Suremed Information

Waiting Periods

Please take note of your “Benefit Date” as indicated on your membership card. This is the date from which you qualify for benefits from Suremed Health. This may well differ from your “Joining Date” which is the date from which your contributions are due.

Membership

  • Please ensure that your details and those of the dependants listed on your membership card are correct.
  • Should you require any amendments to your card, please contact your broker or MomentumTYB for the relevant form.
  • A member may apply to register a newborn or newly adopted child as a dependant within 30 days of the date of birth or adoption of the child. Increased contributions shall be due as from the first day of the month following the month of birth or adoption and benefits will accrue as from the date of birth or adoption.
  • Students studying at recognised institutions may continue membership to the age of 25 as a child dependant, provided that documentation certifying their age and student status is produced each year.
  • Children over the age of 21 may remain on the scheme if financial dependency is proved for support from the main member, but will be charged at the same rate as an adult dependant.

Termination of Membership

Members are advised that unless they terminate their membership in writing, before the last working day of the month prior to the month of termination, they will remain liable for the contributions. Therefore, it is in your best interests to confirm that such termination has been received and acknowledged by MomentumTYB on behalf of the scheme.
A full month’s notice period is required.

Designated Service Provider (DSP)

The Medical Schemes Act 131 of 1995, as amended, has been revised to provide Prescribed Minimum Benefits (PMBs) for the treatment of 25 chronic conditions and any emergency medical condition. Members are advised that the scheme will appoint Designated Service Providers (DSPs) from time to time. Details of the appointed DSP will be advised at the time of the member requiring authorisation for benefits relating to any of the PMB conditions. Members who choose not to use the DSP and cannot demonstrate that they have attempted to obtain this treatment from a DSP, could be liable for co-payment. Should the scheme approved DSP be unable to accommodate you, please contact the scheme as it is continually evaluating and appointing new service providers.

Pharmacy Advised Therapy (PAT)

You may buy medication from a pharmacy, for which you do not require a doctor’s prescription. These are medicines that are classified as schedule 1 and schedule 2 drugs, which generally do not pose a serious danger to your health when taken without constant supervision from a doctor. It is always advisable to obtain your pharmacist’s advice on what medication to take for your condition. This benefit is included in your prescribed medication benefits and can be accessed by your pharmacist through the normal claiming process.