The Best Medical Aids
The Best Hospital Plans
Overall, SAMWUMed (South African Municipal Workers Union Medical Scheme)Β offers 2 medical aid plans (Option A and Option B) starting from R1,585 per month on a 100% contribution. Additionally, SAMWUMed offers 24/7 emergency support but does not offer comprehensive gap cover on any policy.
π Medical Aid | π₯ SAMWUMed |
π Registration Number | 394 |
π₯ The average number of members | 35,000+ |
π Average Customer Rating | 3/5 |
βοΈ Average Number of Reviews | 20+ |
π Market Share | <1% |
2οΈβ£ Number of plans | 2 |
π₯ Number of Hospitals in Network | 100+ |
π Home Care | β No |
π€ Sponsorships | None |
π± Mobile App | β Yes |
π Medical Aid | π₯ SAMWUMed |
π Date Established | 1952 |
π Headquartered | Cape Town, South Africa |
βοΈ Registration Number | 394 |
π₯ The average number of members | 35,000+ |
β‘οΈ Number of Markets | South Africa |
π€ Number of Employees | 100+ |
π Listed on the JSE | β No |
π JSE Stock Symbol | None |
π Average Customer Rating | 3/5 |
π Average Number of Reviews | 20+ |
π Market Share | <1% |
2οΈβ£ Number of plans | 2 |
π₯ Number of Hospitals in Network | 100+ |
π Home care provided | β No |
π€ Sponsorships | None |
π± Mobile App | β Yes |
π SAMWUMed Magazine for clients | No |
π» Medical Claims Portal | β Yes |
π· Information Hub for COVID-19 | β Yes |
βοΈ Chronic Illness Benefits | β Yes |
π Number of PMB Diagnoses | 270 |
π Number of PMB Chronic Conditions | 26 |
π₯οΈ Screening and Prevention offered | β Yes |
πΆ Maternity Benefit | β Yes |
π΄ Medical Aid Contribution Range (ZAR) | 1,585 β 3,618 ZAR (100%-member contribution) |
β Average Waiting Period | 12 months |
π΅ Late-joiner penalties charged | β Yes |
πΆ Is International Medical Cover offered | β No |
The Council for Medical Schemes regulates SAMWUMed Medical Scheme.Β The Council governs South Africa’s medical plan business for Medical Schemes (CMS), a regulating body set up under the Medical Schemes Act, No. 131 of 1998 (the Act). The CMS is responsible for a range of tasks related to the oversight of medical insurance plans, such as:
Furthermore, if a medical scheme is found to violate the law, the CMS has the authority to issue administrative fines and penalties.
POLL: 5 Best Medical Aids under R1500
π Plan | π΄ Contributions Range (Main) | π΅ Contributions Range (+ Adult) | πΆ Contribution (Child) | π· Main + Spouse | Main + 1 Parent + 1 Children | Main + 1 Parent + 2 Children |
π °οΈ Option A | R1,585 β R2,617 | R1,585 β R2,617 | R559 β R923 | R3,170 β R5,234 | R3,729 β R6,157 | R4,288 β R7,080 |
π ±οΈ Option B | R2,639 β R3,618 | R2,639 β R3,618 | R926 β R1,192 | R5,278 β R7,236 | R6,204 β R8,428 | R7,130 β R9,620 |
With a maximum annual outlay of R961,500 per family, this plan is best for those with moderate annual medical expenses who want and need access to Comprehensive Maternity Benefits and high-quality Hospital care.Β Furthermore, providing medical insurance to a young family who is still trying to start a family or has young children is a great investment. In addition, the Comprehensive Preventive Care Program makes a wide range of Early Detection Tests available to members under this Option.Β Options A and B cover primary care physician visits and treatments for members and their dependents, whether received in the doctor’s office or at the patient’s residence. They, and their families, have access to Emergency Care coverage.
The following pharmaceutical benefits are provided to participants in the Scheme:
Furthermore, Depression, GORD, and Gout are included under medication with SAMWUMed.Β There is R3,630 available to each beneficiary per year for medication.Β Over-the-counter medication is limited to R2,110 per family per year.Β The over-the-counter sub-limit is R180 per script per beneficiary per claim.
This is the best option if a member wants the maximum benefit across the board, including coverage for chronic illness, excellent hospital care, and comprehensive day-to-day medical coverage.Β This choice gives members access to a pool of R1 921 000 per family per year, allowing them to support a larger number of dependents.Β In addition, just like with Option A, Option B’s Comprehensive Preventative Care Program members have access to a wide range of Early Detection Tests.Β Options A and B cover primary care physician visits and treatments for members and their dependents, whether received in the doctor’s office or at the patient’s residence. They, and their families, have access to Emergency Care coverage.
The following pharmaceutical benefits are provided to participants in the Scheme:
Furthermore, Eczema, Depression, GORD, Gout, and Menopause are included under medication with SAMWUMed.
READ more: 10 Best Hospital Plans in South Africa
To apply for Medical Aid through SAMWUMed, you must:
SAMWUMED is dedicated to processing member claims as quickly as possible. To do so, members must submit all necessary information to allow the claim to be processed.Β The Scheme requires an Account Statement that is no more than four months old and shows the following:
Reasons for nonpayment of claims include the following:
The scheme will notify the member within 30 days when claims are denied. Furthermore, the member will be given 60 days to revise the claim and resubmit it to SAMWUMED.Β When a member pays for treatment and then requests reimbursement from the Scheme, the claim must be accompanied by an original receipt.Β Furthermore, members can submit claims to SAMWUMed online, by post, or by hand delivery.
Compliments can be sent directly to SAMWUMed using any communication methods available.
To switch your medical aid to SAMWUMed, you can follow these steps:
Discover more about Health Insurance
SAMWUMed can be contacted using several communication channels, including the following:
π Medical Aid | π₯ SAMWUMed | π₯ Bonitas | π₯ Keyhealth |
π Years in Operation | 71 Years | 40 Years | – |
π Average # Members | 35,000+ | 750,000+ | 150,000 |
π GCR Rating | – | AA | – |
π₯ Number of Employees | 100+ | 150+ | 500+ |
β‘οΈ Market Share | <1% | +-25% | <2% |
π Market Coverage | South Africa | South Africa | South Africa |
π Customer Rating | 3/5 | 4.9/5 | 3/5 |
βοΈ Number of reviews | 20+ | 5,000+ | 200+ |
π± Mobile App | Yes | Yes | Yes |
π΄ Contribution Range (ZAR) | 1,585 β 3,618 ZAR | 1,378 β 9,853 ZAR | 1,990 β 11,308 ZAR |
πΆ International Travel Benefit (ZAR) | No | Up to 10 million ZAR | Between 2.5 and 6 million ZAR per beneficiary |
Great Support.
SAMWUMed has been nothing but supportive.Β – Tasha Williams
Excellent Provider.
With heartfelt appreciation, I extend my gratitude for your reconsideration of the matter and reversal of the previous decision, enabling my wife to receive the crucial procedure. The port and line were successfully removed last Monday, and we are deeply grateful for this act of kindness. – Katy McCain
Highly Recommended.
I recently had to inquire about upgrading my health plan. I was pleased that the company had a virtual chat option on its website. This convenient feature allowed me to get all the information and assistance quickly and easily I required, taking only two minutes of my time. – Constance Huff
SAMWUMed is a medical aid scheme that provides quality and affordable healthcare to its members. SAMWUMed offers different premium options to suit members’ budgets, with a focus on providing quality healthcare at an affordable cost.Β Furthermore, SAMWUMed is committed to providing its members with the best possible healthcare experience and offers a range of initiatives to support their health and well-being.Β However, a drawback is a lack of choice between options, as SAMWUMed only offers two plans. In addition, there is no medical savings account, and coverage might be limited because there are only two options.
β Pros | β Cons |
SAMWUMed is extremely member-focused | There are only two options |
SAMWUMed offers affordable and premium options to members | There is a limited international cover |
There are several benefits offered on each plan | There are limited alternative therapies |
There is a significant network of healthcare providers | There is the potential for long waiting periods for some benefits |
SAMWUMed is a medical aid scheme that provides its members with quality and affordable healthcare services.
You can join SAMWUMed by contacting their offices and speaking with one of their advisors. They will guide you through the process and help you choose the best option for your needs.
The cost of SAMWUMed depends on the level of coverage you choose and your personal circumstances, such as your age and the number of dependents you have. The plans range from 1 585 up to 3 618 ZAR (100%-member contribution).
SAMWUMed covers various healthcare services, including hospital cover, day-to-day benefits, specialist cover, and more.Β The specific benefits available will depend on the level of coverage you choose.
SAMWUMed covers pre-existing conditions according to their rules and conditions.Β It is best to consult with a SAMWUMed advisor to determine the specific coverage available for your pre-existing conditions.
SAMWUMed covers alternative therapies, but the extent of this coverage may depend on the specific level of coverage you choose.
Yes, SAMWUMed members can change their options at the end of the year, subject to the terms and conditions of their specific option.
SAMWUMed provides limited international cover, subject to the terms and conditions of your specific option.Β Therefore, it is best to consult with a SAMWUMed advisor to determine the international coverage available.
Claims can be made with SAMWUMed by submitting the necessary documentation to their offices, such as receipts and invoices.
To downgrade your plan with SAMWUMed, you contact SAMWUMed customer service via their customer service number or by visiting a SAMWUMed service center.
If you want to add a child or adult dependent, you can log into your SAMWUMed profile or reach out to SAMWUMed by calling their customer service number or visiting a SAMWUMed service center.
You might also like
We work with leading medical aid companies in South Africa.
π Report a bug or outdated data to be updated to [email protected]
Β© Medicalaid.com | All rights Reserved |
Copyright 2024
Top 5 Medical Aids
Top 5 Gap Cover Plans