SAMWUMED's two benefit plans, Option A and Option B, have been carefully designed to provide relevant medical benefits for local government employees at low contributions.
Benefits can be grouped into two categories:
Day-to-day Benefits: benefits that you can access outside of hospital such as doctor and specialist consultations and visits, dental procedures, medication and optical care. Each benefit category is subject to limits as specified in the Scheme Rules. These benefits allow you and your family to access a wide range of healthcare services.
Secondary or Tertiary Care: includes hospitalisation and the treatment of Prescribed Minimum Benefit (PMB) conditions. The hospitalisation benefit makes provision for in-hospital admission or transfers to rehabilitation and step-down facilities.
Preventative Healthcare Benefits
Apart from ensuring that our members do not find themselves hospitalised, the SAMWUMED Preventative Healthcare Benefit provides members with an opportunity to take ownership of their own health as a means to better manage quality health outcomes which would ultimately result in lower medical aid premiums.
- Free Vaccinations (flu vaccination)
- Free Screenings (Type II diabetes, Papanicolaou test, mammogram, HIV testing and counselling, prostate cancer)
- Healthcare Assessments (Blood pressure, cholesterol, bone density test)
- Robust Maternity Programme (Folic acid, ultrasounds, HIV testing and counselling, vitamin supplements)
It is important that you use your benefits wisely. Ask your healthcare providers questions to make sure that the care prescribed is necessary and appropriate. This will ensure that your benefits are available for the entire year.
Benefits are available from 1 January to 31 December each year, except for members who join the Scheme later in the year, in which case pro-rated benefits will apply. Click here to find out more about Contributions and pro-rated benefits.