In accordance with regulations, private members will all be community rated together and pay according to our premium table that can be found in our brochure.
Cinagi premiums are calculated based on age, family size, and medical scheme benefit options, to assist you in calculating family premiums you can make use of our premium calculator )
Group schemes of less than 25 members will also be rated the same so the premium table below will apply to such groups.
Cover Pay Level (CPL) – this is the percentage of the medical scheme tariff at which a member’s benefit option reimburses in-hospital medical specialist treatment.
Members on a benefit option reimbursing at 200% (or higher) will pay the CPL- 200 premiums. Members on a benefit option reimbursing at 100% will need to pay the CPL-100 premiums.
NOTE: It is important that members notify us any benefit option changes they make on their medical scheme in case
they need to also change the CPL. If a member is on the CPL-200 policy but is on a benefit option covering at 100% of the
scheme tariff, then there may be a shortfall on gap cover claims for specialists. If we are not correctly notified of a CPL
change, membership will not be backdated nor will premiums be refunded.
Eligibility - Please note that only the following dependent types are eligible for cover under the policy:
- a spouse – this includes a common law spouse or life partner
- Children – this includes stepchildren, adopted children, foster children or special needs children.
All insured persons under the policy must be covered under the same medical scheme membership.
The main member (applicant) on the policy can be either the principal member of the medical scheme membership or the spouse of the principal member – as long as all dependents registered on the policy are covered under one medical scheme membership. Other beneficiaries registered on the applicant’s medical scheme (eg parents) would need to take out a separate policy.
Dependent Premiums - a maximum of two children are charged for at child rates up until they turn 24. From age 24, all children are charged as adult dependents.
Example: If there are three children on a policy and they are all under 24, then the only charge for children will be
two child premiums. When the oldest child turns 24, then there will still be two child premiums charged plus one
new adult premium.