Benefit limits and contributions
The benefit limits, including dentistry, have once again increased on all benefit options. The overall weighted contribution increase is 9.7%. Please access the Benefits Comparator on the website, which will assist you and your clients to compare benefits and contributions for 2020. The attached Schedule of Benefits, About Profmed and Benefits at a Glance provide comprehensive information on all the benefits, and our Easy Reference guide provides a summary of the benefit changes for 2020. You can also click here to view the benefit highlights.
Since their introduction in January 2019, we have seen remarkable interest in our Savvy options, namely, ProPinnacle Savvy, ProSecure Plus Savvy, ProSecure Savvy, ProActive Plus Savvy and ProActive Savvy. The Savvy options are hospital network options and provide members with significant savings on their contributions without compromising on benefits. Members who choose to voluntarily be admitted to a non-network hospital will be liable for a R10 000 co-payment. It is important to inform your clients that when they visit a GP or specialist, that healthcare provider should consult at a network hospital in case hospitalisation is required, to avoid a co-payment at a non-network hospital. Click herefor more information on the Savvy options.
ProSecure, ProSecure Plus and ProPinnacle options (Premium and Savvy)
- We are particularly pleased to advise that contributions will only be charged for up to three children on these options. Any additional child dependants will be covered at no cost. Please note that the Benefits Comparator does not cap the contributions to three child dependants.
- To ensure that we continue to meet the needs of our members we have added Attention Deficit Hyperactivity Disorder (ADHD) to the list of chronic conditions and believe that this benefit will be welcomed.
- The in-hospital delivery fees as well as consultations for midwives have increased to pay at the same rate as medical GPs and specialists.
- We have also increased the tariff fees for the maternity programme and will be paying a higher rate for ante-/post-natal consultations.
Virtual consultations via Medici
Members can now consult their doctors for follow-up consultations via text, call or video chat. This benefit is available to members on all options and a maximum of three consultations is available per beneficiary per annum. By first downloading the Profmed App, members then click on the Virtual Consultation tab, download and register on Medici to start a virtual consultation. Both the member and their healthcare provider must download the Medici app. The Profmed App can be downloaded by the principal member and all their registered dependants, via the smartphone stores.
How to change benefit options
It is important that members, with your assistance, understand their benefits and select the most suitable option for 2020. Members who are registered users on the member portal on the Profmed website can change their benefit option online. Alternatively, they can download and print a hard copy of the Benefit Option Change form from the website. All benefit option changes for 2020 must be submitted to the Scheme by 30 November 2019. Option changes are effective 1 January 2020 and members’ contributions will be adjusted accordingly. Contributions are due by the 1st of each month.
Multiply Wellness and Rewards Programme
All members of the Scheme have automatic access to Multiply Starter, at no cost. Members have the option to upgrade to Multiply Provider or Multiply Premier, which offer a wider range of benefits and rewards at a nominal monthly fee. Please visit the website or call 0861 100 789 for more information on what Multiply offers.
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