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Published byMaria Stewart Modified over 8 years ago
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PROFMED BENEFITS AND NEW CHANGES FOR 2013 Carin Swanepoel
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HISTORY/DEMOGRAPHICS Profmed was established in 1959 and registered in 1960 Serves 64 000 lives Restricted medical scheme Healthy Professional risk pool
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PROFMED SCHEME DEMOGRAPHICS AS AT 2012 SOLVENCY 40+/-% PRINCIPAL MEMBERS26800 AVG CONTRIBUTION INCREASE FOR 2013 8.59% GLOBAL CREDIT RATINGAA-
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BENEFIT OPTIONS
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PROPINNACLE In Hospital Benefits Unlimited Cover 300% of Profmed Tariff Surgery & In-hospital procedures Consultations in hospital Private Ward
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PROPINNACLE Chronic Medication Unlimited cover 58 chronic conditions
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PROPINNACLE Out of Hospital Benefits 100% of Profmed Tariff GP & Specialist consultations Procedures in Doctor’s rooms
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PROPINNACLE Out of Hospital Benefits Day-to-day benefits Pooled benefit 100% of Profmed tariff MR13 000 - R 13 500 M+1R19 500 - R 20 000 Max R26 000 - R 26 000 per family
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PROSECURE PLUS In Hospital Benefits Unlimited Cover 300% of Profmed Tariff – 2013 Profmed Tariff 200% Surgery & In-hospital procedures Consultations in hospital
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PROSECURE/ PROSECURE PLUS Chronic Medication MR12 000 M+1R20 400 Family R27 000 38 chronic conditions - Unlimited
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PROACTIVE PLUS In Hospital Benefits Unlimited Cover 300% of Profmed Tariff - 2013 Profmed Tariff 200% Surgery & In-hospital procedures Consultations in hospital 26 PMB’s
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PROACTIVE In Hospital Benefits Unlimited Cover 100% of Profmed Tariff Surgery & In-hospital procedures Consultations in hospital 26 PMB’s
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Profmed Benefit Philosophy There when our members needs us Unlimited hospital cover on all options No co-payments or deposits paid in hospital In-hospital dental cover on both ProActive options Preventative care benefits on all options Oral contraceptives on all options Trauma an post HIV exposure assistance on all options
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New Benefit for 2013 HPV Vaccine International Travel Dental Benefit
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Contribution Increase for 2013 Average Increase (member weighted) – 8.59% -ProActive7.94% -ProActive Plus8.10% -ProSecure9.42% -ProSecure Plus9.28% -ProPinnacle9.26%
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CONTRIBUTIONS R0-R3000 MONTHLY INCOME ProPinnacleProSecure PlusProSecureProActive PlusProActive AdultNOT AVAILABLE NOT AVAILABLE NOT AVAILABLE NOT AVAILABLE R416 R452 Adult Dependant NOT AVAILABLE NOT AVAILABLE NOT AVAILABLE NOT AVAILABLE R416 R452 ChildNOT AVAILABLE NOT AVAILABLE NOT AVAILABLE NOT AVAILABLE R268 R290
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CONTRIBUTIONS R3001-R6 000 MONTHLY INCOME ProPinnacleProSecure PlusProSecureProActive Plus ProActive AdultNOT AVAILABLE NOT AVAILABLE R1 286 R1 412 NOT AVAILABLE R688 R746 Adult Dependant NOT AVAILABLE NOT AVAILABLE R1 286 R1 412 NOT AVAILABLE R688 R746 ChildNOT AVAILABLE NOT AVAILABLE R584 R640 NOT AVAILABLE R308 R334
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CONTRIBUTIONS R6 000 + MONTHLY INCOME ProPinnacleProSecure PlusProSecureProActive Plus ProActive AdultR3698 R4040 R2202 R2412 R1790 R1964 R1040 R1128 R924 R1002 Adult Dependant R3430 R3748 R2038 R2232 R1656 R1818 R966 R1048 R854 R926 ChildR924 R1010 R880 R940 R716 R766 R416 R440 R370 R390
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PREVENTATIVE CARE Early detection of high risk Testing for particular diseases Facilitates early treatment – maximise outcome Influenza vaccine Oral contraceptives Human papillomavirus (HPV) vaccine
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PROFMED WELLNESS Profmed partnered with Multiply to provide members with a lifestyle program to maximise health care Some of the benefits include: Online wellness profile to assess your health status Lower fees for fitness assessments Discounted gym fees Discount on selected nutritional supplements Up to 50% reduction on flights. Other rich discounts on lifestyle products
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THANK YOU
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