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About Us

Established in 1961, Cape Medical Plan is a veteran provider of simple and reliable comprehensive medical aid. Although our offices are in Cape Town, we operate throughout South Africa, serving individuals, families, small businesses and corporate groups.

How Cape Medical Plan is run

We're a mutual society

CMP was established by its members and for its members to help defray the cost of medically-necessary healthcare. To this day, our members own the scheme and all its funds. They also share a common goal, and understand their responsibilities toward the scheme and their fellow members.

Our core business is medical aid

Did you know that CMP is the only medical scheme in the country that is self-administered and doesn't make use of brokers? We perform all our functions in-house, and our daily operations are overseen by a member-elected Board of Trustees. We have no corporate infrastructures, and no extensive budgets for non-healthcare expenses. In fact, while most schemes in South Africa build the cost of administration into their members' fees, 98% – 99% of our members' fees are paid out as benefits. What remains is put into our reserves – the interest from that is used to keep the scheme running. 

We don't deal with brokers

We prefer dealing directly with clients. Our sales force is therefore internal – no brokers or third parties are ever involved. With no broker commission or fees to pay, this is another way we ensure that more funds are allocated to healthcare expenses.

We maintain a high solvency ratio

A medical scheme's solvency ratio is the percentage of annual member contributions that are “in the bank” at any given time. By law, all schemes are required to maintain a 25% solvency ratio, which is seen as an indication of financial sustainability. CMP has carefully controlled its growth since inception, allowing for a solvency ratio that's well above the legislated 25%. It's thanks to this that we are always able to pay properly submitted claims within two weeks.

Our divisions

Membership division

The Membership division is responsible for processing all things member-related, including:

•  application forms
•  resignation requests
•  proof of contribution payments
•  cheques

Member Relations Management division

Our Member Relations Management (MRM) division is made up of trained medical nurses, an in-house doctor and knowledgable customer care staff. Between them, they handle:

•  all requests for authorisation
•  doctor's quotes for procedures
•  chronic-medication queries
•  disease-management queries
•  our maternity programme, Mum's the Word
•  queries around claims and benefits
•  contact detail updates
•  member feedback

Thanks to their specialised industry knowledge and experience, the MRM team is ideally positioned to advise on all things medical and all things member-related. They can also provide members with contact details for doctors who charge competitive rates.

And because we don't operate in a call-centre environment, members will always receive one-one-one attention with a member of our team. Be it via email or telephone, or face-to-face at our offices.

Sales division

The Sales division, comprising both internal and external salespeople, handles all queries and requests from prospective members and member groups, and further develops existing relationships with member groups.

Finance, Admin and IT division

All our internal administration, including our HR and accounting function, is delivered by the Finance, Admin and IT division. They also oversee the collection of member contributions and the payment of claims.

Claims division

The Claims division is responsible for the accurate assessing and processing of all member claims. They work closely with Customer Care, as well as Finance, to maintain our two-week turnaround time for the payment of claims.

Complaints division

Our Complaints division handles all claims-related complaints and disputes. Once a complaint is received, they're responsible for responding to the member within 30 days.    

Distribution division

Our well-oiled machine would be worse for wear without the Distribution division. They receive all postal, hand-delivered, electronic and fax communication, and ensure that these documents are delivered to the correct divisions.

Our staff

Cape Medical Plan is operated by a small, but dedicated, team of staff members. Kept on their toes by general manager Charlene Schoeman, all our employees are clued-up about the industry and committed to our members and the way in which we operate. We're best described as a close-knit family who support each other at all times. And who better to trust than family to take care of your healthcare expenses?

Our promises

•  We promise to answer your questions correctly and accurately.
•  We promise to explain and clarify details where necessary.
•  We promise to follow through on promises made.
•  We promise to treat you with respect.
•  We promise to communicate effectively.
•  We promise to maintain the integrity of your personal information.

Thinking of joining CMP? Get started by submitting a membership enquiry.

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