SAMWUMED Medical Schemes is a self-administered medical aid scheme with a national footprint. It covers approximately 73,000 lives within the South African local government and associated agencies.
Beyond merely providing medical cover, SAMWUMED advocates for its members’ interests and their right to a healthy life. Rooted in this commitment is the pledge to maintain its status as one of South Africa’s most cost-effective schemes within its category.
Samwumed Health Options
SAMWUMED has two health options, namely Option A and Option B.
Option A – With an annual limit of R961 500 per family, this option is suited for members who need moderate day-to-day medical care but require Comprehensive Maternity Benefits and good Hospital care. It is ideal for young families still planning to have children or those with young children.
This SAMWUMED option also gives members access to various early detection tests through the comprehensive Preventative Care Programme.
Option B – 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 R192 1000 per family, this option allows members to take care of more dependents living with them and those who are extended family.
This SAMWUMED option also gives members access to various early detection tests through the comprehensive Preventative Care Programme.
Samwumed Healthcare Benefits
SAMWUMED boasts nearly 20 healthcare benefits for members to enjoy. These include access to doctors for routine medical checkups, specialists, private and state hospitals, and various medications, including chronic and over-the-counter, dental, optometry, pathology, prosthetics, mental health and substance abuse benefits, infertility, and ambulance benefits.
Samwumed Healthcare Programmes
In line with its commitment to member well-being, SAMWUMED implements various healthcare programmes aimed at assisting members in managing their conditions and achieving better health outcomes. The programmes encompass wellness initiatives, primary health, cancer, mental health, chronic disease, HIV, back and neck rehabilitation, and stopping smoking.
Some Frequently Asked Questions
- Is SAMWUMED a Good Medical Aid/Scheme?
Yes – SAMWUMED is a good medical scheme/medical aid. It boasts rich, quality, and competitive healthcare options and benefits. It also has extensive healthcare networks and a vast sales network across South Africa.
SAMWUMED Healthcare Networks
SAMWUMED continuously invests in expanding its healthcare networks to ensure greater accessibility to healthcare services for its members. These networks are constantly updated as new service providers are added. They include hospitals (day clinics, mental health facilities, and acute facilities), doctors and specialists, pharmacies, and more.
SAMWUMED Customer Care
SAMWUMED is committed to the highest levels of customer care. It has invested in several communication platforms, including a world-class website, mobile app, publications, customer care centre and social media platforms.
In addition, SAMWUMED has a vast network of sales agents who, among others, are responsible for:
- Claims queries
- Changing contact details
- Explanation of Scheme rules and processes
- Membership card requests and collections
- Premium related queries
- Member profile maintenance
- How do I claim from SAMWUMED?
Claiming from SAMWUMED is simple. Members are encouraged to download the SAMWUMED Mobile App to upload their claims. They can also submit their claims via email: claims@samwumed.org - Which hospitals does SAMWUMED cover?
SAMWUMED offers members comprehensive hospital coverage on its healthcare options, encompassing private and state hospitals. They include day clinics, mental health facilities, and acute facilities.
- How do I get treatment authorisation?
SAMWUMED Members can call 0860 33 33 87 for treatment authorisation. They must have the following information on hand:
- Membership number
- Patient’s name, surname, and date of birth
- Doctor’s name and practice number
- Name of hospital
- Procedure to be performed and ICD-10 code(s)
- Date of admission
SAMWUMED Management
SAMWUMED is managed by a Board of Trustees responsible for ensuring the Scheme is well-governed, adheres to governance principles, and remains financially sustainable.
Day-to-day operations are managed by a management team led by a Principal Officer.
SAMWUMED Partners
SAMWUMED partners with organisations that share its ideology of providing affordable medical aid for local government employees in South Africa. These organisations assist the Scheme in promoting quality healthcare that is fair and adequately covers our members’ needs.
Joining SAMWUMED
SAMWUMED accepts local government employees as members. If you qualify, click here.
SAMWUMED Vision
- To be the leading medical scheme in the local government sector.
- To provide a holistic and progressive primary health service nationally.
- To provide guaranteed affordability by offering appropriate benefits and access to the best medical services.
- To create healthy and satisfied members through education and efficient administration in a member-friendly environment.
- Commitment to the principle of non-profit and to remain sustainable.
- To be one of the most desired organisations to work for in South Africa.
- To promote a clean, healthy, and sustainable environment.
SAMWUMED Mission
- We commit ourselves to service excellence by providing the most affordable, member-friendly, accessible, and accountable scheme and administration.
SAMWUMED Values
- Member centric
- Integrity
- Responsibility
- Discipline
- Accountability
- Ubuntu
- Value of the self, organisation, and society
Conclusion
In conclusion, SAMWUMED Medical Scheme stands as a beacon of affordable and comprehensive healthcare solutions, dedicated to the well-being of its members and ensuring access to quality healthcare services across South Africa’s local government sector.
Click here: https://samwumed.org/contact/ to find out more about SAMWUMED medical aid benefits and how you can join.
