There for you

Many people regard their medical scheme mainly as a way to help cover visits to the doctor or dentist, or to fund a new pair of spectacles. The monthly contributions then seem disproportionately high, and many medical scheme members (whatever scheme they belong to) complain that they are not getting value for money.

The first thing to understand is that a medical scheme is MAINLY there to help you when things go wrong. It’s comparable to your short-term insurance. You may go many years without claiming for anything, but when you’re burgled, it’s great to be able to claim for everything you’ve insured.

Likewise, members who are in accidents, develop cancer or need life-saving procedures are usually extremely relieved that they have a medical scheme to fall back on. And because the costs involved in these major medical events are often very high, this is where the benefit amounts are typically the highest, and where the Society spends most of its money.

During a typical member’s lifetime, there will be many occasions where the Society’s benefits would be extremely valuable. The “journey” on the next page shows different life stages, and the type of healthcare challenges a member may face.

The typical healthcare journey

Your benefits in a nutshell

The Society offers a wide range of benefits to its members. These can be categorised (and are covered in the following chapters) as follows:

Preventative benefits, which include health screening tests and vaccines to help you manage your health pro-actively;
Day-to-day benefits, which typically cover expenses such as consultations with GPs and other healthcare professionals, optometry, dentistry, and acute medicine;
Chronic medicine benefits, which help members manage certain chronic conditions in a cost-effective way;
Hospital and major medical benefits, which cover from small in-rooms procedures to high-cost hospitalisation and treatment for trauma cases, oncology and more; and
Emergency transport benefits, to ensure that you and your beneficiaries can get emergency medical care when you urgently need it.

Unless otherwise specified, the benefits described in this guide apply to the Society’s benefit year, which runs from 1 January to 31 December. Benefits are not transferable from one benefit year to another.

How to save money for the Society and make the most of your benefits

Your responsibilities as a member

Stretch your benefits by knowing how claims are covered

Where you are covered

Contributions for 2021

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