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DAY-TO-DAY BENEFITS
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DAY-TO-DAY BENEFITS

Oct 23, 2015 by

COVER DEPENDS ON SELECTED PLAN

All about Day-to-Day Benefits, the Primary Care Benefit, the benefits available under each Plan, the Fund’s designated service providers and acute medicine.

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SUPPLEMENTARY BENEFITS
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THESE BENEFITS MAY DIFFER ACROSS PLANS

Details about a range of out-of-hospital benefits that most schemes cover from PMSA, but that for OMSMAF members are paid from their Hospital Benefits.

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WELLNESS BENEFITS
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WELLNESS BENEFITS

Oct 23, 2015 by

THESE BENEFITS ARE THE SAME ACCROSS ALL PLANS

How the Wellness Benefit can help you, and what is available under the pharmacy and the non-pharmacy Wellness Benefit.

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CHRONIC BENEFITS
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CHRONIC BENEFITS

Oct 23, 2015 by

COVER DEPENDS ON SELECTED PLAN

All about chronic conditions and which are covered by the various Plans, how to apply and make changes, and which service providers to use.

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HOSPITAL BENEFITS
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HOSPITAL BENEFITS

Oct 23, 2015 by

THESE BENEFITS MAY DIFFER ACROSS PLANS

All about Major Medical Benefits, what cover is available, the importance of pre-authorisation before hospitalisation and services and procedures covered during hospitalisation.

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MANAGED CARE PROGRAMMES
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THESE BENEFITS MAY DIFFER ACROSS PLANS

More about the Managed Care Programmes for HIV and AIDS, Oncology, Mother and Baby Care, as well as the Beneficiary Risk Management Programme.

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CLAIMING MADE EASY
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CLAIMING MADE EASY

Oct 23, 2015 by

What to do with claims, how much time you have to submit a claim, how claims are paid, how soon you can claim after joining the Fund and what happens if you do not have enough benefits left to settle claims.

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FREQUENTLY ASKED QUESTIONS
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Questions ranging from overseas medical expenses, motor vehicle accidents, claims in terms of the Compensation for Occupational Injuries and Diseases Act, handling complaints against the Fund, keeping medical costs low, reporting fraud, as well as getting additional cards/certificates.

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TOOLS
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TOOLS

Oct 23, 2015 by

A contribution calculator, a decision-making tool for SELECT  Plans, a look-up tool for a SELECT  list of hospitals and a Plan change form.

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