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  • Frequently Asked Questions

    What is Health Security?

    Health Security is all that you have in place to ensure that you and your dependents can access healthcare even under the most adverse conditions.

    What makes the MEDISERV Plan effective in providing Health Security?

    Mediserv Medical Plan is the only plan that truly considers the cycle of illness. The Cycle of illness gives a general picture of the various stages one passes from good health; to sickness; then recovery.

    Good Health Phase :

    Now is the time to put in place those things that only you can do and those things that can best be done by others, example medical coverage. This Cycle recognizes that while you are in good health, you have the best opportunity to prepare for the misfortune of ill health, by putting coverage in place.

    Emergency Phase

    In this phase you have symptoms. You have not yet accessed a competent healthcare professional to diagnose your condition. This phase can be extremely passive, dramatic or fleeting. The GEMS Card is the best devise to provide admittance. Blood is something required and obtainable via the Blood for Life Program.

    Diagnostic Phase

    In this phase you have the attention of a competent healthcare professional who diagnoses your illness. The GEMS Card can be useful to cover extra expenses due to the various diagnostic tests which you may be required to perform. This card can be obtained from the medical fund contract.

    Treatment Phase

    This is the phase where you have a definite diagnosis and a treatment is prescribed. This is where you can suffer cost escalation, recovery or death. The medical fund contract provides medical coverage optional up to $1,000,000 to pay for cost escalation that may arise.

    • We also provide Compassionate Care
    • Death Benefit in the event of death

    What do I look for in a Medical Plan?

    • Viability – Adequate Rates and rules designed to protect the plan from abuse and thus ensuring long-term viability.
    • Reasonableness – All rules must be reasonable and be supportable with reasonable explanations
    • Fairness – Any benefit given to one member must be available to any other member in the same circumstance; also when any benefit, if given to all members who qualify, will cause the plan to go into decline, shall not be available to anyone.
    • Ability to provide access to medical care when needed.
    • Plan designed to survive over long term.
    • Covers widest range of ailments.
    • No restrictive definition of what is an ailment.

    How can I continue to keep my contributions affordable?

    • Purchasing plan which covers only expenses and circumstances which I cannot afford to bear
    • Avoiding fraudulent claims practices and discouraging others from the practice
    • Encouraging others to participate in the plan, which will to increase group size and stabilize rates
    • Purchase a plan with the greatest potential for growth in membership; this stabilizes rates.
    • Encourage younger persons to participate in the plan; young members stabilizers rates

    What are Mediserv Student Scholarship Medical Plans?

    Mediserv Student Scholarship Medical Plans are a less expensive range of Medical Plans designed specifically for students

    Plan is designed to address the economic needs of students and also provides robust coverage

    Why have you chosen the special name “student’s scholarships” for these medical Plans?

    The underlying aim is to offer a scholarship-grade value-added to make it affordable for the student to obtain robust coverage

    The effect of the highly discounted rates for coverage is that Mediserv is offering to students a scholarship value

    Mediserv applied this concept to two (2) of our medical Plans: our Classic Gold Mediserv Medical Plan and our Classic Diamond Medical Plan. These plans are thereby transformed into the Gold Scholarship Medical Plan and the Diamond Scholarship Medical Plan respectively.

    How does a student benefit from these scholarship Plans in comparison to having one of your regular Mediserv Classic Range of Medical Plans?

    Rates are significantly lower. For example:

    Diamond Scholarship Plan offers a discount on the Classic Diamond Plan. The percentage discount is the scholarship value that Mediserv is offering to students.

    What is a deductible?

    The part of a claim that the member accepts as his responsibility and is deducted from the eligible expense before the Company settles the claim.

    What do you mean by co-payment?

    A benefit whereby MEDISERV and the claimant shares the responsibility of settling the claim using a pre-agreed percentage ratio. It is transacted after the deductible. The percentage that Mediserv bears is listed in the contract

    Do Mediserv plans cater for retired employees?

    Yes, Mediserv Jewel Range of Plans provides coverage for retired persons and anyone who needs to commence coverage after age sixty (60)

    How long after my treatment do I have to submit my claim to my Mediserv?

    Most health plans allow a period of 90 days from the start of your illness for you to submit a claim. Mediserv permits ninety (90) days for participants in the Mediserv Classic range and sixty (60) days for participants in the Jewel Range.

    What is a pre-existing condition?

    Generally refers to medical condition, which existed before the commencement date of the plan. In the Mediserv plans this term applies to any illness that emerges or show symptoms before the member has expired his Incubation Period in the plan for that respective illness.

    What is Reimbursement?

    A benefit that is the net money payable to the claimant after the Deductible and or the Co-payment is transacted.

    What is an Allowance?

    A benefit payable from the sum assured whereby the deductible and co-payment s zero.

    What is a Claim?

    Each submission of documents for reimbursements of eligible expenses per illness per person.

    In the contract, what does 100% or Unlimited mean?

    Refers to benefits with fixed reimbursement quo that are payable up to the maximum reimbursement available within the category of Coverage purchased.

    In the contract, what does Lifetime mean?

    Applies to benefits with fixed Reimbursement quotas within the sum assured and are not replenishable over the lifetime of members.

    Applies to benefits with fixed Reimbursement quotas within the sum assured and are not replenishable over the lifetime of member
    Disclaimer: This info is intended and believed to be accurate,
    but Mediserv does not guarantee its accuracy. Mediserv disclaims any liability
    for errors or omissions either expressed or implied.
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