FAQs

Designated Service Providers are providers that the scheme has agreements with and the members must make use of these providers in order to avoid co-payments and enjoy benefits.

Yes, until the last day of membership provided contributions are being paid.

Yes – as soon as your baby is born, he or she is eligible to be added as your dependant to your medical aid, and they’ll be covered immediately. To ensure your baby is covered without any waiting periods, medical schemes can request that the baby is added within 30 days of the baby’s birth. If you add your baby after this period, your child may be subject to waiting periods which can be 3 months general waiting period or 12 months if your baby was born with a specific condition.

Yes, you can take out medical aid you’re already pregnant, although any costs associated with your antenatal care and the birth of your baby will not be covered by your new medical aid for a period of 12 months.

Can I add my boyfriend or girlfriend as a beneficiary on my medical aid?

Yes. If your boyfriend or girlfriend is living with you, you will be able to add them as an adult dependant to your medical aid – just as you would if they were your spouse if you can prove that they are financially dependent on you.

Yes – customer transferring from another medical aid are welcome to join Bomaid. We would need you to complete a membership application available on our website and your preferred health plan. Please attach an original certificate of membership from your previous medical insurance to your application form if:

• Your Membership period was more than two years
• The period between your break from previous medical aid to application for joining Bomaid is no more than three months

Late joiner fee can be applied by medical aid fund if you join after the age of 35, or if you haven’t belonged to a medical aid fund for a specific period. Fees applied vary depending on the medical aid fund concerned but are calculated as a percentage of your monthly contribution.

Any ailment, illness, or condition that, in the opinion of a medical advisor appointed by the Fund and with reasonable medical certainty, existed at the time of the member joining the Fund. The pre-existing condition waiting period applies to new members.

A portion of the bill for which the member is responsible. Some options have co-payments for certain procedures meaning that the member needs to pay the designated amount when receiving treatment for that procedure. The term co-payment can also be used to describe the member’s portion of the bill if the scheme/option only covers treatment at a certain % and the provider charges above that %.

The period in which a Member is not entitled to claim any benefits. Delayed period is normally applied on new members joining a medical aid and further imposed on certain benefits like specialised dentistry, chronic conditions etc. There are two kinds of waiting periods i.e.:

• General waiting period of up to three months.
• Condition-specific waiting period of up to 12 months

There are four base options that one can choose from i.e. Access, Comprehensive, Executive, Prestige. After selection of base cover, you can now select the level of outpatient cover:

Core -Basic outpatient cover. Offers minimum cover

Plus -Unlocks additional outpatient benefits

Extra -Provides more access to more cover for consultation

Max-Unlocks maximum outpatient benefits available with the fund

In-patient care refers to medical treatment and services that are provided to a patient who has been admitted to a hospital, or other equivalent healthcare facility and requiring an over-night stay or more.

Out-patient care, also known as ambulatory care, refers to medical services and treatments that are provided to patients who do not require an overnight stay in a hospital or healthcare facility. Instead, patients receive care on an appointment basis and return home the same day.

PAC stands for Principal; Adult & Child dependants

With the New Health plans, the fund has also introduced a New Pricing Model. This model is simple, accurate and differentiates pricing for child and adult dependants and one can add a dependant from any of the available options.

PAC is cheaper and recognises the individual differences and healthcare needs especially for individual customers and younger families This means that a customer is charged monthly subscription according to their health plan, age, and the number of dependants they have on their health plan.

To register a company, we will need for following company registration documents

• Certificate of incorporation
• Company Extract
• Completed Company Registration and Debit Authorisation form
• Identification documents of the person (s) managing the company
• Resolution specifying who is authorised to act on behalf of the company and their partnership
• Identification document (s) of the person authorised to act on behalf of their partnership
• Corporate Company KYC
• Individual KYC (completed by Company Representative)
• Confirmation of Employment letter (Company Representative)

Spouse/Adult Dependent:

• A certified ID copy or passport copy for non-citizens
• Marriage certificate
• Residence permits for non-citizens

Children

• Birth certificate (for minors) and Omang copy for those over 16 years

Parent:

• Certified copy of Omang
• Residence permits for non-citizens

People such as a spouse or children who are under your medical aid policy, whereby you are the primary or Principal Member. A dependant is any individual who belongs to a Principal Member’s health plan, and whose medical aid fees are covered by the principal member. For example, if a principal member adds their children to their medical aid plan, their children are the dependants on that plan. Individuals who qualify as dependants are spouses, children (including stepchildren, adopted children), parents of the Primary Member.

Any person duly admitted to the membership of the Society and who is the policy holder.

You will need to attach the following documents to your application:

Principal Member:

• Certified Identity Document Copy
• Passport copy, residence and work permit (for non-citizens)
• Source of income in the form of either:
• Employment letter stating salary
• Affidavit confirming source of funds, postal and physical address if you are self employed
• Copy of payslip

2. Proof of residence

• Confirmation of employment stating residential address
• Affidavit
• Residential Lease
• Utility bill bearing your name and residential address

3. Proof of bank account

• Bank letter or Bank statement
• Payslip with banking information

Yes, we have travel cover for members who are in Scheme B and Scheme C Health Plans. The Travel Cover offers medical emergency cover for 90 days from date of departure outside the borders of Botswana. Kindly contact us on 3633100 for more information on this benefit.

Alternatively, members who travel outside Botswana and are not either on Scheme B or Scheme C, will be subject to Bomaid’s ‘Foreign Claim Processing’ requirements as indicated under ‘Claim Reimbursement’

An employee retiring from a Constituent Body on pension (normal retirement age 65 years) or who terminates his employment on account of early retirement due to ill health (age 55) and who has at the date of retirement paid subscriptions to Bomaid for a minimum period of ten years shall have the option at the date of retirement of applying for pension membership.

You can apply for Bomaid membership either as an individual or a corporate member

Individual member - customers applying in their own capacity

Corporate member - customers applying under a company/employer group. Normally a group of 10 or more members