Claim Reimbursement Process
What is a claim?
It is financial reimbursement made to you or your service provider for medical services rendered. You may claim for reimbursement if you paid for your own treatment. Payment will be made in line with scheme rules and applicable tariffs. Submit your claims within 4 months of the treatment or service.
You have a choice of where to obtain medical services (locally, regionally and internationally) in line with your health plan.
If you are not sure whether a treatment or service is covered by your health plan, please contact our call centre on +267 3633100 for clarification.
FOREIGN CLAIM PROCESSING:
The following documentation will be required to process all claims incurred outside Botswana:
- Proof of travel (stamped passport showing departure and return dates)
- Medical report and or referral letter
- Original detailed invoice with member and service provider signature (NB: All documents to be written in or translated to English. Only translations from sworn translator will be accepted)
- Proof of payment: original or scanned receipt / proof of bank transaction / sped point slip
- All members undergoing major or planned hospital procedures outside Botswana will be required to notify the scheme of such prior to the procedure or treatment
- Reimbursement amounts will be in accordance with the exchange rate applicable and Scheme Rules and Tariffs.
To claim a refund, you will need to submit the following:
- Member needs to fill out and submit a completed Member Claim Form
- All original invoices and receipts for the treatment or service. You can post all invoices and receipts to: P O Box 632, Gaborone, Botswana (original documents) or email to firstname.lastname@example.org (scanned copies of original documents, but the originals are still needed for payment, so these can be posted)
- Bomaid does not reimburse for VAT
- The amount refunded is subject to the limitations of the member’s benefits under their scheme
- Refunds may not exceed the published Bomaid service provider tariffs
- Original invoices and receipts should be submitted for a claim to be paid
How it Works
PLEASE NOTE THAT FOR YOUR CLAIM TO BE PAID: ORIGIONAL INVOICES & RECEIPTS SHOULD BE SUBMITTED
Doctor/ Hospital/ Lab/ Pharmacy Claims
These claims are submitted by the service provider, but it is the member’s responsibility to ensure the details are correct. Payments will be deducted from your Bomaid account, and are subject to the same conditions as member claims.
View our list of registered doctors and service providers who claim directly on your behalf.