Principal Officer’s Foreword
Dear Valued Member,
We hope you enjoyed our March edition, which placed a special focus on Women’s Health and Maternity Care—an important reminder of our Pulababy Maternity Programme and Fertility Care Benefits.
As we come out of the Easter season—a time that invited reflection, renewal, and reconnection—we carry forward its message of hope and wellbeing. Pulamed remains committed to supporting your health through timely, relevant, and accessible healthcare offerings.In this edition, we’re excited to share:
- A spotlight on Travel Insurance cover for Executive and Deluxe Members—because applying is as important as packing your passport
- The importance of getting your flu vaccine, especially as colder days roll in
- An educational focus on Waste in healthcare—what it means and why reducing it matters
- A reminder to download and use the Pulamed App, your self-service tool for effortless access to medical aid benefits
- Highlights from our participation in World Oral Health Day, reinforcing our dedication to preventative care and community well-being
As we step into May, let’s carry the momentum of the season forward—making informed choices and embracing tools that support better health. From travel to vaccinations and digital convenience—Pulamed is here to support your wellness journey, every step of the way.
Yours in Health,
Dr. Khumoetsile Mapitse
Principal Officer
Member Benefit Spotlight
Travel Insurance cover is Your Ultimate TravelEssential
Don’t leave home without it, this is as importantas your passport.
If you’re planning a getaway, don’t just plan youritinerary—make sure your health is covered, too.For Executive and Deluxe Members, Pulamedoffers International Travel Insurance cover atno extra cost. Members are advised to apply atleast 48 hours before departure.
Two cover options are available:
Silver Package
For travel within Lesotho, South Africa, Namibia, andEswatini. Provides cover for up to 92 consecutive days,to the value of P1 million
Gold Package
For travel worldwide (excluding the above countries)Provides cover for up to 92 consecutive days, to thevalue of P25 million
Whether you’re traveling for business or leisure, this benefit offers comprehensivecover.
Pulamed International Travel Insurance
Please note: Turnaround time is typically 24–48 hours. If you haven’t received feedback withinthat period, don’t forget to check your spam or junk folder.
FLU VACCINE – Winter has come early, are you protected?
The cold weather is creeping in—and so is flu season.
Now’s the perfect time to roll up your sleeve and protect yourself with your
annual flu vaccine, available to allPulamed members.
Prevention is better than a pounding headache and runny nose.
Stay ahead of the flu. Stay healthy.
Annoucements
Fraud, Waste and Abuse Series
– This month’s Focus: WASTE
Last month, we introduced the topic of fraud. This edition, we turn our attention to waste.
Waste is defined as the thoughtless or careless expenditure, mismanagement, or abuse of resources to the detriment (or potential detriment) of the Scheme. Waste also includes incurring unnecessary costs resulting from inefficient or ineffective practices, systems, or controls.
It’s not just the loss that medical aids face through fraudulent claims; there’s the dilemma that wasteful expenditure poses. A member might have a good reason to have access to medication but doesn’t need it and will be perfectly fine and healthy without.
Those resources could have been allocated to another medical scheme member in need, or saved to increase the member pool funds.
This results in medical aid schemes having to increase their rates and premiums to cover this loss.So, members—you and I—end up paying more.
By understanding waste and working together to prevent it, we contribute to the long-term sustainability and effectiveness of your medical aid fund.
Report Fraud, Waste & Abuse
REMEMBER, REPORTS CAN BE SUBMITTEDANONYMOUSLY OR IN CONFIDENCE
PULAMED APP
Medical aid in your pocket!
We are pleased to announce our new App Feature. Members can now check their claims status on the Pulamed mobile app.This benefit allows members to have sight of their claims and timely tracking.
The Pulamed App is designed to make your medical aid experience smoother, smarter, and more accessible—wherever you are.With the app, members can:
-Instantly access their digital membership card
-View their billing statements
-View their benefit balance utilisation
-Monitor and track their wellness reporting
-Access wellness content on mental health, preventative care, financial wellness, and healthy living
-Download their membership certificate
This is all part of Pulamed’s ongoing focus on digital convenience—giving you control and insight into your healthcare, in the palm of your hand.
Get the app now from the App Store or Google Play Store—just search “Pulamed”.
Pulamed Processes
Pre-authorisation Requirements:
-Diagnosis and ICD 10 code
-Medical history and date of onsetIndication of services to be provided/procedure with related tariff/CPT codes where applicable
-Cost estimatesAnticipated Length of stay and level where hospitalisation is indicated
-Date of Procedure/Appointment date
-Any other relevant information
In accordance with the Fund rules, hospital admissions require pre-authorisation and case management from Pulamed.
Take note of the Preauthorisation requirements for each hospitalisation
News & Events
Celebrating Smiles: World Oral Health Day
Pulamed, in collaboration with Supplementary Health Service Botswana (SHSB), the Botswana Dental Association, and the Ministry of Health, proudly joined the World Oral Health Day commemoration held at Tloaneng Primary School.
As part of our continued commitment to preventative care and oral health awareness, Pulamed and SHSB supported the event by donating toothbrushes, floss, and toothpaste to learners, school staff, community members, and stakeholders.
Together, we continue to champion healthier smiles and brighter futures.
Stay connected
For more information on your Pulamed benefits, our services, and more, stay connected!
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