FAQs

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.

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.

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.

Contributions are based on your basic salary, the benefit option you have selected and the number of dependants covered under your membership. Once your application form has been assessed and approved, you are liable to pay half (by salary deduction) of the monthly contributions, while your employer pays the other half. The entire amount will then be remitted by your employer to the Scheme’s Administrators.

Generally, contributions are kept constant for a year at a time except when your salary changes or when you add a dependant. The Scheme may review contributions on an annual basis and adjustments may be influenced by inflation, benefit utilization, and general financial performance of the Scheme.

Members may post or hand deliver signed claims, within three (3) months of date of service, to the Administrators. A statement signed by the member or dependant certifying the truth and correctness thereof shall accompany every claim submitted to the Scheme.

A recognized tariff is a health service fee that has been approved by the management committee. Different tariffs exist for different services e.g. consultation tariff, hospital tariff.

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.