BENEFIT UPDATES

Be in the Know

At OMSMAF, our core purpose is to understand and meet the changing healthcare needs of our members, and that means we are constantly striving to improve what we do and how we do it. It’s with this in mind that we are introducing a number of attractive benefit updates.

New lactation consultation

Let’s start off with the new lactation consultation benefit that will have our new parents breathing a sigh of relief. It is widely accepted that breast milk is best for babies, and while breastfeeding is one of the most natural processes in the world, it’s not instinctive. In other words, it’s something that you have to learn to do and having an expert light the way really does take the pressure off. As any new mom or dad will tell you, stress less, sleep more, feel better!

As you will see in our upcoming maternity benefit campaign, OMSMAF has introduced an out-of-hospital benefit providing access to a registered lactation nurse for one consultation within two weeks of discharge from hospital to help set you and baby on the right path to successful breastfeeding. This consultation is paid at Medical Scheme Rates (MSR) and  is available on the Network, Network SELECT, Savings, Traditional, Traditional Select and Traditional Plus plans.

Specialists reimbursed at 200% of the Medical Scheme Rate

With global cancer rates on the rise, early detection through screening is vital and a matter close to our hearts. We are, therefore, paying for one specialist visit per beneficiary per benefit year for a Urologist and a Dermatologist at 200% of the Medical Scheme Rate (MSR) from your wellness benefit.

All female beneficiaries will have access to a consultation with a Gynaecologist paid at 200% of the Medical Scheme Rate or a General Practitioner paid at 100%. This benefit is limited to one consultation per beneficiary per benefit year for the following services to be performed at the same visit:

• Pap smear,
• Syphilis and chlamydia infection screening,
• Obtaining a referral for one mammogram per benefit year to be performed by a radiologist,
• Obtaining a referral for one bone density scan per benefit year to be performed by a radiologist, and
• To discuss your contraceptive options and obtain the necessary script for this.

PLEASE NOTE:

• For the Network and Network SELECT Plans, these benefits are subject to the Fund’s clinical guidelines, protocols and referral from a Network GP, and authorisation.
• Please remember to kindly advise all service providers performing any Wellness Screenings to submit claims with the ICD 10 code Z00.0.