South African healthcare & funding
Schemes reimburse at their own tariff, often expressed as a percentage of a base rate. Specialists may charge more than that rate, and the difference is billed to you. Asking both the clinic what it charges and the scheme what it pays, before treatment, is the only reliable way to know your shortfall.
Also known as: scheme rate, medical scheme rate, tariff
Related South Africa guides
Sources
- Council for Medical Schemes (South Africa)
Last reviewed: 8 September 2026. Written by the Antega Editorial Team. General information only — always follow the advice of your own clinic, doctor or pharmacist.