Your benefit entitlement will depend on the option you choose between the three benefit options that the scheme has, Standard Benefit Option, High Benefit Option or Premium Benefit Option. For members on High Benefit and Premium Benefit, when you and any of your dependants fall sick, the Scheme will settle 90% of the medical expenses up to the specified limits: within the prescribed Rules. You have the responsibility of settling the remaining 10%. For members on Standard Benefit Option, the scheme settles the medical bill 100%. You get value for money, excellent service and health. Your claims are settled twice a month. The Scheme will pay suppliers directly if a valid membership card is produced before treatment. Members on High Benefit and Premium Benefit Options have a Dread Disease of P165 000 for members on High Benefit and P300,000 for members on Premium Benefit which applies to 10 specified conditions namely: Heart Attack, Coronary Heart Disease, Stroke, Cancer, Kidney Failure, Organ Transplant, Paraplegia, Blindness, Multiple Sclerosis and Motor Vehicle Road Traffic Accident. The Scheme also has other benefits that it offers to the members and their covered dependents at no extra cost, this benefits include; funeral benefit up to P12,5000, Premium waiver and a medical emergency evacuation service, of international standing; through Med Rescue International (MRI) Botswana.
When a member has exhausted (finished) their benefits, they can make a request to the scheme for more benefits through exgratia. The management committee will assess the member’s request.
Effective 1st April 2019, members on BPOMAS will have the opportunity to add their parents and parents in law through the Parents and Parents In Law Cover. For children that have finished school but not yet employed, the parents can continue covering them under the Adult Child Dependent up to the age of 35years. For both the Parents Cover and Adult Child Cover, The member will have to pay the monthly subscription 100%, without the government subsidy.
The following persons may be registered as dependants: Your spouse (husband/wife) Your children (children are covered until the age of 21, and up to 25 if they are still students. Children who are students will be required to submit letter from school, to confirm their academic status every year in order to remain covered by the medical aid). For children that have finished school but are not yet employed, the parents can continue covering them under the Adult Child Dependent up to the age of 35years.
In order to gain membership you must fill in the prescribed application form. This form must be counter-signed by your department / ministry before submission to the Administrators for processing. The turnaround for applications is a week after receipt by the administrator. The form must be accompanied by the member’s ID/Passport (for foreigners) and copy of the payslip. For member adding their children, a copy of birth certificate is required, for members adding their spouse, a copy of marriage certificate and spouse ID are required.
Membership of the Scheme is available to ALL Botswana Government employees, pensioners, those working on contracts (with a medical aid as a benefit), employees that used to be classified as industrial workers and their dependants (spouse and children).
Members can easily walk in our offices located at Gaborone or Francistown. Members can also reach the scheme via email: marketing@bpomas.co.bw or call our call centre at +267 370 2907
No, there is no cash back reason being that BPOMAS uses a Community Based Pricing Model, where members buy into a risk pool. For member on High Benefit, earning over P8,000.+ with one dependent, their monthly contribution would be P488, should a need arise and a member need a P120,00 cover, the medical aid would pay, this is made possible because of the contribution of other members.
Your benefit entitlement will depend on the option you choose between the three benefit options that the scheme has, Standard Benefit Option, High Benefit Option or Premium Benefit Option. For members on High Benefit and Premium Benefit, when you and any of your dependants fall sick, the Scheme will settle 90% of the medical expenses up to the specified limits: within the prescribed Rules. You have the responsibility of settling the remaining 10%. For members on Standard Benefit Option, the scheme settles the medical bill 100%. You get value for money, excellent service and health.
Your claims are settled twice a month. The Scheme will pay suppliers directly if a valid membership card is produced before treatment. Members on High Benefit and Premium Benefit Options have a Dread Disease of P165 000 for members on High Benefit and P300,000 for members on Premium Benefit which applies to 10 specified conditions namely: Heart Attack, Coronary Heart Disease, Stroke, Cancer, Kidney Failure, Organ Transplant, Paraplegia, Blindness, Multiple Sclerosis and Motor Vehicle Road Traffic Accident.
The Scheme also has other benefits that it offers to the members and their covered dependents at no extra cost, this benefits include; funeral benefit up to P12,5000, Premium waiver and a medical emergency evacuation service, of international standing; through Med Rescue International (MRI) Botswana.
Members that have been with the medical aid for at least 1 year before retirement have an opportunity to continue with their medical aid. The government will continue to pay 50% towards the monthly subscription and the member 50%. Members are required to notify the scheme 3 months before retirement of the intention to retire so that arrangements can be made on how to pay the monthly premium before the pension salary. Pensioner membership is for life.
