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BENEFIT ENHANCEMENTS

BENEFIT ENHANCEMENTS

In furtherance of the Pula Medical Aid Fund’s ability to discharge its principal mandate of defraying the cost of access to quality healthcare services, the Fund has made enhancements to some benefits as part of the Fund’s commitment to being there for its Members. The benefit enhancements are effective from 01 July 2021 and are as outlined in the schedule below:
 

Optical Benefit

The Fund has:

  • Increased the optical limit.
  • Removed the frame sublimit.
  • Removed the 10% member co-payment.
Option Optical (OLD)  Optical (NEW)  Increased by  
Executive P 3,500 P 5,720 P 2,280 Per Beneficiary, every two (2) years
Deluxe P 3,000 P 4,680 P 1,680 Per Beneficiary, every two (2) years
Galaxy P 1,400 P 1,664 P 264 Per Beneficiary, every two (2) years
Standard P 1,400 P 1,644 P 264 Per Beneficiary, every two (2) years

 

Maternity/ Confinement

The Fund has:

  • Increased the benefit limit.
  • Removed the 10% member co-payment on both the Caesarean and Normal delivery benefit.
Option Natural Birth (NEW) Caesarian Section (NEW)  
Executive P 10,000 P 20,878 Per beneficiary, Per Annum
Deluxe P 9,072 P 20,245 Per beneficiary, Per Annum
Galaxy P 9,072 P 20,245 Per beneficiary, Per Annum
Standard P 8,640 P 15,969 Per beneficiary, Per Annum

 

Publication Date