SAMWUMED provides cover for both internal and external prostheses. These are artificial body parts such as legs, arms and eyes.
OPTION A
Paid from Risk
Conditions:
- Members are encouraged to use the Scheme’s Network Providers for hip and knee replacement prostheses to avoid a R10,000 co-payment.
- A clinical motivation, quotations from at least three providers and pre-authorisation are required to access these benefits.
- The Scheme maintains the right to procure prostheses on behalf of members and to deduct the members’ allocated benefits.
OPTION B
Paid from Risk
Conditions:
- Members are encouraged to use the Scheme’s Network Providers for hip and knee replacement prostheses to avoid a R10,000 co-payment.
- A clinical motivation, quotations from at least three providers and pre-authorisation are required to access these benefits.
- The Scheme maintains the right to procure prostheses on behalf of members and to deduct the members’ allocated benefits.
