| Agreed Rate |
The fees for any healthcare services which are determined by the Board of Trustees in conjunction with a network of service providers |
| DSP |
Designated Service Provider is a network of service providers appointed by the Scheme as preferred providers to provide members with diagnosis, treatment and care in respect of one or more PMB conditions |
| ICON |
The Independent Clinical Oncology Network (ICON) is a DSP for the provision of oncology benefits |
| MRP |
The Medicine Reference Price (MRP) is the price the Scheme will pay for the generic equivalent of patented medication |
| PMBs |
Prescribed Minimum Benefits are the minimum benefits that the Scheme is legally obliged to provide to its members in terms of the Medical Schemes Act |
| Scheme rate |
The rate at which the Scheme pays for medical services; in 2022 the Scheme rate will be the 2021 Scheme rate increased by 4,6% |
| SEP |
Single Exit Price is a price set by the manufacturer or importer of a medicine or scheduled substance, combined with a logistics fee and VAT |
| UPFS |
Uniform Patient Fee Schedule, is the tariff structure used by provincial hospitals |