What it takes to be a member of PSMAS

Last article articulated PSMAS product offerings for both public and private sector members. The article explained that public sector products are meant for Government employees while private sector products are for non-Government employees, that is corporates, informal sector, and even those in the diaspora.

This week will focus on being a member of the medical aid.

Joining PSMAS

The most important part of joining or re-joining medical aid is to have adequate information on the medical aid and the package one wants to join. One must understand the medical aid concept itself, how it is different from other policies such as funeral cover, understanding the different product offerings available and their benefits, and choosing the one that best suits their budget and needs.

What determines the choice is primarily the benefit and the costs (monthly subscriptions to be paid). The benefit outlines what is covered and the limits in terms of which the prospective member should seek medical attention.

It may also include the type of facilities one can access with the available options for example some plans have limited access to certain medical facilities and procedures.

There are also issues to do with waiting periods for cover, which must be well appreciated before committing to any particular society.

When one is fully equipped with this knowledge, they can then sign up for cover with medical aid and their plan of choice.

For PSMAS, the sign-up process can be done via the following platforms:

Completing a physical application form at any of the PSMAS branches countrywide

Joining through the PSMAS 24/7 Mobile App

Sending an email to [email protected]

Sending a WhatsApp to 0783183530 indicating intention to join once done, PSMAS customer service agents will get in touch with the prospective member and take them through all the necessary requirements and also provide them with more detailed information.

Upgrade or downgrade my PSMAS plan and how do I go about it? Indeed, it is possible to either downgrade or upgrade your membership depending on prevailing circumstances.

Downgrading is moving from a higher scheme to a lower one and vice-versa. Ordinarily, upgrading has a waiting period.

The members wait for three (30 months) before they can begin benefiting from the higher scheme. During that period, the member will still be accessing their lower scheme benefits while paying for the higher scheme.

This is meant to protect the Fund from possible abuse by members who may wish to upgrade when they have noted they have a major healthcare cost to be incurred.

There are exceptions when the upgrading has to do with conditions of service (employer initiated) or would have been initiated by the medical society. In some situations, PSMAS runs promotions to upgrade with no waiting periods and members are encouraged to take advantage of such window periods.

For example, we are currently encouraging our members with chronic conditions who are on the Standard Plan to upgrade to Optimum Plan with no waiting period.

Downgrading membership is immediate as the society appreciates possible changes in circumstances such as income.

Waiting periods

To ensure protection of the fund, if one is joining medical aid, they will have a waiting period. This is a period under which a member is expected to be contributing before they start utilising their benefits. This ensures members will not be coming in to utilise the funds, but are also prepared to pay subscriptions to help build the fund.

There are, however, exceptions that include those that join within three months of their employment, spouses registered within three months from the date of marriage, newborn babies registered within three months from the date of birth and those that show proof that they are moving from another Medical Aid Society, where such benefits were covered.

Beneficiaries?

These are other members you want covered under your medical aid. It can be your spouse, children, parents, in-laws etc. To add beneficiaries, one can complete a physical application form at any of the PSMAS branches countrywide, joining through the PSMAS 24/7 mobile App, sending an email to [email protected], or sending WhatsApp to 0783183530.

Please note other beneficiaries outside the core family of spouse and three children have different subscriptions. Always check with for current subscriptions through [email protected].

 

For feedback please email: [email protected]