Who is covered?
All beneficiaries who are registered on the Scheme are covered under this benefit.
The benefit covers members travelling outside South Africa, as well as 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.
Members are not required to activate cover prior to departure.
SADC Region refers to a group of countries in southern Africa, including Angola, Botswana, Comores, 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.
Other important information
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. Only emergency and unexpected medical events will be covered. No elective or pre-planned medical treatment will be covered.
If you are travelling for longer than 90 days or should you require additional travel cover over and above what Profmed provides, contact your travel agent to make the necessary arrangements prior to departure to ensure you have appropriate cover for the duration of your travel.
Members in a general waiting period will not be entitled to any benefits during the waiting period. Members in a condition-specific waiting period will not be entitled to benefits for that specific condition.
Members on the ProActive and ProActive Plus options, and the Savvy equivalents are not covered for out-of-hospital expenses. Members on the ProSecure, ProSecure Plus and ProPinnacle options, and the Savvy equivalents are entitled to out-of-hospital cover, provided such cover is offered on their benefit option, but out-of-hospital expenses are subject to an upfront co-payment of R1 500.
All medical expenses while travelling, whether in-hospital or out-of-hospital, are funded from the R6 million limit.
If you require an embassy letter, you can obtain 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, excluding public holidays.
If you want to avoid a co-payment, it is important that you contact International SOS prior to receiving any treatment, whether in- or out-of-hospital treatment.
If International SOS is not contacted prior to medical treatment being accessed and the treatment is found to be inconsistent with the medical condition or that the cost of the treatment is in excess of what International SOS would have negotiated with service providers, you will be responsible for the cost of the treatment or a minimum co-payment of 20%, whichever is applicable. All claims will be assessed in terms of the Scheme rules and International SOS protocols.
To access treatment while travelling call +27 11 541 1225.
Members who are registered for chronic medication and travelling outside the borders of South Africa can apply for an extended supply of chronic medication of not more than three months.
Claims paid by you must be submitted with the following documentation:
- Copy of identity document of the member and the 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.