Imperial Motus Med

This is the most distinctive thing the scheme does and it is identical on both plans. R5 600 per family per year, paid at 100% of cost, sits behind every other benefit and pays for:

• any co-payment on any benefit the scheme pays;
• any shortfall on any benefit the scheme pays, which means the gap where a provider charges above the Medical Scheme Rate;
• any shortfall caused by an annual benefit limit running out; and
• any healthcare service with a tariff or Nappi code that falls outside the scope of scheme benefits altogether.

The Board introduced it on 1 January 2024 and estimated it put about R30 million of extra benefit into members' hands in that first year. It is a genuinely useful safety net on a plan that otherwise pays at scheme rate and no more. It is also small: R5 600 covers roughly four and a half of the R1 000 in-hospital deductibles, or one moderate specialist shortfall. Once it is depleted every further co-payment and shortfall for the rest of the year is yours.

This is the single biggest difference between the two plans. Both cover the statutory Chronic Disease List and a set of non-CDL PMB conditions. Only the Health Plan covers anything beyond that.

CDL conditions on both plans: Addison's disease, asthma, bipolar mood disorder, bronchiectasis, cardiomyopathy, COPD, chronic renal failure, congestive cardiac failure, coronary artery disease, Crohn's disease, diabetes insipidus, diabetes mellitus types 1 and 2, dysrhythmia, epilepsy, glaucoma, haemophilia, HIV, hyperlipidaemia, hypertension, hypothyroidism, multiple sclerosis, Parkinson's disease, rheumatoid arthritis, schizophrenia, systemic lupus erythematosus and ulcerative colitis.

Non-CDL PMB conditions on both plans: aplastic anaemia, benign prostatic hyperplasia, cardiac arrhythmia, Cushing's disease, endometriosis, glomerular disease, hyperthyroidism, hypoparathyroidism, immune thrombocytopenic purpura, menopause and hormone replacement therapy, pancarditis, paraplegia, pemphigus, pituitary adenoma, polycystic ovarian syndrome, pulmonary hypertension, pulmonary interstitial fibrosis, quadriplegia, sarcoidosis, stroke and transient ischaemic attack, thromboangiitis obliterans, tuberculosis, valvular heart disease and venous thromboembolism.

Additional conditions, Health Plan only: severe acne, allergic rhinitis, Alzheimer's disease, ankylosing spondylitis, ADHD, cryoglobulinemia, cystic fibrosis, depression, dermatomyositis, dystonia, eating disorders, severe eczema and allergic dermatitis, embolism and thrombosis, gastro-oesophageal reflux disease, Huntington's disease, motor neuron disease, myasthenia gravis, narcolepsy, obsessive compulsive disorder, osteoporosis, Paget's disease, psoriasis, scleroderma, Sjogren's syndrome, systemic sclerosis and tic disorders.

Registration is compulsory before the benefit starts. Your doctor can phone the Medicine Risk Management team on 0860 467 374 and often get it done while on the call, or you can complete an application form with your doctor and email it to chronic@imperialmotusmed.co.za, or use the webchat on the scheme's website. Allow up to five working days. Clinical entry criteria apply.

Medicine is covered only if it is on the scheme's formulary and within the limit. A 10% co-payment applies to non-formulary medicine, and on top of that the Mediscor Reference Price applies to everything with a generic equivalent, so a brand-name choice adds a second co-payment. Schedule 3 to 5 prescriptions can be issued for six months. Schedule 6 and 7 prescriptions cannot be repeated and need renewing monthly.

PMBs themselves are paid at 100% of cost and are unlimited on both plans, but the rules make that subject to protocols, formularies, designated service providers and pre-authorisation. The rules also state that diagnostic tests which do not end up confirming a PMB diagnosis are not treated as PMBs, except in an emergency.

Enrolment on the oncology programme is compulsory for any beneficiary receiving cancer treatment, and the benefit only opens once the treating specialist has submitted a treatment plan and it has been approved. Contact oncology@imperialmotusmed.co.za or 0860 467 374.

Beyond these limits, cover falls back on what the Prescribed Minimum Benefits require. The rules exclude specialised drugs that have not convincingly demonstrated a survival advantage of more than three months in advanced or metastatic solid tumours, naming Sorafenib for hepatocellular carcinoma and Bevacizumab for colorectal and metastatic breast cancer, unless they form part of public sector protocols and are authorised. On the Budget Plan, with no specialised oncology medicine benefit and a R127 090 overall cap, an aggressive cancer will exhaust the plan benefit quickly and leave you relying on PMB entitlement.

Maternity cover is identical on both plans and it is decent, provided you register on the maternity programme. If you do not register, four of the benefits below stop being major medical benefits and come out of your day-to-day limits instead.

The midwife benefit is only payable where no GP or gynaecologist is involved in the delivery. A 3D or 4D scan is paid up to the rate of a 2D scan, so you cover the difference. Register the baby with the scheme within 30 days of birth and benefits accrue from the date of birth. Register between 30 days and six months and the child is only registered from the first day of the month after you apply, with benefits from the registration date, which leaves a gap you pay for. Miss six months and the child is subject to the ordinary waiting period rules.

In hospital, both plans allow a maximum of 21 days per beneficiary a year in a psychiatric institution or for substance and alcohol abuse treatment, at 100% of scheme rate and subject to pre-authorisation.

Out of hospital, the Health Plan gives R6 510 per beneficiary a year at 85% of scheme rate for psychologist and psychiatrist consultations for non-PMB conditions. The Budget Plan has no separate mental health benefit at all: psychology and psychiatry come out of the R6 910 medical auxiliaries limit shared by the whole family with physiotherapy and nursing consultations.

Four conditions are treated as PMBs and paid at 100% of scheme rate outside those limits, on both plans, but only if you register on 0860 467 374 and the ICD-10 codes and treatment fall within PMB level of care: acute stress disorder accompanied by recent significant trauma, anorexia nervosa and bulimia nervosa, attempted suicide, and major affective disorders including unipolar and bipolar depression.

Depression that does not meet PMB level of care is covered as a chronic condition on the Health Plan only. On the Budget Plan the medicine is not covered.

AZOZA's Personal Health Advisor on 0861 737 283 offers 24-hour telephonic counselling, including addiction counselling, stress management, trauma debriefing and immediate support for rape survivors, in most official South African languages. It is not a substitute for treatment but it is free and it is there at 2am.

Dentistry is where the two plans diverge most visibly for an ordinary family. The Health Plan gives every beneficiary their own basic limit. The Budget Plan gives the entire household one.

Pre-authorisation is required for advanced dentistry, implants, orthodontics, root canals, crowns, bridges, dental surgery and maxillofacial surgery. Email dentalauths@imperialmotusmed.co.za. Study models, plastic dentures, retainers, space maintainers and bite plates do not need it.

Dental work in hospital is split: the hospital, theatre, sedationist and anaesthetist are paid at 100% of scheme rate from major medical, while the dental procedures themselves come out of your day-to-day dental limits at 85%. Pre-authorisation for conservative dentistry under general anaesthetic is only considered for children aged eight or younger. Older children and adults need a written motivation from the dental practitioner. Gold and other metal inlays in dentures are not covered, and neither is tooth bleaching or a sports gum guard.

Spectacles and contact lenses are paid at 85% of cost, not 85% of a tariff, so you contribute 15% of whatever the optometrist charges plus anything above the limit. Tinted or coloured plano lenses, cosmetic contact lenses, lens accessories and solutions are excluded, as are optical devices the managed care programme does not regard as clinically essential or desirable. Glaucoma screening is separate and free: one test every two years from age 40 to 49, and one a year from 50, on both plans.

All of these are paid at 100% of scheme rate from major medical and do not touch your day-to-day limits. This is the one area where the Budget Plan gives you exactly what the Health Plan gives you.

The childhood vaccine schedule runs from BCG and oral polio at birth through to a tetanus booster at 12 years. The scheme will not pay for a vaccine given late. There is a leeway of four weeks on each age band and after that the claim is rejected, which falls hard on parents who miss a clinic appointment. Vaccines outside the formulary come out of the acute medicine limit. The consultation itself is paid at 85% from the medical auxiliaries limit, not from the wellness benefit.

Note how these are constructed. Most are family limits assembled from a per-person building block: a family of four does not get four separate GP limits, it gets one pool that any beneficiary may spend.

The Health Plan's medical auxiliaries limit covers podiatry, orthoptic treatment, audiometry, occupational therapy, therapeutic dietetics, remedial and speech therapy, clinical technology, chiropody, social work, biokinetics, chiropractic, homeopathy and nursing consultations for vaccines and ad hoc injections. The Budget Plan's covers only clinical psychology, psychiatry, physiotherapy and nursing consultations.

Intensive care and high care are authorised in blocks of 72 hours at a time. The scheme pays the rate for a discharge before noon unless the doctor motivates that a later discharge was medically necessary, and pays the rate for an admission after noon where the procedure is scheduled for the afternoon.

These come straight from Annexure C of the registered rules. The Board may authorise an exception, and none of them override a Prescribed Minimum Benefit.

• In-vitro fertilisation, GIFT, ZIFT, pronuclear stage tubal transfer and any egg or sperm collection or transfer. Infertility cover is limited to what state hospital guidelines allow as a PMB.
• Cosmetic surgery, obesity treatment, artificial insemination, impotence and erectile dysfunction, and experimental treatment as defined in the rules.
• Breast reduction, unless it follows breast reconstruction after a cancer diagnosis or the beneficiary has gigantomastia in pregnancy with complications.
• Treatment of scars, keloids and tattoo removal, except severe burn scars on the face and neck or functional impairment such as contractures.
• Otoplasty for children aged 12 or older.
• Wilful self-injury, professional sport, speed contests and speed trials, except for PMBs.
• Robotic assisted surgery.
• Holidays for recuperative purposes.
• Organ harvesting and donor costs where the recipient is not an Imperial Motus Med member.
• Examinations for insurance, employment, visas, pilot or driving licences, or for college and university enrolment.
• Costs of appointments cancelled or not kept.
• Patent medicines, toiletries and beauty preparations, bandages and cotton wool, patented and baby foods, Mirena and similar devices used to prevent pregnancy, tonics, slimming preparations, unapproved vitamins, household remedies, sunglasses, exercise equipment, and any medicine not registered for the specific condition.
• Any travel or conveyance other than by ambulance or ambulance aircraft.
• Tinted or coloured plano lenses, cosmetic contact lenses, contact lens accessories and solutions.
• Tooth bleaching and sports gum guards, and dental devices the managed care programme does not regard as clinically essential or desirable.
• Services from persons or institutions not registered in terms of any law, and services regarded as not medically necessary under the rules' five-part test.
• All costs above the annual maximum benefit for the year.

The rules also cap medicine on a prescription at one month's supply unless the Board decides otherwise, and reserve the Board's right in a protracted illness to insist that you consult a specialist it nominates.

Rule 6.2.1 is blunt: membership of the scheme is restricted to employees. In practice that means:

• Permanent employees of Imperial Logistics (Pty) Ltd, a DP World company, and Motus Holdings Limited, together with their associated and subsidiary companies, and a small number of former subsidiaries the Board of Trustees has approved.
• For certain categories of employee, joining is a condition of employment under the companies' own Medical Aid Membership Policy. Those employees become members from the date they become employees. The only permitted alternative is to register as a dependant on a spouse's or partner's scheme, and you must produce documentary proof that you have done so.
• Retirees and continuation members. A member who retires, or whose employment ends because of age, ill-health, disability, or retrenchment at 55 or older, may keep their membership. The scheme must notify them of that right and of the contribution due. Unless they say in writing that they want to stop, membership simply continues.
• Widows, widowers and dependants of a deceased member who were registered at the time of death may become members in their own right. They have three months from being notified to say so in writing.
• Orphaned child dependants. If child dependants are orphaned, the oldest becomes a continuation member and any minor sibling registered at that time becomes a dependant of that new member.

Dependants you may register: one spouse or partner per principal member, with a marriage certificate or an affidavit; children, stepchildren, adopted children and children placed in your custody by court order, under 21; students aged 21 to 25 with annual proof of studies, who still pay child rates; a child of any age who cannot earn an income because of a mental or physical disability, on medical proof, who pays a child rate; grandchildren, but only if the grandchild's parent is also your dependant or the grandchild has been placed in your care by court order or legal adoption; and indigent parents or siblings you support, on annual proof of indigence, who pay adult dependant rates.

No person may belong to two medical schemes at once, so an employee cannot be a dependant on a spouse's scheme and a member here at the same time. Contributions are charged for a maximum of three children, though further children may still be registered.

If a retiree or continuation member later resigns from the scheme, they may not re-apply. That door closes permanently. Think carefully before cancelling in a tight month.

Whether a waiting period applies turns almost entirely on how quickly you join after becoming an employee, and on your cover history.

No waiting period at all

• Apply within 90 days of first becoming an employee and Rule 6.5.7 says you are registered without any waiting period and without any late-joiner penalty. This is the single most valuable thing on this page. Do not let a form sit in a drawer.
• Apply within 30 days of a transfer to an associated company or subsidiary where membership becomes a condition of employment.
• Apply within 30 days of a specified period of secondment.
• Apply where you had a 90-day break in scheme membership because you were living or working outside South Africa.
• Apply within 30 days of a life-changing event, under Rule 6.5.8.
• Move from one benefit plan to the other inside the scheme, unless a waiting period is already running on your current plan, in which case the remainder carries over.
• A child born while you are a member.
• Transfer in because your employment changed, or because an employer changed or terminated its employees' scheme. Any unexpired waiting period from the previous scheme may still be imposed for its remaining duration.

Where waiting periods do apply

• No cover for at least 90 days before you apply: a general waiting period of up to 3 months, plus a condition-specific waiting period of up to 12 months. During a general waiting period you pay contributions and cannot claim anything except PMBs, including emergencies.
• Up to 24 months of previous cover, ending less than 90 days before you apply: a condition-specific waiting period of up to 12 months, but not for treatment or diagnostic procedures inside the PMBs. Any unexpired waiting period from your previous scheme also carries across.
• More than 24 months of previous cover, ending less than 90 days before you apply: a general waiting period of up to 3 months, again excluding PMBs.

A condition-specific waiting period covers any condition for which medical advice, diagnosis, care or treatment was recommended or received in the 12 months before you applied, and runs for 12 months.

Dependants are assessed individually. Register a dependant later than 30 days after they become eligible, whether by marriage, adoption or anything else, and waiting periods and exclusions can be imposed on that person even though you are already a fully paid-up member. Newborns registered between 30 days and six months are only registered from the first day of the month after you apply.

Service in the South African National Defence Force and membership of the Permanent Force Continuation Fund count as previous cover.

This scheme applies late-joiner penalties differently to an open scheme, and the difference matters. Rule 10.9 and Annexure A both say the penalty applies in respect of adult dependants over the age of 35 years. An employee who applies within 90 days of becoming an employee is registered without any penalty under Rule 6.5.7. So the exposure here is almost always an older spouse, partner, parent or sibling you are bringing onto the scheme.

The band is worked out with the formula A = B minus (35 + C), where B is the person's age when you apply and C is their years of creditable coverage.

Creditable coverage is any period the person was a member or dependant of a medical scheme, or of an exempt entity doing the business of a medical scheme, or a uniformed SANDF employee, or a member or dependant of the Permanent Force Continuation Fund. Time spent as a child dependant under 21 does not count.

The rules state the penalty is not a fixed rand amount: because it is a multiple of the contribution, it rises every 1 July with the annual contribution increase. It has applied since 1 January 2012 and the rules set no end date, so treat it as permanent.

1. Download the Application for Membership form from the scheme's website or get it from payroll.
2. Complete and print it, and gather supporting documents for every dependant: marriage certificate or affidavit for a spouse or partner, birth certificates for children, annual proof of studies for a student aged 21 to 25, medical proof for a disabled dependant, proof of indigence for a parent or sibling, court orders or adoption papers for a grandchild or child in your custody.
3. Submit the pack to your payroll department, not to the scheme. Payroll drives contributions and membership records here.
4. Disclose everything. The rules require evidence of age, income, state of health and any prior scheme membership to the Board's satisfaction, and the Board may require a medical examination at the scheme's expense in respect of a condition advised on or treated in the 12 months before you applied. Rule 9.5 lets the Board terminate membership for non-disclosure of material information, after which you may re-apply only with full underwriting.
5. Within three months of admission you must supply any further information the Board asks for.
6. You may switch between the Health Plan and the Budget Plan only at the start of a benefit year, on 1 January.

Contributions for a new member are due from the first day of the month in which employment starts, unless employment starts on the 15th or later, in which case they are due from the first of the following month. Benefits start on the later of the employment date and the membership date.

This is where a restricted scheme differs most sharply from an open one, and the rules leave no room for interpretation.

• Cover stops on your last day of employment. Not at the end of that month. Rule 9.2 says a member who ceases to be an employee ceases on that date to be a member and all rights to benefits cease, except for claims for services rendered before it. Anything on or after that date is for your own account.
• The contribution rule is not symmetrical. Leave on the 15th or later and the full month's contribution is due. Leave between the 1st and the 14th and no contribution is due for that month, provided the employer tells the scheme immediately.
• No refunds. Rule 10.7 says no portion of a contribution is refunded when membership terminates, other than as the rules specifically provide.
• Continuation membership is only for retirement and its equivalents: retirement, reorganisation, or termination by the employer on account of age, ill-health or other disability, or retrenchment at 55 or older. A resignation at 40 does not qualify. If you resign or are dismissed outside those categories you are simply out, and you will need to join an open scheme.
• Join your next scheme quickly. Leave a gap of more than 90 days and the next scheme may impose a three-month general waiting period and a 12-month condition-specific waiting period on you and your family. Gaps also erode the creditable coverage that keeps late-joiner penalties down.
• Get your certificate. Rule 6.6.3 obliges the scheme to give you, within 30 days of termination or at any time on request, a certificate stating the period and type of cover and whether you qualified for late-joiner status. Your next scheme will want it.
• Voluntary termination while still employed needs 30 days notice and only works if you are joining a spouse's scheme with proof, or on conditions approved by the Principal Officer.
• Membership can also be cancelled for non-payment of contributions or shortfalls, abuse of privileges, fraud, non-disclosure of material information, submission of false claims or misrepresentation.

One more trap. If a dependant stops being eligible because of a divorce and you do not tell the scheme, every claim paid for that person since the divorce date is reversed and becomes a debt you owe.

• Pre-authorisation. Scheduled admissions need authorisation three working days beforehand under the rules, and the member guide asks for at least 48 hours. Emergencies must be authorised within 24 hours or on the first working day after admission. Also pre-authorise specialised radiology, home nursing, step-down and sub-acute care, psychiatric treatment, cancer treatment, oxygen and stoma products. No authorisation means a R500 co-payment on the hospital account. Call 0860 467 374 with your membership number, the main member's ID number, the patient's name or date of birth, the hospital, the admitting doctor's name or practice number, the ICD-10 codes and the admission date.
• Written approval in advance is separately required, with a doctor's motivation or a quotation, for chronic medication, medical and surgical appliances over R1 000, artificial limbs and eyes, maxillofacial and oral surgery, orthodontic treatment and related surgery, root canals, bridges and crowns, dental surgery, and dental implants.
• Submitting a claim. Email it to enquiries@imperialmotusmed.co.za. Faxed claims are not processed. The account must show your membership number, your name and initials, the date of service, the nature of the treatment, the tariff code, the patient's name as it appears on the card, the provider's name and practice number, the scheme's name, the amount charged and the ICD-10 diagnosis code.
• Deadline. Claims must reach the scheme by the last day of the fourth month after the month of service. After that they are rejected as stale, and the rules give no discretion.
• Turnaround. The scheme must pay a benefit within 30 days of receiving the claim, and pays members and providers twice a month. If it considers a claim incorrect or unacceptable it must tell you and the provider within 30 days and give reasons, and you then have 60 days to resubmit a corrected claim. If the scheme fails to do that, the onus shifts onto the scheme to prove the claim was wrong.
• Road accidents. Tell the scheme as soon as possible. You and your attorney must give a written undertaking to refund the scheme once the Road Accident Fund settles. If the RAF rejects the claim, the scheme covers it subject to your limits, but it wants a rejection letter from the RAF.
• Complaints. Start with Client Services on 0860 467 374. If it is not resolved, the Member Care Line run by Medi Call on 0860 105 221 is positioned as an independent second step, since Medi Call reports to the Board rather than to the administrator. The scheme's own website sets out that two-step order, checked 9 September 2026. All written complaints must be answered in writing within 30 days.
• Formal dispute. Rule 24 gives you the right to demand a disputes committee. Three people, none of them officers of the scheme or employees of the administrator, appointed by the Board on request from a member, prospective member, former member or someone claiming through a member. You get at least 14 days notice and the right to be heard in person or through a representative.
• Escalation to the regulator. The disputes committee's decision is binding subject to appeal to the Council for Medical Schemes. The appeal must be by affidavit and must reach the Registrar no later than three months after the decision. You may also complain to the CMS directly on 0861 123 267 or complaints@medicalschemes.com, fax 012 431 0608.
• Fraud. The scheme runs an anonymous fraud hotline on 0800 000 436.

No. Rule 6.2.1 restricts membership to employees of Imperial Logistics (Pty) Ltd, a DP World company, and Motus Holdings Limited, plus their associated and subsidiary companies and a small number of former subsidiaries the Board has approved. There is no public application route. The only other people who may hold membership are continuation members: retirees, employees whose service ended through age, ill-health, disability or retrenchment at 55 or older, and the registered dependants of a member who has died.

Because both plans are priced on the principal member's monthly income. On the Health Plan a member earning under R4 730 pays R3 219 and a member earning over R19 331 pays R4 720 for identical benefits. On the Budget Plan the range runs from R2 264 to R4 290. Dependant rates move with the same bands. This is how the scheme lets lower earners and pensioners into comprehensive cover, and it is why a raise can cost you more than it pays.

You almost certainly crossed a band line. The Budget Plan has the worst step: at R23 630 a month you pay R3 022, and at R23 631 you pay R4 290. That is R1 268 more a month for one rand of extra income, and if you have a partner and two children the household pays R2 375 more. The Health Plan's biggest step is at R9 440, where the member rate goes from R4 040 to R4 495. Check where you sit against the band tables before agreeing to a small increase or an acting allowance.

Not published. The scheme rules, the 2026 member guide and the 2026 benefits brochure all send members to their own payroll or human resources department for the split, and none of them names a subsidy percentage. What the rules do show is that the employer contributes: Rule 25 gives Imperial Limited and Motus Holdings Limited the right to reduce, suspend or terminate their contributions on three months notice, which would trigger a member ballot on whether the scheme continues or is liquidated. Ask payroll for your split in writing.

It is a pot of R5 600 per family per year, identical on both plans, paid at 100% of cost, that funds co-payments and shortfalls the scheme would otherwise leave with you. It covers any co-payment on any benefit, any shortfall where a provider charges above the Medical Scheme Rate, any shortfall caused by an annual limit running out, and even services with a tariff or Nappi code that fall outside scheme benefits entirely. The Board introduced it on 1 January 2024. Once it is used up, every further co-payment and shortfall for that year is yours.

No. Neither plan has a hospital network. Ward, theatre and in-hospital medicine are paid at 100% of the Medical Scheme Rate at any private or provincial hospital, and there is no upfront payment for choosing one over another. What you must do is pre-authorise: three working days before a planned admission, or within 24 hours of an emergency. Skip it and you pay a R500 co-payment on the hospital account.

Only on the Budget Plan. There you nominate two GPs per dependant from the Momentum Health GP Network, and the family gets two out-of-network GP visits a year between them. Specialists are covered only on a referral from your GP. The Health Plan has no GP network, though the scheme has run a specialist network since 2018 and warns of co-payments for using a non-network specialist. It does not publish that list, so check the specialist by name on 0860 467 374 before an elective admission.

Only if the condition is a Prescribed Minimum Benefit. The Budget Plan covers the 26 Chronic Disease List conditions and 24 further non-CDL PMB conditions, unlimited but at Mediscor Reference Price and subject to pre-authorisation and the formulary. It covers nothing else. Depression, ADHD, allergic rhinitis, osteoporosis, reflux, severe eczema, psoriasis and 20 other conditions are covered only on the Health Plan, which has a R28 500 per beneficiary limit and keeps paying authorised PMB medicine after that limit is gone.

Because a defined list of procedures carries a R1 000 deductible when done in hospital: arthroscopies, gastroscopies, colonoscopies, sigmoidoscopies, urological and gynaecological scopes, cystoscopies, biopsies, minor dermatological procedures, nail surgery, minor skin lesions, vasectomies, conservative neck and back procedures and circumcisions. The same procedures carry no deductible in a doctor's rooms and are paid there at 100% of scheme rate from major medical instead of from your day-to-day limits. Ask whether it can be done in rooms.

Not if you are an employee who applied within 90 days of starting, because Rule 6.5.7 registers you without waiting periods or penalties. The penalty in this scheme is aimed at adult dependants over 35. It runs from 0.05 to 0.75 times that dependant's contribution, calculated as A = B minus (35 + C), where B is their age at application and C is their years of creditable coverage. On a top-band adult dependant that ranges from R189 to R2 834 a month, it rises every 1 July with the contribution increase, and the rules set no end date.

It ends on your last day of employment, not at the end of that month. Any treatment on or after that date is for your own account. If you leave on the 15th or later you still owe the full month's contribution, and no portion of a contribution is refunded. Continuation membership only exists for retirement, or termination on account of age, ill-health, disability or retrenchment at 55 or older, so an ordinary resignation gives you no right to stay. Ask for your certificate of membership, which the scheme must issue within 30 days, and join your next scheme within 90 days to avoid new waiting periods.

Until the last day of the fourth month after the month in which the service was rendered. After that the rules require the claim to be rejected as stale. Email claims to enquiries@imperialmotusmed.co.za, since faxed claims are not processed, and make sure the account carries your membership number, the patient's full name, the date of service, the tariff code, the provider's practice number, the amount and the ICD-10 code. Check your claims statement rather than assuming an electronically submitted claim was paid.

On the Health Plan only, up to R1 million per beneficiary a year, paid in rand at the equivalent scheme rates after you settle the account yourself. There is no benefit at all on the Budget Plan. On both plans the cover falls away if you are outside South Africa for more than 90 consecutive days. Buy separate travel insurance before you fly.

Yes, but only at the start of a benefit year on 1 January, under Rule 6.1.1. No new waiting period is imposed when you switch, unless a waiting period is already running on your current plan, in which case the remainder carries over. Bear in mind that contributions change on 1 July while plan choice is locked to 1 January, so a contribution increase cannot be answered by an immediate downgrade.