Questions about benefits
1. How do I know what my benefits are?
For more information benefits, please access the Remedi Benefit Brochure.
2. Are benefits restricted to specific network providers on my Benefit Option?
Click here to view your benefits.
Questions about claims
1. I will be travelling outside the borders of South Africa. Does Remedi provide benefits for "foreign claims"?
No, Remedi members do not have access to the Discovery Health International Travel Benefit.
It is important to note that the Scheme does not make provision for international emergency evacuation services. Members are required to make provision in their personal capacity for international emergency evacuation services, if the need arises while travelling or living outside the borders of the Republic of South Africa.
Questions about your Personal Medical Savings Account (PMSA)
1. What is the Personal Medical Savings Account (PMSA)?
The Personal Medical Savings Account gives members on the Comprehensive Option a way to save money for when they have to visit the doctor, buy medicine at a pharmacy or pay for other day-to-day medical expenses. If you do not use all the funds in your Personal Medical Savings Account during the year, we give you interest on the positive balance and carry it over to the next year.
2. What is paid from my Personal Medical Savings Account (PMSA)?
We pay for the following from the Insured Out-of-hospital Benefit before using the money in your PMSA:
- GPs
- Medical specialists
- Conservative dentistry
- Prescribed acute medicine and injection material
- Physiotherapy, speech therapy, and occupational therapy
- Clinical psychologists
- Social workers
- Eye tests, spectacles or contact lenses and refractive eye surgery
- Radiology: Without hospital admission (excluding MRI and CT scans)
- Pathology: Without hospital admission.
We cover these from the PMSA only:
- Chiropractor, homeopath, osteopath, herbalist, naturopath or dietitian
- Other Contraceptives except oral, emergency pill, condoms and the Mirena device, which if approved, are funded from available benefits as applicable
- Preventive medicine for malaria
- Immunisations, except influenza, pneumococcal vaccines and HPV vaccines, which are covered from the Prevention and Screening Benefit.
3. Who controls the money in my Personal Medical Savings Account?
Since the money in your Personal Medical Savings Account is your money to spend wisely, subject to legislation around what this money may be used for, you may use a service provider of your choice for benefits that will be paid from your Personal Medical Savings Account. However, claims will still be paid according to Remedi rules, as long as there is money available in your Personal Medical Savings Account. If there is no money available in your Personal Medical Savings Account, you will have to pay the outstanding amount directly to the service provider.
4. What happens to the balance in my Personal Medical Savings Account at the end of the year?
If you do not use all the funds in the Personal Medical Savings Account during the year, we give you interest on your positive balance and carry it over to the next year.
5. How can I find out what amount I have available in my Personal Medical Savings Account?
You can find out in one of the following ways:
- Log in to the Remedi website at www.yourremedi.co.za
- Call the Remedi call centre on 0860 116 116.
- Check your most recent claims statement.
6. What happens to the money in my Personal Medical Savings Account if I leave Remedi?
If you resign from Remedi and still have funds in your Personal Medical Savings Account, we will transfer the money to your new medical scheme (if the health plan you move to has a savings account) or refund the money to you four months after transfer if you do not move to a new medical scheme. We follow the requirements in the Medical Schemes Act when we refund.
Questions about emergency services and pre-authorisation
1. What must I do if there is an emergency and someone in my family needs an ambulance?
In a medical emergency, call ER24 on 084 124, at any time of the day or night to obtain authorisation for emergency transportation. Highly qualified emergency personnel from ER24 manage this service. They will send an ambulance or helicopter when you've been in accident or other emergency. This emergency medical transport is covered from your Risk Benefit, whether you are admitted to hospital or not, if you obtain authorisation from ER24. Otherwise, go straight to the emergency room yourself - but get someone to call us within 12 hours if you are admitted to hospital. Your emergency treatment in hospital will be covered according to your Option's benefits. You have full emergency cover. There are times when you may not have access to cover on your Benefit Option, for example when you have run out of benefits, reached a benefit limit or when you are in a waiting period. If you are covered for Prescribed Minimum Benefits, you will still be covered for a life-threatening emergency.
2. Who do I contact for preauthorisation for an emergency hospital admission?
In an emergency, go straight to hospital. If you need medically equipped transport, call 084 124. This line is managed by highly qualified emergency personnel who will send emergency transport to you. It is important that you, a loved one or the hospital let us know about your admission as soon as possible, so that we can advise you on how you will be covered for the treatment you receive. Call us on 0860 116 116.