SAMWUMED BENEFIT OPTIONS

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SAMWUMED offers comprehensive benefit options that covers you and your dependents for primary (day-to-day) and secondary (hospitalisation, preventative & early detection) medical needs.

Option A

YOUNGER MEMBERS AND YOUNG FAMILIES

With an annual limit of R961500 per family, this option is suited for members who need moderate day-to-day medical care, but require Comprehensive Maternity Benefits as well as good Hospital care. It is an ideal cover for young families still planning to have children or those with young children. This Option also gives members access to a wide variety of Early Detection Tests through the Comprehensive Preventative Care Programme.

Option B

MIDDLE AGE MEMBERS AND THEIR FAMILIES

This option is ideal for members seeking to benefit more richly from all the benefit categories including chronic illness benefits, great Hospital care and rich day-to-day Medical benefits. With an annual limit of R1921000 per family, this option allows members to take care of more dependents living with them and those who are extended family. Option B, like Option A, also gives members access to a wide variety of Early Detection Tests through the Comprehensive Preventative Care Programme.

Primary (Day-to-day medical care) Benefits

Day-to-day benefits are those that members 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 (Hospitalisation, Preventative Care Benefits and Early Detection)

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.

The SAMWUMED Preventative Healthcare and Early Detection benefits provide members with the opportunity to take ownership of their own health and so as not to find themselves seriously ill and being admitted to hospitals. The benefits include the following:

  • Free Vaccinations (flu vaccination)
  • Free Screenings (Type II diabetes, Papanicolaou (Pap smear) test, mammogram (breast cancer screening), HIV testing and counselling, prostate cancer (a gland in the male reproductive system)
  • Healthcare Assessments (Blood pressure, cholesterol, bone density test)
  • Robust Maternity Programme (Folic acid, ultrasounds, HIV testing and counselling, vitamin supplements)