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 |
