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w w w . c a m a f . c o . z a
                                                 1.      Important Numbers                                          2

                                                 2.      Introduction                                               3

                                                 3.      Glossary                                                   4

                                                 4.      Benefit Options
                                                         Progressive Generation Benefit Options                     5

                                                               CA–Vital
                                                               CA–Double Plus
                                                               CA–Alliance
                                                         Other Benefit Options                                      7

                                                               CA–First Choice
                                                               Network Choice
                                                 5.      Details of 2007 Benefit Options                            9

                                                 6.      2007 Monthly Contribution Rates                            14

                                                 7.      Overview of Healthcare Programmes                          16

                                                 8.      Chronic Condition Benefits                                 17

                                                 9.      How to access your Chronic Medication                      21

                                                 10. Pre-authorisation and Exclusions                               22

                                                 11. The Claiming Procedure                                         23

                                                 12. Netcare 911 and Communications                                 24




PLEASE NOTE This brochure is for summary purposes only and does not supersede the rules of the Scheme in any way.

                                                                                                                         1
                                                                  Mother-to-be Programme
    CAMAF                                                         Telephone                                                 0860 100 544

    Client relations                 0860 100 545
    E-mail                   custserv@camaf.co.za                 Mental Wellness Programme
    Fax                              0861 113 676
    Reception                        0861 700 600                 Telephone                                                 0860 100 544

    Pre-authorisations                0860 100 544
    Pre-authorisations fax            011 706 9946                Netcare 911
    E-mail              preauth@eternityhealth.com
                or apply on-line at www.camaf.co.za               Emergency number                                           082 911
                                                                  Fax                                                   011 254 1950
    Website                       www.camaf.co.za                 Namibia                                           09264 61 230 612
    Membership fax                  011 707 8735

                                                                  Respiratory Programme
    Cancer Wellness Programme
                                                                  Telephone                                                 0861 700 600
    Telephone                        0860 100 544

                                                                  Stressline
    Cardiac Support Line
                                                                  Telephone                                            0861 700 600
    Telephone                        0860 100 544                 E-mail                                     stressline@camaf.co.za


    Centre for Diabetes and                                       SwiftAuth/Chronic Condition
    Endocrinology                                                 Authorisation
    Emergency Hotline                082 456 7844                 For Doctors & Pharmacists only                            0800 200 300
    General enquiries                011 712 6000                 Fax                                                       011 706 9946


    Concierge Programme                                           For Patients ONLY
    General enquiries                0861 112 922                 Chronic medication /
                                                                  Clinical Risk                                             0861 700 600

                                                                  Chronic medication /
                                                                  Clinical Risk fax             011 706 9946
                                                                  E-mail disease.management@eternityhealth.com




                                       PLEASE NOTE This brochure is for summary purposes only and does not supersede the rules of the Scheme in any way.

2
   Welcome to CAMAF, the Chartered Accountants
   (SA) Medical Aid Fund, the Scheme that offers
   our exclusive membership base exceptional
   healthcare cover at outstanding rates.

   There is no doubt that enormous changes                                                  traditional, reactive focus on benefit limitations
   continue to take place in the management of                                              and generic treatment plans towards a pro-
   healthcare and CAMAF remains committed to                                                active patient focussed partnership. 2007 sees
   maximising its contribution to the wellbeing of its                                      the exciting introduction of metabolic screening
   members.                                                                                 tests for newborn babies.

   CAMAF effectively manages the challenges of                                              These tests make use of the latest technology
   new legislation and complex regulation                                                   available at Lancet laboratories to screen for up to
   changes resulting in revisions to many of the                                            15 different types of inborn errors of metabolism
   benefit structures and product designs. The                                              (IEM) at once. By testing for these metabolic
   robustness of the product design is visible                                              disorders parents can be assured that treatment
   when reflecting the solvency ratio of the Scheme                                         and dietary changes can be implemented sooner
   which is 39.7%.                                                                          rather than later. Please contact the Mother-to-
                                                                                            be Programme on 0860 100 544 for more
   CAMAF continues to place a large emphasis on                                             information
   preventative rather than curative healthcare
   interventions. The preventative wellness cover                                           This brochure sets out the benefits to which
   offered on the benefit options aims to encourage                                         members can look forward to in 2007.
   our members to pro-actively manage their
   wellbeing by having the necessary annual                                                 PLEASE NOTE: The rules of the Scheme will be
   check-ups. CAMAF’s approach has changed the                                              available on our website (under ‘Downloads’)
                                                                                            at www.camaf.co.za. Further more this brochure
                                                                                            is for summary purposes only and does not
                                                                                            supersede the rules of the Scheme in any way.

                                                                                            We believe CAMAF’s benefits and service
                                                                                            continue to be one the healthcare industry's
                                                                                            benchmarks but we continually review our
                                                                                            service to ensure we meet the high expectations
                                                                                            of our elite membership base.


PLEASE NOTE This brochure is for summary purposes only and does not supersede the rules of the Scheme in any way.

                                                                                                                                                   3
                                Adult         All persons turning 22 in the calendar year of cover
                                 Child        Dependants under the age of 22 in the calendar
                                              year of cover
                       Day-to-day             Benefits available for out of hospital treatment
                                              e.g. dentistry, doctors visits etc.
                                  MSA         Medical Savings Account is a top-up cover available
                                              for day-to-day benefits over and above normal
                                              day-to-day benefits
                                  OTC         Over the counter medication
                                  PMB         Prescribed Minimum Benefits, stipulated procedures
                                              and conditions that all Medical Schemes should
                                              cover as set down in the Medical Schemes Act, 1998
              Principal Member                Main member of the Scheme
                                  TTO         To take out medication is medication that is given
                                              to you when leaving hospital
                                   CDL        Chronic Disease List is a list of 27 conditions that
                                              must be covered, as set down by legislation, by
                                              all Medical Schemes
       NHRPL (National Health
          Reference Price List)               This is the rate published by the Council for
                                              Medical Schemes. This was originally referred to
                                              as ‘Scale of Benefits' (SoB)
                  Scheme Tariff               This rate is either a private rate or a rate
                                              specifically negotiated, by the Scheme, with
                                              the service provider
               Single Exit Price              This rate refers to a standard cost for medication
                                              (wholesale price)
                Dispensing fee                Refers to the legislated fee charged by dispensers
                                              of medication. It does not include any additional
                                              fees that may be charged
            Designated Service
      Provider Network (DSPN)                 The network of service providers contracted to
                                              provide healthcare services to Network Choice
                                              members
         Statutory health cover               Refer to the benefit options details                 (page 9)

              Vital health cover              Refer to the benefit options details                 (page 9)

    Preventative wellness cover               Refer to the benefit options details                 (page 14)



                PLEASE NOTE This brochure is for summary purposes only and does not supersede the rules of the Scheme in any way.

4
         CAMAF Progressive Generation
                      Benefit Options


                                                 The diagram on the next page details the three
                                                 progressive generation benefit options. All options
                                                 include:

                                                 •     statutory health cover,
                                                 •     vital health cover;
                                                 •     preventative wellness cover;
                                                 •     day-to-day cover (excluding CA-Vital) and
                                                 •     medical savings account
                                                       (excluding CA-Vital)

                                                 Statutory health cover includes cover for all
                                                 legislated conditions. As a standard benefit both
                                                 CA-Double Plus and CA-Alliance provide you with
                                                 day-to-day cover in addition to your statutory
                                                 health cover, vital health cover and preventative
                                                 wellness cover. Your day-to-day claims will be
                                                 paid from your CAMAF portion at 80% of NHRPL
                                                 and the balance will be paid from your medical
                                                 savings account (MSA).




PLEASE NOTE This brochure is for summary purposes only and does not supersede the rules of the Scheme in any way.

                                                                                                                    5
           MSA




                                                                                    MSA
           Day-to-day




                                                           Day-to-day                            Day-to-day
                                                              80% NHRPL                             80% NHRPL




                                            Preventative Wellness Cover
                                                             100% NHRPL




                                                *Radiology - 100% NHRPL
                                              *Pathology - 100% Scheme Tariff
    Vital health cover
    (non-PMB costs)
        Level 1 B




                                                     Attending Doctors
                                                         100% Scheme Tariff




                                Health cover for hospitalisation 100% Scheme Tariff
                             and the diagnosis, treatment and medication for any
                               additional chronic condition over and above the
                                            statutory requirements
                                                             100% NHRPL
    Statutory health cover
         (PMB Costs)




                                Health cover for the diagnosis, treatment and
          Level 1 A




                                      medication for all PMB conditions
                                                Refer to page 19 for details of cover




                               * Treatment must be performed by a specialist radiologist and pathologist




                                       PLEASE NOTE This brochure is for summary purposes only and does not supersede the rules of the Scheme in any way.

6
                                  OTHER
             CAMAF Benefit Options namely:


                                                  •     CA-First Choice
                                                  •     Network Choice

                                                  CA-First Choice offers statutory health cover, vital
                                                  health cover and day-to-day cover; contributions
                                                  for this option are based on your family’s gross
                                                  monthly household income.

                                                  Network Choice makes use of a Designated Service
                                                  Provider Network (DSPN) with contributions for
                                                  this option being based on your family’s gross
                                                  monthly household income.

                                                  Network Choice has chosen the Medicross clinics
                                                  for Primary healthcare, the PPN Network for
                                                  Optometry and the Medicross contracted network
                                                  for all hospitalisation treatment.

                                                  Medicross and PPN offer a seamless integration of
                                                  primary healthcare services including:

                                                  •     General Practitioners (GPs);
                                                  •     Basic Dentistry;
                                                  •     Basic Radiology;
                                                  •     Basic Optometry;
                                                  •     Basic Pathology; and
                                                  •     A pharmacy.

                                                  The wide range of services and value for money
                                                  offered to CAMAF makes Medicross the ultimate
                                                  choice; we sought high-value healthcare without
                                                  compromising the quality of service to our members.




PLEASE NOTE This brochure is for summary purposes only and does not supersede the rules of the Scheme in any way.

                                                                                                                    7
                                                                                                        Day-to-day
             Day-to-day




                                                Day-to-day                                     Unlimited cover through a DSPN
                                   80% NHRPL (See pages 11-12 for details)              and the benefits include: GP, basic dentistry,
                                   Includes cover for all other conditions not           basic radiology & pathology out of hospital,
                                           listed on the statutory list                   basic acute medication, basic optometry




                                   Preventative Wellness Cover
                                                  80% NHRPL




                                                Radiology*                                       Pathology      (in hospital)
                                                 100% NHRPL                                        Covered at 100% NHRPL
                                                Pathology*                                             through a DSPN
                                                 100% NHRPL
    Level 1 B - Additional Cover
         Vital health cover
          (non-PMB costs)




                                                                                                Radiology (in hospital)
                                          Attending Doctors                                   Basic Radiology through a DSPN
                                                 100% NHRPL                               Advanced Radiology through a DSPN and
                                                                                               subject to R15 000 per family




                                           Health cover
                                      for hospitalisation over                              Hospital Accommodation
                                      and above the statutory                                      Covered at 100% NHRPL
                                                                                                       through a DSPN
                                           requirements
                                                 100% NHRPL




                                                                                                    CDL Medication
    Statutory health cover




                                        Health cover for the                                    100% Single exit price plus a
                                                                                            dispensing fee as per DSPN formulary
                                        diagnosis, treatment
         (PMB Costs)
          Level 1 A




                                         and medication for
                                         all PMB conditions
                                              100% Scheme tariff
                                                                                         Prescribed Minimum Benefits
                                                                                          Covered at 100% NHRPL through a DSPN




                                             * Treatment must be performed by a specialist radiologist and pathologist




                                                 PLEASE NOTE This brochure is for summary purposes only and does not supersede the rules of the Scheme in any way.

8
                                                     Progressive Generation                                                  Other Benefit Options
                                    Cover               Benefit Options

                                                              CA-Vital
                                                           CA-Double Plus                                 CA-First Choice                   Network Choice
                                                             CA-Alliance

                                                                   LEVEL 1 A - STATUTORY COVER

          Prescribed Minimum                        Chronic Condition Benefits                    Chronic Condition Benefits             Chronic Condition Benefits
                      Benefits                            table (Page 19)                                        (Page 19)                        (Page 19)


           Chronic Disease List                       100% single exit price        100% single exit price                                 100% single exit price
                   (Chronic Medicines)            plus a dispensing fee. Subject plus a dispensing fee. Subject                             plus a dispensing fee
                                                   to protocols and formulary     to protocols and formulary                               as per DSPN protocols

LEVEL 1 B ADDITIONAL STATUTORY & VITAL HEALTH COVER (excludes out-patient or casualty services at a hospital)

                   Hospitalisation                     100% Scheme tariff in                         100% Scheme tariff in                   100% DSPN tariff
                  accommodation                          general wards and                             general wards and                      as per protocols
      (subject to pre-authorisation)                      specialised units                             specialised units

              Attending Doctors                          100% Scheme tariff                                 100% NHRPL                    100% DSPN tariff as per
                   & Specialists                                                                                                          protocols (100% NHRPL)

              Supplementary                                   100% NHRPL                                    100% NHRPL                    100% DSPN tariff through
        healthcare in hospital                                                                                                          a DSPN limited to R 5 000 per
             (eg: Physiotherapy)                                                                                                         family (Physiotherapy only)

           Medical & surgical                            100% Scheme tariff                                 100% NHRPL                    100% DSPN tariff as per
       procedures in hospital                                                                                                             protocols (100% NHRPL)

       Medication in Hospital                          100% single exit price                        100% single exit price                100% single exit price
                                                        plus a dispensing fee                         plus a dispensing fee                 plus a dispensing fee
                                                                                                                                           as per DSPN protocols

                                      TTO              100% single exit price                        100% single exit price                100% single exit price
           (to take home medication                     plus a dispensing fee                         plus a dispensing fee                 plus a dispensing fee
            up to one weeks supply)                                                                                                        as per DSPN protocols

            Post hospitalisation                         100% Scheme tariff                                   No Benefit                         No Benefit
                                                           up to 90 days

 Home nursing (up to 21 days,                                 100% NHRPL                                    100% NHRPL                        Subject to case
       subject to pre-authorisation)                                                                                                          management and
                                                                                                                                              pre-authorisation

          Step down approved                             100% Scheme tariff                            100% Scheme tariff                     Subject to case
facilities only, up to 90 days                                                                                                               management and
      (subject to pre-authorisation)                                                                                                         pre-authorisation

                            Radiology                         100% NHRPL                                    100% NHRPL                        Basic Radiology
                    (in hospital and                                                                                                          through a DSPN
       subject to pre-authorisation)

                            Pathology                    100% Scheme tariff                                 100% NHRPL                       100% DSPN tariff
                             (in hospital)                                                                                                    as per protocols

                            Radiology                         100% NHRPL                              100% NHRPL limited                      Basic Radiology
                       (out of hospital)                                                                   to R 1 600                        100% DSPN tariff
                                                                                                    per beneficiary per year                  as per protocols

                            Pathology                    100% Scheme tariff                     100% NHRPL limited to R 2 650                100% DSPN tariff
                       (out of hospital)                                                          per beneficiary per year                    as per protocols



     PLEASE NOTE This brochure is for summary purposes only and does not supersede the rules of the Scheme in any way.

                                                                                                                                                                    9
                                                                                                                                                                    9
                                               Progressive Generation
                               Cover                                                                                 Other Benefit Options
                                                  Benefit Options


                                                        CA-Vital
                                                     CA-Double Plus                                CA-First Choice                             Network Choice
                                                       CA-Alliance

                                          LEVEL 1 B ADDITIONAL STATUTORY & VITAL HEALTH COVER

                   MRI & CT scans                       100% NHRPL                                100% NHRPL                             Advanced radiology through
         (subject to pre-authorisation)                                                        limited to R 12 720                       a DSPN limited to R 15 000
                                                                                             per beneficiary per year                        per family per year

              Chronic Medication                  100% single exit price                       100% single exit price                    100% single exit price plus
         (subject to pre-authorisation)            plus a dispensing fee                        plus dispensing fee                        dispensing fee for CDL
                                                                                              for CDL conditions only                     conditions only through a
                                                                                                                                        DSPN and based on formulary

            Additional Chronic                Chronic Condition Benefits                            Not applicable                                 Not applicable
        condition consultations                     table (page 19)

                      Confinement             100% up to Scheme tariff                            100% NHRPL                              100% Scheme tariff subject
                                                 for practitioners and                        for practitioners and                          to an overall limit of:
                                               100% Scheme tariff for                       100% Scheme tariff for                        3 days for natural birth and
                                              accommodation in general                     accommodation in general                           4 days for c-section
                                              wards and specialised units                  wards and specialised units

            Infertility treatment               CA-Vital: diagnosis subject to PMB         Diagnosis subject to PMB                         Diagnosis subject to PMB
                                                   but no benefit for treatment           but no benefit for treatment                        through a DSPN but
                                                 CA-Double Plus & CA-Alliance:                                                              no benefit for treatment
                                                  diagnosis subject to PMB and
                                                   treatment annually up to a
                                                maximum of R 21 190 per family


              Internal prosthesis                       100% of cost                                 100% of cost                               100% DSPN limited
         (subject to pre-authorisation)                                                                                                             to R 15 000
                                                                                                                                                per family per year

             External appliances            100% of cost subject to an annual overall
              100% off cost in and          limit of R 15 900 per beneficiary per year
                   out of hospital            and subject to the following sub-limits       100% of cost in hospital                             100% DSPN tariff
     (Purchase, hire and maintenance)                1. Hearing aids: R 12 750              and 80% of cost out of                                limited R 5 000
                                            2. Wheelchairs for Quadriplegics: R 26 500    hospital with an overall limit                        per family per year
                                               3. Wheelchairs for others: R 15 900         of R 6 350 per beneficiary
                                            4. Additional external appliances: R 5 300


              Blood transfusions                        100% of cost                                 100% of cost                             100% of cost limited
               (in and out of hospital)                                                                                                       to R 6 000 per family

                 Substance abuse                PMB applied to hospital         PMB applied to hospital     PMB applied to hospital based
                                             based treatment and limited     based treatment and limited     treatment and limited to one
                                            to one rehabilitation treatment to one rehabilitation treatment   rehabilitation treatment per
                                                per beneficiary per year        per beneficiary per year      beneficiary per year subject
                                              subject to pre-authorisation    subject to pre-authorisation   to pre-authorisation through
                                                 and limited to 21 days          and limited to 21 days     a DSPN and limited to 21 days

                   Immunisations                  Single exit price plus                      Single exit price plus                                Not applicable
                                                     a dispensing fee                            a dispensing fee
                                                     limited to R 530                            limited to R 530
                                                 per beneficiary per year                    per beneficiary per year




                                                           PLEASE NOTE This brochure is for summary purposes only and does not supersede the rules of the Scheme in any way.

10
                                                         Progressive Generation
                                      Cover                                                                                     Other Benefit Options
                                                            Benefit Options


                                                                  CA-Vital
                                                               CA-Double Plus                                    CA-First Choice                    Network Choice
                                                                 CA-Alliance

                                                                     PREVENTATIVE WELLNESS COVER

       One GP Consultation ONLY                           100% NHRPL up to a                                 80% NHRPL up to a                 Included in GP, specialist &
                                                           maximum of R 145                                  maximum of R 145                     basic dentistry (below)
                                                         per beneficiary per year                          per beneficiary per year

One specialist consultation ONLY                         100% NHRPL up to a              80% NHRPL up to a                                     Included in GP, specialist &
(including gynaecologists, urologists                     maximum of R 360               maximum of R 360                                         basic dentistry (below)
      pulmonologist and physicians)                  per adult beneficiary per year per adult beneficiary per year

One dentistry consultation ONLY                           100% NHRPL up to a                                 80% NHRPL up to a                 Included in GP, specialist &
               (excluding CA-Vital)                        maximum of R 115                                  maximum of R 115                     basic dentistry (below)
                                                         per beneficiary per year                          per beneficiary per year

     One optometry consultation                           100% NHRPL up to a                                 80% NHRPL up to a                        Part of spectacle
              (excluding CA-Vital)                         maximum of R 245                                  maximum of R 245                         and lenses cover
                                                         per beneficiary per year                          per beneficiary per year

                       Psychotherapy                      100% NHRPL limited to                            80% NHRPL limited to                Included in GP, specialist &
                                                          R 3 180 per beneficiary                          R 2 650 per beneficiary                basic dentistry (below)
                                                                 per year                                         per year

             Metabolic screening                         100% NHRPL limited to                             80% NHRPL limited to                            No benefit
             for new born babies                        R 550 per new born baby                           R 550 per new born baby


                                                                         LEVEL 2 - DAY-TO-DAY COVER

                                                               CA-Double Plus                                    CA-First Choice                    Network Choice
                                                                 CA-Alliance

                                                                All pooled benefits and beneficiary specific limits
                                                                                                                                                       Through a DSPN
                                                       are subject to the availability of the annual overall day-to-day limit


                                                              Annual overall                               Beneficiary specific
                                                             day-to-day limit                              sub-limits (per year)
                                                              CA-Double Plus                            (a) Medicines R 1 170 and
                                                          Adult     R       4 560                       (b) Specialised dentistry
                                                                                                            R 2 450 and                              Unlimited through
                                                          Child     R       3 360
                                                                                                        (c) Optometry                                     a DSPN
                                                                CA-Alliance
                                                                                                            refer to “Spectacles & lenses”
                                                          Adult     R     11 520
                                                                                                            section and
                                                          Child     R       8 400                       (d) Other day-to-day benefits
                                                                                                            R 1 170

                    GP's, Specialists                              80% NHRPL                                          80% NHRPL                 General practitioner consultations:
                       and Dentists                                                                           subject to sub-limit (d)               unlimited through a DSPN
             (including basic dentistry)                                                                                                              Specialist consultations:
                                                                                                                                              100% of agreed tariff limited to 4 visits
                                                                                                                                              per beneficiary up to a maximum of 10
                                                                                                                                                per family or R 4 000 and only on
                                                                                                                                                   referral from your network GP
                                                                                                                                              Dental consultations (basic dentistry):
                                                                                                                                                      100% of agreed tariff at
                                                                                                                                                       network provider only

 Prescribed acute medication                                  80% single exit price                           80% single exit price              100% Single Exit Price for basic
 (Including injections and materials)                          plus dispensing fee                             plus dispensing fee           formulary list through a DSPN or 50%
                                                                                                               subject to sub-limit (a)      Single Exit Price plus a dispensing fee
                                                                                                                                                for extended list through a DSPN

                      Out of area                                  Not applicable                                     Not applicable           One visit per beneficiary or two
               non-network visits                                                                                                               per family per year limited to
                                                                                                                                                   R 600 per family and a
                                                                                                                                                 20% co-payment is applied




  PLEASE NOTE This brochure is for summary purposes only and does not supersede the rules of the Scheme in any way.
                                                                                                                                                                                11
                                                     Progressive Generation
                                        Cover                                                                                Other Benefit Options
                                                        Benefit Options


                                                          CA-Double Plus                                 CA-First Choice                                 Network Choice
                                                            CA-Alliance

                                                                   LEVEL 2 - DAY-TO-DAY COVER

                          Emergency                           Not applicable                                Not applicable                        Unlimited provided visits are
                out of network visits                                                                                                              authorised within 48 hours
                                                                                                                                                      and the visit is for an
                                                                                                                                                     emergency condition*

             Casualty & out patient                        80% Scheme tariff                            80% Scheme tariff                           All casualty visits through
            treatment at a hospital                                                                    subject to sub-limit (d)                           a DSPN subject
    (All medication will be paid out of prescribed                                                                                                        to authorisation
    acute medication unless a PMB condition)


                           Home nursing                        80% NHRPL                                      80% NHRPL                          Through a DSPN and subject
            (Subject to pre-authorisation)                    up to 21 days                            subject to sub-limit (d)                      to pre-authorisation

               Supplementary health                            80% NHRPL                                      80% NHRPL                               Occupational therapy and
                                                                                                        limited to R 635 and                        physiotherapy 100% NHRPL
                                                                                                       subject to sub-limit (d)                  Limited to R 1 000 per beneficiary
                                                                                                                                                  or R 1 500 per family on referral
                                                                                                                                                     from Network provider only
                                                                                                                                                    subject to pre-authorisation,
                                                                                                                                                  protocols and case management


                                                              FAMILY BENEFITS                                    BENEFICIARY SPECIFIC LIMITS

              Specialised dentistry                   80% NHRPL limited to:                                  50% NHRPL
                                                         CA-Double Plus                               (subject to sub-limit (b)
                                                      M0       R      4 560                          excluding dental implants)
                                                      M1       R      6 840
                                                      M2+      R      9 120                                                                                     No benefit
                                                           CA-Alliance
                                                      M0       R      5 500
                                                      M1       R      7 600
                                                      M2+      R      9 700
                                                      Subject to annual day-to-day limit


    Over the counter medication                      80% single exit price plus                   80% single exit price plus                     100% single exit price plus a
                                                      a dispensing fee up to                       a dispensing fee up to                          dispensing fee limited to
                                                       R 670 per beneficiary                        R 670 per beneficiary                        R 150 per beneficiary up to a
                                                                                                      subject to sub-limit (a)                   maximum of R 30 per event
                                                                                                                                                     subject to formulary

              Spectacles and lenses                       Consultation:                                Consultation:                                     (This is a two year
                                                        Part of preventative                         Part of preventative                                  benefit cycle)
                                                              wellness                                     wellness                                     One Consultation:
                                                       80% NHRPL limited to:                        50% NHRPL limited to:                                       R325
                                                             Add ons:                                     Add ons:                                           Add ons:
                                                               R 400                                         R 115                                           No benefit
                                                           Single vision                                Single vision                                      Single vision
                                                              R 400 or                                     R 180 or                                     Bifocal & varifocal
                                                              Bifocal                                      Bifocal                                            including
                                                             R 1 050 or                                    R 475 or                                           Frames:
                                                             Varifocal                                    Varifocal                                        up to R 450 or
                                                            R 1 400 and                                   R 475 and                                       Contact lenses:
                                                              Frames                                       Frames                                           up to R 750
                                                             R 1 100 or                                    R 300 or                                       through a DSPN
                                                         Contact lenses                               Contact lenses
                                                               R 1 500                                       R 670
                                                     Subject to annual day-to-day limit


*     Emergency medical condition means the sudden and, at the time, unexpected onset of a life threatening health condition that requires immediate medical or
      surgical treatment where failure to provide medical or surgical treatment would result in serious impairment to bodily functions; serious dysfunction of a bodily
      organ/part or would place the persons life in serious jeopardy.


                                                                        PLEASE NOTE This brochure is for summary purposes only and does not supersede the rules of the Scheme in any way.

    12
                                                          Progressive Generation
                                        Cover                                                                                   Other Benefit Options
                                                             Benefit Options


                                                                CA-Double Plus                                    CA-First Choice               Network Choice
                                                                  CA-Alliance

                                                                    FAMILY BENEFITS                                    BENEFICIARY SPECIFIC LIMITS

                                     Laser K                  80% NHRPL limited to                                    No benefit                    No benefit
                                                                R 1 700 per eye

          Ante-natal foetal scans                                     80% NHRPL                                       80% NHRPL               Two ultra sounds per
(Maximum of two scans per pregnancy)                                                                             Subject to sub-limit (d)     pregnancy per annum

                  Ante-natal classes                          80% NHRPL limited to                                    80% NHRPL                     No benefit
                 (Subject to enrolment on                     R 425 per pregnancy                                Subject to sub-limit (d)
                Mother-to-be programme)


                                                                             ADDITIONAL BENEFITS

                          Netcare 911                             Unlimited,                                       Unlimited,                       Unlimited
                  (emergency services)                      subject to Netcare 911                           subject to Netcare 911           subject to Netcare 911
                                                                 authorisation                                    authorisation                    authorisation




  PLEASE NOTE This brochure is for summary purposes only and does not supersede the rules of the Scheme in any way.

                                                                                                                                                                   13
         Progressive Benefit Options
                                    (See page 9 for details)



                                      Monthly Vital Health                       Monthly MSA                  Total Monthly
                Benefit option     contribution per beneficiary           contribution per beneficiary Contribution per beneficiary



                    CA-VITAL

        Statutory health cover       Adult             R       750                  Not applicable                          Adult         R        750
        plus vital health cover      Child             R       450                                                          Child         R        450




          CA-DOUBLE PLUS

        Statutory health cover,      Adult             R 1 160                   Adult        R        160                  Adult         R 1 320
             vital health cover,     Child             R   760                   Child        R        105                  Child         R   865
     day-to-day cover and MSA




               CA-ALLIANCE

        Statutory health cover,      Adult             R 1 740                   Adult        R        245                  Adult         R 1 985
             vital health cover,     Child             R 1 085                   Child        R        120                  Child         R 1 205
     day-to-day cover and MSA




                                                 PLEASE NOTE This brochure is for summary purposes only and does not supersede the rules of the Scheme in any way.

14
                                                                                                   Other Camaf Benefit Options
                                                                                                   (See page 9 for details)




                                                                     Benefit option               Monthly contribution
                                                       *Monthly income category 2007                per beneficiary


                                                            CA-FIRST CHOICE

                                                                     R 0 - R 1 900                      Adult          R 175
                                                                                                        Child          R 115

                                                              R 1 901 - R 3 800                         Adult          R 340
                                                                                                        Child          R 230

                                                              R 3 801 - R 7 400                         Adult          R 520
                                                                                                        Child          R 345

                                                            R 7 401 - R 10 400                          Adult          R 765
                                                                                                        Child          R 500

                                                                        R 10 401 +                      Adult          R 950
                                                                                                        Child          R 675


                                                           NETWORK CHOICE

                                                                     R 0 - R 9 500                      Principal      R 595
                                                                                                        Adult          R 525
                                                                                                        1st Child      R 300
                                                                                                        (the rest are free)


                                                                          R 9 501 +                     Principal      R 740
                                                                                                        Adult          R 600
                                                                                                        Child          R 450


                                         * Combined gross monthly household income

                                         PLEASE NOTE There is no medical savings account for these benefit options




PLEASE NOTE This brochure is for summary purposes only and does not supersede the rules of the Scheme in any way.

                                                                                                                                 15
     CAMAF has approached wellness in a unique man-
     ner; by partnering with relevant stake holders
     CAMAF believes that the quality of life of our
     members can be improved.

     With our unique approach the holistic
     management          programme  partners   with
     employers and offers personalised attention
     to our members thereby achieving increased
     productivity, improved wellbeing and ultimately
     a richer lifestyle.

     1. Cancer Wellness Programme
     2. Cardiac Support Line
     3. Diabetes Programme
        (not applicable to Network Choice members)
     4. HIV Programme
     5. Mental Wellness Programme
        • Exam stress survival guide
        • Stress line
     6. Mother to be Programme
     7. Respiratory Programme

     For more information on CAMAF’s healthcare
     programmes please contact the CAMAF Managed
     Healthcare department on 0860 100 544 or visit
     the CAMAF website; www.camaf.co.za.

     The Concierge programme takes a holistic view of
     each CAMAF member’s healthcare, either from a
     preventative perspective or from the perspective
     of improving your health. Concierge provides
     outstanding customer service with the primary
     focus on health and wellness. Concierge members
     have immediate access to exclusive benefits.

     For more information on the benefits and how to
     join the programme contact Concierge Customer
     Services on 0861 112 922.




              PLEASE NOTE This brochure is for summary purposes only and does not supersede the rules of the Scheme in any way.

16
   List of chronic conditions                                                               Newly diagnosed chronic conditions:
   Conditions covered under CAMAF's chronic                                                 If, during the course of the year, a patient is
   medication benefit are listed in the table on                                            diagnosed with a new chronic condition listed in
   page 19. The list includes the conditions on the                                         the table on page 19, then registration of the
   Prescribed Minimum Benefit Chronic Disease List                                          chronic condition is required before access to
   (PMB/CDL).                                                                               chronic medication benefits will be granted.

   The prescribed minimum benefit                                                           Who can register the chronic condition?
   Chronic Disease List (PMB/CDL)                                                           As detailed clinical information including the
                                                                                            condition’s ICD 10 code and severity status are
   In terms of the Medical Scheme Act Regulations                                           required, the treating doctor is required to register
   that came into effect on 1 January 2004, Medical                                         the patient’s chronic condition.
   Schemes are required to fund the cost of the
   diagnosis, medical management (consultations                                             ICD 10 codes
   and procedures) and medication of a specified list
   of chronic conditions (see table on page 19). This                                       A detailed list of all the ICD 10 diagnostic codes
   list of conditions is referred to as the Prescribed                                      applicable to CAMAF's chronic condition list is
   Minimum Benefit Chronic Disease List or PMB/CDL.                                         available on the CAMAF website: www.camaf.co.za
   All of these conditions are covered by CAMAF.                                            under downloads. All chronic prescriptions must
                                                                                            have an ICD 10 code.
   In terms of the legislation a medical scheme may
   limit the treatment in accordance with the gazet-                                        Confirm with your doctor that the ICD 10 code has
   ted therapeutic algorithms and apply managed                                             been written on the prescription.
   care interventions to improve the efficiency and
   effectiveness of healthcare provision.                                                   Procedure and consultation benefits
   Registration of chronic conditions                                                       At the time of registration of a patient's chronic
                                                                                            condition, a treatment protocol for consultations
   Patients can only access chronic medication if their                                     and procedures will be authorised.
   prescribing/treating doctor has REGISTERED their
   chronic conditions with CAMAF on the following                                           Please note:
   number: 0800 200 300.                                                                    • The benefit for procedures and consultations
                                                                                               will be paid from the insured benefit. Payment
   This applies to all approved chronic conditions.                                            will not be from the patient’s day to day benefit,
                                                                                               as long as the treatment protocols are adhered
                                                                                               to. Any procedures and/or consultations over
                                                                                               and above that which has been authorised
                                                                                               will not be funded from the insured benefit.




PLEASE NOTE This brochure is for summary purposes only and does not supersede the rules of the Scheme in any way.

                                                                                                                                                    17
                                                                     •     Certain products will only be authorised if
                                                                           prescribed by the appropriate specialist
                                                                           physician. In certain circumstances these
                                                                           drugs may be authorised by other doctors who
                                                                           should contact CAMAF pre-authorisation on
                                                                           0800 200 300.
     Condition medicine list (cml)
                                                                     Extended supply of
     Once a patient’s condition has been registered,                 Chronic Medication
     a patient will have access to the CONDITION
     MEDICINE LIST (CML). This is a list of drugs,                   CAMAF will only grant a three month supply of
     appropriate for the condition, that do not require              medication if the member is going overseas.
     pre-authorisation – they are automatically
     authorised. The CML is available on the website                 An extended supply form must be completed
     under downloads.                                                (see website) and either faxed or emailed to the
                                                                     Clinical Risk Department at least two weeks prior
                                                                     to departure.
     Medication authorisation
                                                                     Members paying cash
     The Condition Medicine Lists do not list all                    for Chronic Medication
     medication that may be required to treat a
     patient’s condition. Some medication requires                   Please ensure that a copy of the prescription is
     specific pre-authorisation. As detailed clinical                faxed to the Clinical Risk Department to ensure
     information is required to pre-authorise these                  that your condition and chronic medication is
     drugs, the treating doctor is requested to obtain               authorised.
     this authorisation from CAMAF on the following
     number: 0800 200 300.                                           Pharmacies claiming
                                                                     for Chronic Medication
     PLEASE NOTE:
                                                                     Please ensure that your pharmacy claims for
     •   The CML is not a fixed list of products. It is              your approved chronic medication on the chronic
         constantly revised and updated in accordance                benefit (Code CAMGC). Check your statements
         with new products registered, discontinued                  monthly to ensure that your medication has been
         products, price changes as well as changes to               claimed from the correct benefit. It is your responsi-
         product registration details.                               bility to ensure that your pharmacy claims correctly.




                                          PLEASE NOTE This brochure is for summary purposes only and does not supersede the rules of the Scheme in any way.

18
CAMAF provides cover for the 270 conditions listed
in the Prescribed Minimum Benefits (PMB) as well
as the 27 conditions listed in the Chronic Disease
List (CDL) in accordance with the provisions of the
Medical Schemes Act and its Regulations.

All PMB/CDL treatment will be subject to the
application of treatment protocols and formularies
(Condition Medicine List), which will be more or
less restrictive depending on the option chosen
by members.


                                                 CAMAF CHRONIC CONDITIONS 2007 For:
                               CA-Vital; CA-Double Plus; CA-Alliance; CA-First Choice and Network Choice

                                                            & Radiology
                                                             Pathology
                                                  PMB/CDL




                                                                                                                       Level of Cover
                                                                                                                          CA-Vital           Level of Cover
                 Condition                                                            Consultations                                          CA-First Choice
                                                                 **
                                                                                                                       CA-Double Plus
                                                                                                                        CA-Alliance          Network Choice
                                                                                                                                            (through a dspn)

 Addison's Disease                                 X           X          General Practitioner (GP), Physician,     100% Scheme tariff   100% Scheme tariff
                                                                          Paediatrician

 Agranulocytosis                                                          Physician                                 100% NHRPL

 Allergic Rhinitis                                                        Ear Nose and Throat Specialist            100% NHRPL
                                                                          (ENT), GP, Paediatrician

 Alzheimers Disease                                                       Neurologist or Psychiatrist               100% NHRPL

 Ankylosing Spondylitis                                                   Physician                                 100% NHRPL

 Aplastic Anaemia                                                         Physician                                 100% NHRPL

 Asthma*                                           X           X          GP, Physician, Pulmonologist,             100% Scheme tariff   100% Scheme tariff
                                                                          Paediatrician, Physiotherapist

 Benign Prostatic Hypertrophy                                             Urologist                                 100% NHRPL

 Bipolar Mood Disorder*                            X                      Psychiatrist, Psychologist,               100% Scheme tariff   100% Scheme tariff
                                                                          Social Worker

 Bronchiectasis*                                   X           X          GP, Physician, Pulmonologist,             100% Scheme tariff   100% Scheme tariff
                                                                          Physiotherapist

 Cardiac Failure                                   X           X          GP, Physician, Cardiologist, Dietician    100% Scheme tariff   100% Scheme tariff
 Cardiomyopathy Disease                            X           X          GP, Physician, Cardiologist, Dietician    100% Scheme tariff   100% Scheme tariff
 Chronic Renal Disease                             X           X          GP, Physician, Urologist,                 100% Scheme tariff   100% Scheme tariff
                                                                          Clinical Technologist, Dietician

 Chrohn's Disease                                  X           X          Gastroenterologist, General Surgeon,      100% Scheme tariff   100% Scheme tariff
                                                                          Dietician, GP, Physician

 Chronic Granulomatosis Disease                                           Physician                                 100% NHRPL
 Chronic Obstructive Pulmonary                     X           X          GP, Physician, Pulmonologist,             100% Scheme tariff   100% Scheme tariff
 Disorder (COPD)*                                                         Physiotherapist

 Coagulation Disorders                                                    Physician                                 100% NHRPL

 Coronary Artery Disease                           X           X          GP, Physician, Cardiologist, Dietician,   100% Scheme tariff   100% Scheme tariff
                                                                          Clinical Technologist

 Cystic Fibrosis                                                          Physician, Physiotherapist,               100% Scheme tariff
                                                                          Pulmonologist, Paediatrician

 Deep Vein Thrombosis                                                     Physician                                 100% NHRPL

 Depression*                                       X           X          Psychologist, Psychiatrist                100% Scheme tariff   100% Scheme tariff

 Diabetes Mellitus (type 1)*                       X           X          GP, Physician, Ophthalmologist,           100% Scheme tariff   100% Scheme tariff
                                                                          Paediatrician, Dietician, Podiatrist,
                                                                          Endocrinologist

 Diabetes Mellitus (type 2)                        X           X          GP, Physician, Ophthalmologist,           100% Scheme tariff   100% Scheme tariff
                                                                          Dietician, Podiatrist,
                                                                          Endocrinologist

 Diabetes Insipidus                                X           X          GP, Physician, Urologist,                 100% Scheme tariff   100% Scheme tariff
                                                                          Paediatrician, Endocrinologist

 Dysrhythmia                                       X           X          Physician, Cardiologist, Paediatrician,   100% Scheme tariff   100% Scheme tariff
                                                                          GP, Clinical Technologist

 Eczema                                                                   Dermatologist                             100% NHRPL


PLEASE NOTE This brochure is for summary purposes only and does not supersede the rules of the Scheme in any way.

                                                                                                                                                              19
                                                      CAMAF CHRONIC CONDITIONS 2007 Continued...




                                                        & Radiology
                                                         Pathology
                                                                                                                    Level of Cover




                                            PMB/CDL
                                                                                                                       CA-Vital          Level of Cover
              Condition                                                           Consultations                     CA-Double Plus       CA-First Choice




                                                             **
                                                                                                                     CA-Alliance         Network Choice
                                                                                                                                        (through a dspn)

 Endometriosis                                                        Gynaecologist                              100% NHRPL

 Epilepsy                                    X            X           GP, Physician, Neurologist,                100% Scheme tariff   100% Scheme tariff
                                                                      Neurosurgeon, Occupational
                                                                      Therapist, Speech Therapist,
                                                                      Physiotherapist, Paediatrician

 Gastro-Oesophageal Reflux Disease                                    Gastroenterologist, Physician              100% NHRPL

 Gauchers Disease                                                     Physician or Paediatrician                 100% NHRPL

 Gout Prophylaxis                                                     GP                                         100% NHRPL

 Glaucoma                                    X            X           GP, Physician, Ophthalmologist             100% Scheme tariff   100% Scheme tariff

 Haemophilia A & B                           X            X           GP, Physician, Paediatrician               100% Scheme tariff   100% Scheme tariff

 Haemolytic Anaemia                                                   Physician                                  100% NHRPL

 Hormone Replacement Therapy                                          Gynaecologist                              100% NHRPL

 HIV/AIDS*                                   X            X           GP, Physician, Paediatrician               100% Scheme tariff   100% Scheme tariff

 Hyperlipidaemia                             X            X           GP, Physician, Cardiologist,               100% Scheme tariff   100% Scheme tariff
                                                                      Paediatrician, Dietician

 Hypertension                                X            X           GP, Physician, Cardiologist,               100% Scheme tariff   100% Scheme tariff
                                                                      Dietician

 Hyperthyroidism                                                      GP                                         100% NHRPL

 Hypothyroidism                              X            X           GP, Physician, Paediatrician               100% Scheme tariff   100% Scheme tariff

 Malignancies*                                                        By individual case                         100% Scheme tariff

 Meniere’s Disease                                                    Ear Nose and Throat Specialist (ENT), GP   100% NHRPL

 Migraine Prophylaxis                                                 GP                                         100% NHRPL

 Multiple Sclerosis                          X            X           GP, Physician, Neurologist,                100% Scheme tariff   100% Scheme tariff
                                                                      Ophthalmologist, Urologist,
                                                                      Occupational Therapist,
                                                                      Physiotherapist

 Muscular Dystrophy                                                   Neurologist, Physician, Paediatrician      100% Scheme tariff

 Organ Transplant                                                     Physician, Ophthalmologist,                100% Scheme tariff
                                                                      Physiotherapist

 Osteoarthritis                                                       Physician, Rheumatologist                  100% NHRPL

 Osteoporosis                                                         Physician or Gynaecologist                 100% NHRPL

 Parkinson’s Disease                        X             X           GP, Physician, Neurologist                 100% Scheme tariff   100% Scheme tariff

 Plegia; Hemi, Para & Quad                                            Physician, Orthopaedic Surgeon,            100% Scheme tariff
                                                                      Physiotherapist, Urologist,
                                                                      Neurologist, Neurosurgeon,
                                                                      Occupational Therapist,
                                                                      Paediatrician, Speech therapist

 Polycystic Ovarian Syndrome                                          Gynaecologist                              100% NHRPL

 Psoriasis                                                            Dermatologist                              100% NHRPL

 Restrictive Lung Disease                                             Pulmonologist, Physician                   100% NHRPL

 Rheumatoid Arthritis                       X             X           GP, Physician, Paediatrician,              100% Scheme tariff   100% Scheme tariff
                                                                      Physiotherapist, Dietician,
                                                                      Orthopaedic Surgeon, Rheumatologist

 Schizophrenia*                             X             X           Psychiatrist, Psychologist,                100% Scheme tariff   100% Scheme tariff
                                                                      Social worker

 Sickle Cell Anaemia                                                  Physician                                  100% NHRPL

 Systemic Lupus Erythematosis               X             X           GP, Physician, Dermatologist,              100% Scheme tariff   100% Scheme tariff
                                                                      Paediatrician

 Thalassaemia                                                         Physician                                  100% NHRPL

 Tuberculosis                                                         GP                                         100% NHRPL

 Ulcerative Colitis                         X             X           Gastroenterologist, General                100% Scheme tariff   100% Scheme tariff
                                                                      Surgeon, Dietician, GP, Physician

             *        Subject to registration on the relevant wellness programme
20           **       For the 27 PMB/CDL conditions Pathology and Radiology are paid from the statutory health cover
                                                                                                 access your
                                                                                                 chronic medication benefit



                                                                                Patient phones                        Patient is informed
                                        Patient obtains new
                                                                               for authorisation                     that the doctor must
                                            prescription
                                                                                                                    phone for authorisation




                                                                                 Doctors phone
                                                                                    SwiftAuth
                                                                                for authorisation




                                                                                                                       Condition declined -
                                                                              Condition On Hold                       does not meet clinical
                                                                                 until clinical                      entry criteria or is not an
                                        Condition Approved                                                          approved chronic condition/
                                                                              information given                     medication or is a scheme/
                                                                                                                        member exclusion




                                                                                     Clinical
                                                                                  information
                                                                                    received




                                                                            Medication not on CML                    Medication declined -
                                       Medication on CML -                                                              does not meet
                                      automatically approved                 - clinical information
                                                                                      given                          treatment guidelines




                                         Pharmacist claims
                                                                            Medication approved -                     Medication on hold
                                       from chronic benefit -
                                                                              meets treatment                         until further clinical
                                          claim paid from
                                                                                 guidelines                          information received
                                          Statutory Cover




                                                                                                                    Pharmacist claims from
                                                                                                                      day to day benefit –
                                                                                                                         claim paid if no
                                    Important numbers for                                                             exclusions exist and
                                                                                                                        benefits available
                                    chronic medication queries                                                       from day-to day cover


                                    Clinical Risk Department:
                                    Tel: 0861 700 600 or Fax: 011 706 9946
                                    for member queries option 3

                                    SwiftAuth line:
                                    Tel: 0800 200 300 or Fax: 011 706 9946
                                    for doctors and pharmacists only

                                    Email:
                                    disease.management@eternityhealth.com


PLEASE NOTE This brochure is for summary purposes only and does not supersede the rules of the Scheme in any way.

                                                                                                                                                   21
     It is vital that, before undergoing certain
     procedures, pre-authorisation (0860 100 544) is
     obtained. This pre-authorisation number should
     then be quoted on relevant claims.                              The following is a summary of gen-
                                                                     eral exclusions that are applicable
     Treatments requiring                                            to all members
     pre-authorisation
                                                                     •      Willful and material breach of law
     •   All non-emergency hospitalisation                           •      Educational or remedial therapy
         (at least 24 hours prior to being admitted)                 •      Elective cosmetic surgery (unless you have
     •   Endoscopies (in & out of hospital)                                 savings to cover the claim as a cash payment)
     •   Home nursing (post hospitalisation)                         •      Expenses recoverable from a third party
     •   MRI & CT scans                                                     (e.g. motor vehicle accident)
     •   Oncology treatment                                          •      Insurance examinations
     •   Step-down facilities                                        •      Long term care for the frail, infirm and
     •   Treatment plans for psychotherapy                                  chronically ill
                                                                     •      Professional sport-related injuries
                                                                     •      Hypnotherapy
                                                                     •      Psychometric testing

                                                                     Elective Caesarean section without valid medical
                                                                     reasons are subject to a penalty of R 3 000

                                                                     Failure to pre-authorise may result in the
                                                                     non-payment of your claims or a penalty being
                                                                     imposed (20% of the amount claimed up to a
                                                                     maximum of R 2 500)




                                          PLEASE NOTE This brochure is for summary purposes only and does not supersede the rules of the Scheme in any way.

22
                                                                                              The CAMAF website allows you to track your claims,
                                                                                              check which have been paid and when they were
                                                                                              paid (whether these payments were made directly
                                                                                              to you or the provider), visit the CAMAF website on
                                                                                              www.camaf.co.za and click on ‘member login’.


                                                           YOU or the DOCTOR must submit a detailed account
                                                           within 4 months of the treatment date, containing:
                       Consultation
                      with a doctor or                     • Principal member’s name & surname
                         specialist                        • Details of the beneficiary concerned
                                                           • Medical aid number as per your
                                                             membership card
                                                           • Pre-authorisation number (if applicable)
                                                           • Proof of payment (if applicable)
                                                           • ICD-10 code for condition treated




                                                               Claim received                                                        Claim rejected if
                                                                via the post                     Claim received via fax           illegible or until the
                                                                PO Box 2964                          or photocopy                  original account is
                                                               Randburg 2125                                                             received




                                                                                                    Is there missing
                                                                                                      information
                                                                                                    on the account?
                                                                                                                                           YES




                                                                                                                                  Claim rejected until
                                                                                                            NO
                                                                                                                                      the missing
                                                                                                                                information is received




                                                            The member settled                      Processing and
                                                              the account with                      payment within
                                                             the doctor upfront                       two weeks




                                                                  NO                                        YES



                                                            Deposit the amount                     Deposited directly
                                                              due directly into                    into the member’s
                                                             the doctor’s bank                        bank account
                                                                  account




                                                                    Receive a weekly claims statement
                                                                            via e-mail or post.
                                                                   Please confirm your communication
                                                             preference with Client Relations (0860 100 545)




                                                        PLEASE NOTE 1. Your original detailed invoice must be submitted to CAMAF within 120 days of service date
                                                                             2. No copies and/or faxes are accepted
                                                                             3. Please ensure that your member number is clearly visible and indicate, on the claim,
                                                                                whether payment should be made to either the member or the service provider (if due to
                                                                                the member the claim must have a receipt attached or ‘paid’ stamped on the invoice)




PLEASE NOTE This brochure is for summary purposes only and does not supersede the rules of the Scheme in any way.

                                                                                                                                                                         23
                                                                     Netcare 911
                                                                     All CAMAF members have the use of Netcare 911
                                                                     Emergency Services. Should you, as a member,
                                                                     make use of another emergency service provider
                                                                     an authorisation procedure needs to be followed
                                                                     to ensure that the claims are paid.

                                                                     •    Should another service provider be used, other
                         SMS facility & E-mail                            than Netcare 911, in an emergency situation
                              communications                              you have 48 hours (during the week) and 72
                                                                          hours (over a weekend) to advise us. An
     In order to ensure our members have access to                        authorisation number will be given to you.
     all the necessary information in the most effective             •    The account must be submitted to us within
     manner we have a variety of communication                            120 days, from date of service.
     methods available namely:
                                                                     By calling 082 911, in an emergency situation,
     1. postal                                                       you can be assured of timeous and professional
     2. e-mail                                                       service.
     3. sms

     (In order to update your communication method
     please contact Client Relations on
     0860 100 545)




                                          PLEASE NOTE This brochure is for summary purposes only and does not supersede the rules of the Scheme in any way.

24

				
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