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 bariatric surgery

 Application for out of hospital management of a Prescribed Minimum Benefits

 Application for registration of a newborn baby

 Application to add dependants (with MQ)

 Application to become a member (with MQ)

 Application to become a member (without MQ)

 Application for special payments to be made from the Accumulated Savings Account

 Becoming an employer contact

 Chronic Illness Benefit

 Continuation form (changing the main member)

 Ex Gratia

 HIV Programme Application

 International Claims Form

 Member withdrawal

 Permission to make certain information available to a third party

 Pre-assessment request

 Request for additional cover for approved Chronic Disease List conditions

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

 Request for extended supply of medicine

 Request for extra Prescribed Minimum Benefit (PMB) cover for HIV

 Request for pre-exposure prophylaxis (PREP)

 Request to change banking details

 Request to reverse the payment of a claim that Engen Medical Benefit Fund received and paid

 Transfer from active to retiree status

Benefit Guides

 Advanced Illness Benefit

 Bank details for manual payments Employer

 Contribution

 Chronic Illness Benefit medicine list (CDA formulary)

 Chronic Disease List (CDL) Conditions Treatment Baskets

 Claiming for medical expenses after a road accident

 Coronary stents

 Diabetes Care Programme

 Disease Prevention Programme

 Dispute process

 Endoscopic Procedures

 Guide to Dental Benefits

 Guide to Maternity Benefits

 Guide to Prescribed Minimum Benefits (PMBs)

 Guide to Prescribed Minimum Benefits for In-Hospital Treatment

 Guide to Screening and Prevention Benefits

 Guide to Transplant Claims

 HIV Programme

 HIV Antireteroviral (ARV) medicine list (formulary)

 HIV Basket of Care medicine list (formulary)

 HIV Nutritional and mother-to-child prevention medicine list (formulary)

 HIV Supportive medicine list (formulary)

 Maternity Benefit

 Menopause medicine list (CDA formulary)

 MRI and CT Scans

 Mental Health Care Programme

 Oncology Innovation Benefit

 Oncology Programme

 Oncology Supportive Medicine (formulary)

 Optical Benefit

 Prescribed Minimum Benefit (PMB) chronic medicine list (formulary)

 Prescribed Minimum Benefit (PMB) acute medicime list (formulary)

 Prescribed minimum benefits basket of care for world health organization global outbreak benefit

 Preventative and Screening Benefits

 Readmission Preventative programme

 Trauma Recovery Extender Benefit

 Spinal Care Programme

 Updating banking details online

 WHO benefit guide

 COVID-19 recovery booklet

Mental Health Information Hub

Here for you, here for your health

Feel assured, you are not alone. Our information hub covers a wide range of mental health topics and is created for anyone interested in understanding more about mental wellbeing, whether you are diagnosed, experiencing symptoms, or seeking information for a family member or loved one.

 Depression

 How can you best support a loved one who has a mental illness?

 How the four aspects of mental health affect your wellbeing

 Online privacy vs safety: The delicate balance we have to get right with our kids!

 Taking strain? Take these 7 steps to practice mindfulness

Oncology Article Hub

Understanding cancer allows you to better cope with and combat the condition. Read on to find information to help you understand cancer, what it is and how it is treated.

 Engaging with your employer about your cancer

 Engaging with your family and friends

 How to tell your children about your cancer diagnosis

 Navigating your Cancer Journey

 Understanding Cancer

 You've just been diagnosed: now what?

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