Dec 13, 2015
Who are we?
• We are a registered medical scheme –serving our members since 1961.
• We are a non-profit organisation with our members as our primary stateholders.
• We are truly independent – being a self administered fund.
• Excellent administration system – we process patient claims within 48 hours.
• Our reserves exceed the statutary regulation by 120%. (Current Solvency 150%) – amongst the industries highest.
When considering a Medical Scheme - we think you need to ask?
• Is in-hospital or out-of-hospital/ Day to Day benefits important to you?
• Can I go to a hospital of my choice and will it be a Government or a Private Hospital? AND can I have a private Ward?
• Can I choose my own doctors?
• How long must I wait for my bills to be paid?
• Do I have a say in how “they” use my money?
• Does your company contribute towards your Medical Aid subscriptions and if so, how much per month? – What's the tax implication to me?
OPTION 1 - Health Pact Premium aimed at …
• Individuals that require top quality private hospital care.
• Not concerned about day-to-day care, because he/she has disposable cash to cover this.
• Tax efficient product.
Our offer to you.
Chronic Meds: Asthma, Epilepsy, Juvenile Rheumatoid Arthritis
Pediatrics R600 per child
Ante-natal R1600 per family
Unlimited Hospital cover in a hospital of your choice
Full Pathology
MRI / CT R6000 per beneficiary,with co-payment of R1500
Specialists up to 200% of NHRPL/CMP tariff
Emergency ambulance services of your choice
Laparoscopic procedures according to (SASES) SA Society of Endoscopic Surgeons guidelines and pre-authorization
This product is not designed for ongoing chronic usage
PM
B’s
HealthPact Premium
OPTION 2 - Health Pact Silver aimed at …
• This option is not designed for , “ I want full freedom of choice”, but rather at members that require – Balanced cover at an Affordable cost.
• Families with children, often single parent families.
• Little disposable income – monthly budgeting may be an issue.
• Limited chronic medicine requirements.
• Hospital benefits are important, but secondary to day-to-day
Our offer to you. P
MB
’s
Chronic Meds: Asthma, Epilepsy, Juvenile Rheumatoid Arthritis
2 Visits to GP
Dental R300 per beneficiary
Pediatrics R600 per child
Ante-natal R1600 per family
Acute medication R300 per family
Unlimited Hospital cover in a hospital of your choice
Full Pathology
MRI / CT R6000 per beneficiary, with co-payment of R1500
Specialists up to 111% of NHRPL /CMP tariff
Emergency ambulance services of your choice
No Laparoscopic procedures
Pre-Funded Med Pre-Funded Med Savings R2100 per Savings R2100 per
adultadult
HealthPact Silver
OPTION 3 - Health Pact Gold aimed at …
• The high income business executive.
• The person who requires significant savings and day-to-day cover, to avoid the hassle factor.
• Who demands seeing top quality medical practitioners – who charge above tariff.
• Who demands top quality hospital cover.
• The person who requires top quality chronic medication.
• Who demands freedom of choice and is not really worried about monthly cost. In most cases these individuals are subsidised.
Our offer to you.
Unlimited Hospital cover in a hospital of your choice. Semi Pvt Wards Included.
Full Pathology
MRI / CT R12000 per beneficiary, with co-payment of R1500
Specialists up to 200% of NHRPL/CMP tariff
Emergency ambulance services of your choice
Laparoscopic procedures according to (SASES) SA Society of Endoscopic Surgeons guidelines and pre-authorization
Dental R1200 per family
Orthodontic R8000 per minor beneficiary per family
4 Visits to GP per beneficiary
Pediatrics R1200 per child
Ante-natal R2400 per family
28 Chronic conditions
Acute medication R1200 per family
Pre-Funded Med Pre-Funded Med Savings R4800 per Savings R4800 per
adult adult
HealthPact Gold
PM
B’s
Typical Hospital Event
Medicine 10%
Specialist 20%
Hospital 70%
CMP Portion CMP Portion
Medicine Co-Payment
Amount over NHRPL Limit
Amount over NHRPL Limit
Covered by Medical Aid
Co-Payment Procedure
Co-Payment Procedure
2006
New Age Payment of Procedure
2007
New Age Payment of Procedure
CMP Portion
Co-Payment Procedure
Amount over NHRPL Limit
Take Home Tablets
2008
The CMP Difference
CM
P M
an
ag
es
Industy Overview
Paid by member either cash or from savings portion
Work with us and we manage on your behalf
Rates 2008Beneficiarie
sPremium Silver Gold
Adult R610R805
----------------MSA=R2100
Per adult
R2025---------------MSA=R4800
Per adult
Child R100R115
-----------------MSA=R300
per child
R498----------------
MSA = R1176
per child
• All claims are processed within 48 hours & paid within two weeks• A positive balance on your MSA earns you 5% pa and your funds are
carried forward.• Financial stability.• No channeling – freedom of choice when going to hospital.• Unlimited pathology (blood tests) via Pathcare or Lancet Laboratories.• 5 Nursing sisters at your disposal. Their job is to manage and PRE
QUOTE all hospital events, remove the stress points in you r time of need and just as important, give you a say in what you are going to be charged, BEFORE YOU ARE CHARGED IT!
• We understand Medical Schemes and we promise listen to you.
What we promise you is :