Benefits: Healthcare Costs while Travelling

IMPORTANT!

Medical care abroad can be very expensive (depending on the country you will be travelling to) and, given our exchange rate, it would probably not be fully covered, so it may be wise to take out additional medical cover. Your travel agent will be able to assist you with this.

What should I keep in mind if I plan to travel outside South Africa?

You will be glad to know that you can claim from the Scheme for medical expenses incurred while travelling outside South Africa. However, you need to be aware of the following:

  • You will be responsible for settling the account upfront. You can then submit the claim to the Scheme when you return.
  • If your account is in a foreign language, it must be fully translated and detailed before you submit it to the Scheme.
  • When you send in foreign claims, please add a cover letter or email explaining the situation. The more detailed your cover letter and claim, the quicker the Scheme can process the claim. You need to clearly indicate the following details:

    • The name of the country in which you were treated
    • Treatment dates
    • Whether there was anaesthesia involved and if so, how long it was for
    • The medicine, materials, treatment, procedures and operations involved. These must all be clearly specified and charged individually.
    • The patient’s name
    • The currency in which the claim was paid
  • Submit your claim to: foreign.hos at medscheme.co.za
  • Your claim will be subject to the Scheme’s Rules as if the treatment was rendered in South Africa. In other words, the same exclusions, benefits and limits will apply.
  • Your claims will be paid according to the equivalent tariff and will be refunded to you in Rands, at the exchange rate that applied on the treatment date.
PLEASE NOTE

In the event of the claim being covered under your travel insurance policy, you will not qualify for a refund for the claim from the Scheme. Should you claim from the Scheme and fail to disclose that you have been indemnified by your insurer for this claim, this will be regarded as fraud.

 

If you or one of your accompanying dependants use chronic medicine, you must also remember to arrange for advance supplies by contacting ScriptPharm on 011 100 7557, or visiting www.scriptpharm.co.za, for an extended supply form. The completed form, together with a copy of the flight tickets and travel itinerary must reach ScriptPharm at least ten working days before you leave, to ensure that you receive your medication in time.

 

What if we have a medical emergency outside the borders of South Africa?

Members outside the borders of South Africa (members in Namibia, Lesotho and Swaziland) may call ER24 by dialling +27 10 205 3052 for the following services:

  • Life-threatening emergency (primary)
  • For primary service, but not life-threatening
  • Any inter-hospital transfers

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