The Fund allows children beyond 21 years to remain dependants once they have provided proof of schooling. The proof may be submitted to clientservices@afa.co.bw to ensure the child remains covered.
An employee retiring from an Employer Group on pension (normal retirement age 65 years) or who terminates his employment on account of early retirement due to ill health (age 55) and who has at the date of retirement paid subscriptions to Pulamed for a minimum period of ten years shall have the option at the date of retirement of applying for pension membership.
Yes, it is possible to apply for medical cover for your parents. All you have to do is complete application forms for them. Note that all members joining us from the age 50 and above are subject to medical exam as well as Late Joiner penalty fee if they have never had previous medical aid cover.
Certainly! Any male applicant or male member wishing to register children born out of wedlock can simply attach a certified birth certificate bearing the fathers name and the additional dependant form available on the website.
Yes, continuation of membership is available for members in your situation. However you are required to complete a Continuing member form available on the website and submit to clientservices@afa.co.bw immediately to avoid lapse of your membership.
Once you are 12 weeks pregnant you can register for Pulababy Maternity Care Programme on our website. You will also need to contact The Fund for authorisation of hospital admission for the delivery of your baby. Your cover for delivery is subject to your health plan’s benefits and rules.
After the birth of your child, The Fund requires you to register the baby within 30 days from delivery. You may send the Additional Dependant form and attach a certified copy of the birth certificate to clientservices@afa.co.bw to register your child.
There are four (4) applicable waiting periods for new members:
- Maternity - 9 months
- Specialised/Limited dentistry - 12 months.
- Pre-existing conditions- 24 months.
- Infants not registered within 30 days of birth - 3 months.
The above waiting periods do not apply to anyone who joins the fund and has been a registered member or dependent of a recognized medical aid fund for a continuous period of at least one (1) year and the application to join Pulamed is made within three months from termination of previous cover.
Where & How Can I Submit My Claims?
You can send in your claims by scanning and emailing your signed invoice and receipt to rsaclaims@afa.co.bw
The following documentation will be required to process all claims incurred outside Botswana:
- Proof of travel (stamped passport showing departure and return dates).
- Medical report and or referral letter.
- Original detailed invoice with member and service provider signature (NB: All documents to be written in or translated to English. Only translations from sworn translator will be accepted).
- Proof of payment: original or scanned receipt / proof of bank transaction / sped point slip.
- All members undergoing major or planned hospital procedures outside Botswana will be required to notify the scheme of such prior to the procedure or treatment.
- Reimbursement amounts will be in accordance with the exchange rate applicable and Fund Rules and Tariffs.
You must send us your claim within six (6) months from the date you saw your healthcare professional.
Simply request a new card by contacting us 3650555 or email us at clientservices@afa.co.bw. While you wait for your card you can use your card through the Pulamed Mobile APP.
Yes, we have International Travel Insurance for members who are in Executive & Deluxe plans worth P25million. The Travel Cover offers medical emergency cover for 92 consecutive days from date of departure outside the borders of Botswana per single trip. Kindly visit our website or contact 365 0555 for more information.
Pulamed will guarantee payment for in-patient hospitalisation in South Africa once the hospital guarantee request is received as per our arrangements with the hospital. The hospital must communicate with The Fund at the time of admission of the patient. Members have to ensure before leaving, that their membership is up to date; subscription payments, benefit availability so that they have a clear indication of what their liability to the hospital will be depending on the hospital charges. Pulamed has a network of Hospital Groups which The Fund pays directly on your behalf.
You can get proof of membership by contacting us on 3650555 or email us on clientservices@afa.co.bw
Pulamed undertakes to resolve all customer complaints within 15 days of receipt of a complaint together with all supporting documents from our member.
