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
Applying to become a member of Remedi (with underwriting)
Applying to become a member of Remedi (without underwriting)
Application to register an additional adult dependant
Application for registration of newborn baby
Advanced Illness Benefit application form
Application for claims incurred outside of South Africa
Application for registration of newborn baby
Application for special payments made from the PMSA
Application for out of hospital management of a PMB condition
Chronic Illness Benefit application form
Consent form to allow disclosure of information to a third party
Disputes Form (Application to investigate a Dispute-Complaint)
HIVCare Programme application form
Member withdrawal application form
Permission to change banking details
Request for additional cover for PMB Chronic Disease List application form
Request for additional cover from the HIV Prescribed Minimum Benefits Baskets of care
Request to reverse the payment of a claim that Remedi received and paid
Transfer from active member to retiree status
Request for an extended supply of medicine
Request for pre exposure prophylaxis
Request for treatment of a maintenance or physical nature
Settlement agreement for an amount owing to Remedi Medical Aid Scheme
Benefit guides
Advanced Illness Member Support Programme
Prescribed Minimum Benefit Nutritional Formulary Adult
Prescribed Minimum Benefit Nutritional Formulary Paediatrics
Your cover for Designated Service Providers (DSPs) and providers who are not DSPs
Exclusion List for Additional Chronic Conditions
Trauma Recovery Extender Benefit
Cover for Diabetes and the Diabetes Cardiometabolic Care Programme one-pager
Banking details for manual payments
Chronic illness benefit medicine list (Formulary)
Chronic Illness Benefit medicine list (Provisional Formulary) 2025
Guide to transplant claims submission
Guide to Prescribed Minimum Benefits In-hospital
HIV supportive medicine formulary
Menopause medicine list formulary
Oncology supportive medicine list formulary
Prescribed minimum benefit treatment guide
Prescribed minimum benefit basket
Screening and Prevention benefit
Underwriting policies and protocol
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