Schedule of Benefits

The Fund is pleased to introduce the highly anticipated RFMCF Schedule of Benefits to its valued Members effective 01 April 2023. 

A Schedule of Benefits is a basket of benefits for various medical services outsourced by the SAMHS. The Fund is aware of the historical challenges in obtaining authorisations for medical services. Therefore, the pre-authorisation process will also change with the introduction of the Schedule of Benefits. This will streamline the process to enhance the member experience and ensure effective healthcare management of the RFMCF Members.

Please ensure you read and understand the Schedule of Benefits. Additional educational material, such as infographics and videos, has been created and is available below to help you understand how the Schedule of Benefits and Pre-Authorisation Process will work.

Schedule of Benefits 2024

The comprehensive layout of your annual benefits for services outsourced by the SAMHS

Schedule of Benefits 2023

The comprehensive layout of your annual benefits for services outsourced by the SAMHS

Infographics

Educational material that explains each benefit and process in terms of the Schedule of Benefits in detail.

Schedule of Benefit Videos

Educational videos that explain the Schedule of Benefits.

Pre-Authorisation Request Form

The Fund requires certain patient and clinical information to evaluate an authorisation request. This form must be completed to process an authorisation request.

Pre-Authorisation Guide

Use this document to verify whether the services you require are subject to pre-authorisation or not.