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Application forms

Editable application forms are now available for you to complete digitally. You can navigate through the form by pressing the down arrow. If you can't physically sign a form, you must sign it digitally. We accept digital signatures from these digital signature providers:

  • SigniFlow
  • DocuSign
  • Quickly Sign
  • Hellosign
  • Santamflow
  • Smart Advice signatures
  • Adobe Sign with certificate

Advanced Illness Benefit application form

Application for addition of dependants

Application for out-of-hospital treatment of a Prescribed Minimum Benefit condition

Application for registration of a newborn baby

Applying for cover for lymphoedema

Applying to become a member of MEDiPOS Medical Scheme

Becoming an employer contact

Chronic Medicine Benefit application form

Exgratia application

Foreign claim form

HIV PMB application form (Request for additional cover from the Prescribed Minimum Benefits)

Hospital admission feedback

HIVCare Programme application form

Option change form

Pre-assessment request

Permission to make certain information available to a third party

Request for additional cover for out-of-hospital Prescribed Minimum Benefit (PMB) conditions

Request for additional cover for Chronic Disease List (CDL) conditions registered on the Chronic Medication Benefit

Request for extended supply of medicine

Request for pre-exposure prophylaxis prep

Request to change banking details

Request to change the main member

Request to reverse the payment of a claim paid by MEDiPOS Medical Scheme

Termination of dependant/membership form

Transfer from active to retiree status

Benefit guides

Advanced Illness Benefit

Advanced Illness Member Support Programme

Banking details for manual payments of contributions

Benefit guide 2026

Chronic Medicine Benefit medicine list fomulary 2026

Chronic Medicine Benefit medicine list (Provisional) formulary 2027

Chronic Medicine Benefit treatment basket

Cover for dental treatment

Cover for MRI and CT scans

Depression Admission Basket of Care

Diabetes Care Programme

Disputes Process

Disease Prevention Programme Guide

Exclusion list

Guide to Prescribed Minimum Benefits

Guide to Prescribed Minimum Benefits for in-hospital treatment

Guide to transplant claims submission process

HIV ARV medicine list formulary

HIV ARV medicine list formulary 2027

HIV basket of care medicine list

HIVCare programme

MEDIPOS HIV Mother & Child

HIV supportive medicine list

Hospital Network List

How to read your statement

Maternity Programme guide

Medical scheme disputes process

Member Care Programme

Menopause Medicine List (Formulary)

Mental Health Care Programme

Motor Vehicle Accident (MVA)

Oncology Management Programme benefit guide

Oncology supportive medicine list formulary

Optical benefit

Prescribed Minimum Benefit Acute Medicine List (Formulary)

Prescribed Minimum Benefit Acute Medicine List (Provisional) formulary 2027

Prescribed Minimum Benefit adult nutritional formulary

Prescribed Minimum Benefit Chronic Medicine List Formulary

Prescribed Minimum Benefit Chronic Medicine List (Provisional) formulary 2027

Prescribed Minimum Benefits Chronic Medicine List (Formulary)

Prescribed Minimum Benefit Paediatric Nutritional Formulary

Preventative Care Benefit

Spinal Conservative Care Programme

Summary of benefits 2026

Underwriting guidelines

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