Member can submit invoices after treatment – please see checklist to ensure you’ve attached all the required documentation
Foreign claims require pre-authorisation.
There’s typically no waiting period for basic dentistry
All specialised dentistry procedures are subject to a twelve (12) month waiting period.
There’s typically no waiting period for basic dentistry
All specialised dentistry procedures are subject to a twelve (12) month waiting period.
Hospital cases and orthodontic treatment authorisations are valid for one (1) month and for other procedures validity is six (6) months. (You’re advised to verify benefit availability if procedure is delayed)
For BPOMAS and Pulamed, a claim submitted three (3) months after service date is classified as stale and will not be redeemed, processed or re-imbursed.
For MVA Fund, a limited claim may not be submitted after 6 months
Treatment or procedures that are not covered by the scheme or medical aid. The member is responsible for the total cost for the procedures NOT the scheme.
