The Essential and Basic Plans provide cover for basic healthcare expenses, known as Prescribed Minimum Benefits (PMBs).
This means you receive cover for PMBs even if you have a restricted budget. You are required to use our Bankmed networks to ensure full cover.
On the Basic, Essential and Traditional Plans you must use Bankmed networks and follow defined processes to see a specialist. You must also use our medicine lists (formularies) for certain treatments and medication. Consider where you work and live before choosing a Plan that relies on your being restricted to networks.
You still benefit from using our networks on the Core Saver, Comprehensive or Plus Plans, but using networks are not a requirement for cover on these Plans.
Allow you to decide how to use the funds set aside for day-to-day medical expenses.
The advantage is that you do not pay for benefits you do not use, and you can carry over unused funds to the next year. You are in charge of your day-to-day medical spend.
Cover specific day-to-day medical expenses (for example, one visit to a network dentist a year covered from Insured Benefits).
The advantage is that you still have cover for different categories of medical expenses even if you have used up one category's benefits. For example, if you have used up the benefits for GP consultations, you still have cover for blood tests.
All Bankmed Plans offer cover for chronic conditions that qualify as PMBs on the Chronic Disease List. You must register for the Chronic Illness Benefit to get cover for the medication, tests and treatment you need for your condition.
Addison's disease, asthma, bipolar mood disorder, bronchiectasis, cardiac failure, cardiomyopathy, chronic obstructive pulmonary disease, chronic renal disease, coronary artery disease, Crohn's disease, diabetes insipidus, diabetes mellitus types 1 and 2, dysrhythmias, epilepsy, glaucoma, haemophilia, hyperlipidaemia, hypertension, hypothyroidism, HIV and AIDS, multiple sclerosis, Parkinson's disease, rheumatoid arthritis, schizophrenia, systemic lupus erythematosus and ulcerative colitis.
While higher Plans can offer additional cover for these chronic conditions, we pay for specific care (PMBs) for these conditions, no matter which Plan you are on.
Acne, Attention Deficit Hyperactivity Disorder, Allergic Rhinitis, Anxiety Disorder, Atopic Dermatitis, Benign Prostatic Hypertrophy, Cardiac Dysrhythmia, Cystic Fibrosis, Gastro Oesophageal Reflux Disease, Gout, Hyperthyroidism, Myasthenia Gravis, Ankylosing Spondylitis / Osteoarthritis, Osteoporosis, Peptic Ulcer Disease, Psoriasis, Schizo-Affective Disorder, Trans Ischaemic Attack, Major Depression, Urinary Incontinence, Menopause, Paraplegia and Stroke.
The Basic Plan covers treatment for Major Depression. The Comprehensive and Plus Plan, covers treatment for Alzheimer's disease, Meniere's Disease and Interstitial Lung Fibrosis.