SAMWUMED members who have finished or exhausted their medical aid benefits before the end of the year don’t have to despair, as the Scheme may still be able to help them settle their medical bills in full or in part under the Ex-Gratia grant (fund).
What is Ex-Gratia Grant?
This is a special fund set up by the Scheme to help the neediest and most deserving members.
“Ex Gratia grant is only allowed in exceptional cases” says Ms Sindisiwe Ngcobo, SAMWUMED’s Clinical Risk Manager. “It is considered only if the treatment needed by the member is life threatening, medically necessary and is not covered under the Prescribed Member Benefits (PMB)”, she explained. Furthermore, it covers only medical or health costs.
How to get the Grant
To be considered, members must send a full motivation to the Scheme supported by: – the treating doctor’s motivation, the cost of the treatment. In addition, the member must send their pay slip and monthly expenses and income for the Scheme to do an affordability assessment.
The applying member will also be interviewed by the Scheme as part of the process.
Qualifying members are those who have been with SAMWUMED for more than 1 year. A shorter period will only be considered if the member joined the Scheme during the Freedom of Association (FOA) period.
To read more click on the Ex Gratia Grant Booklet