Getting Value from your Plan

Tips on how to get the most value out of your Plan:

  • Use a Healthcare Professional in our network. This helps you avoid co-payments and helps your benefits last longer.
  • Find a Healthcare Professional who has agreed to only charge you the Scheme Rate. We pay them in full.
  • Have your procedures done in a day surgery or day clinic to avoid paying a deductible if admitted to hospital
  • Manage your MSA wisely. Strategise your spending and take advantage of our Wellness and Preventative Care Benefits that are paid by Bankmed to help your MSA last longer.
  • Use chronic medication on our formulary list.
  • Avoid using your day-to-day benefits by registering on the CIB for chronic medication. Use medication on the formulary list (where applicable) to ensure you don't pay co-payments.
  • Maximise your benefits with the Baby-and-Me Programme. If you're pregnant, consider enrolling in our Baby-and-Me Programme to preserve your out-of-hospital benefits for other medical treatments.
  • Use a facility in Bankmed's Day Surgery Network and avoid paying a deductible for a defined list of procedures and treatments.
  • Bankmed's Disease Management Programmes, Care Programmes, Wellness and Preventative Care Benefits, and Chronic Baskets-of-Care provide benefits and support without using your day-to-day benefits.
  • Confirm your benefits beforehand to avoid possible non-payment for a procedure or treatment.
  • Avoid deductibles by using our Day Surgery Network.

Baby-and-Me Programme

Baby-and-Me is Bankmed's dedicated maternity programme. Baby-and-Me, offers enhanced coverage for pregnancy and childbirth. Access to this programme is exclusive to members on the Basic, Core Saver, Traditional, and Comprehensive Plans only.

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Oncology Programme

If you receive a cancer diagnosis and your cancer treatment is approved, the Oncology Programme provides comprehensive coverage. To benefit from this offering, you must enrol on the Oncology Programme.

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Contraceptive Benefit - The Pill Squad

You can now order your contraceptive pill or emergency contraceptive online, and have it delivered to you.

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Prescribed Minimum Benefits (PMBs)

PMBs are essential medical services that medical schemes in South Africa are obligated to provide to all their members under the Medical Schemes Act number 131 of 1998. These benefits include the diagnosis, treatment, and ongoing care costs for life-threatening emergency medical conditions, a specified set of 270 medical conditions (defined in the Diagnosis Treatment Pairs), and 27 chronic conditions (defined in the CDL).

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Upfront Payments

Upfront payments (deductibles) to the hospital before you receive treatment.

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