3179

  • dummy(012) 991 0446

  • dummy(012) 991 0438

  • dummy086 552 3917

  • dummy info@cmac.co.za

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Accredited by the Council of Medical Schemes (ORG 35)

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