International Travel Medical Assistance


Who is covered?

All beneficiaries who are registered on the Scheme are covered under this benefit.

The benefit covers members in South Africa while travelling outside the borders of South Africa and members who reside in the SADC region when travelling outside the borders of their country of residence.

SADC region members may not access benefits when travelling to South Africa, as they will have access to their standard benefits while in South Africa.

SADC region refers to a group of countries in southern Africa, i.e. Angola, Botswana, Democratic Republic of Congo, Lesotho, Madagascar, Malawi, Mauritius, Mozambique, Namibia, Seychelles, South Africa, Swaziland, Tanzania (including Zanzibar), Zambia and Zimbabwe.

This benefit is managed by International SOS, who provides assistance to members while travelling.

How to access medical treatment

Members are not required to activate cover prior to departure.

Members requiring medical assistance outside the borders of South Africa should call International

SOS on the international emergency number +27 11 541 1225.

If circumstances permit, International SOS will arrange for a suitable, appropriate, local emergency transport organisation to assist you or you will be referred to a local suitably equipped and appropriate medical facility.

If suitable facilities are not available where you are situated, appropriate emergency transport will be despatched to evacuate you to the nearest centre of medical excellence or to repatriate you to South Africa, provided that you are fit to travel.

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What is covered?
Members on all options are covered up to the limit of R6 million per beneficiary per journey for a travel period of not longer than 90 days, with no exclusions imposed on age or pre-existing medical conditions.

However, members in a general waiting period will not be entitled to any benefits during this period and members in a condition-specific waiting period will not be entitled to benefits relating to that condition, during this period.

Members on the ProActive Plus and ProActive options are not covered for out-of-hospital expenses. Members on the ProPinnacle, ProSecure Plus and ProSecure options are entitled to out-of-hospital cover while travelling internationally provided such cover is offered on their benefit option, but out-of-hospital expenses are subject to an excess of R1 100.

All medical expenses while travelling, whether in-hospital or out-of-hospital, are funded from the
R6 million limit.

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Embassy letter for visa requirements
If you require an embassy letter, you can request it directly from the Profmed app. The app can be downloaded for Apple and Android devices. Alternatively, request your letter from Client Services on 0860 679 200, Mondays to Fridays between 07:30 and 18:00, and Saturdays between 08:00 and 12:00, exclusive public holidays.

How to avoid a co-payment

If you want to avoid a co-payment, it is important that you contact International SOS prior to receiving in-or out-of-hospital treatment. To access treatment while travelling call +27 11 541 1225.

All claims will be assessed in terms of the Scheme rules and International SOS protocols. Co-payments may apply if the member/patient does not contact International SOS prior to obtaining treatment.

If you are travelling for longer than 90 days or should you require additional travel insurance, contact your travel agent prior to departure.

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How to request an extended supply of medication
Members who are registered for chronic medication and travelling outside the borders of South Africa can apply for an extended supply of chronic medication for a period of up to three months.

You need to apply at least seven working days prior to departure. To request your extended supply of medication, contact us on 0860 679 200 or send an e-mail to info@profmed.co.za.

Please remember to provide us with your member number, name and surname of the beneficiary, the name of the medication, the amount of medication required as well as the expected purchase date.

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How to submit a claim
Claims paid personally must be submitted with the following documentation:

  • Copy of identity document of the member and claimant/patient
  • Fully completed international travel claim form
  • Proof of travel (passport, airline ticket, etc)
  • Medical report from the attending doctor.

Claims must be submitted within four months from the date of treatment. Please note that claims will not be processed should all the required documentation not be submitted.

Co-payments could apply if International SOS was not contacted for assistance or if treatment is contrary to the Scheme rules and International SOS’s protocols.

Claims can be submitted as follows:

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ELIGIBILITY
Membership of Profmed is only available to persons who have obtained:

  • A degree and/or qualification of four years or more
  • Two three-year degrees
  • A three-year degree with a post-graduate qualification of not less than one year

*Eligibility rules apply.

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