With Profmed, your child’s important immunisations are covered
Our Preventative Care benefit covers child immunisations according to the Department of Health Immunisation Schedule.
All expectant mothers who register on Profmed Baby receive a fridge magnet listing these immunisations.
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.
Members in a general waiting period or a condition-specific waiting period will not be entitled to any benefits during the waiting.
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, 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 a minimum co-payment of 20%. 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 for a period of up to three months.
Claims paid personally 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.