Topmed is a registered medical scheme that is passionate about providing a variety of healthcare options that have been specifically formulated to cater to the needs of individuals, SME’s and corporate clients alike. Established in 1972, they believe in an innovative approach offering members the highest level of service excellence. Driven by their desire to provide their members with the best healthcare possible they have joined hands with Momentum Medical Scheme as partners in managed care and administration.
The board members are chosen by their members to provide customer reassurance that the needs and interests of scheme members are attended to with the greatest of care. The scheme has secured its place in the private healthcare industry through strict governance and a solvency level that is well above the required 25%.
As part of their service excellence the medical scheme strives to provide members with clear and open communication, outstanding administration and product flexibility. Each member receives a comprehensive member guide; therefore members know exactly what their benefits are and what they are paying for.
With more than 40 years worth of experience TopMed takes full advantage of their strengths, working alongside service providers and members to ensure that the healthcare provided by them is both affordable as well as comprehensive allowing members to live a healthier lifestyle.
TopMed rely on their core values of efficiency, stability and personal service to ensure that each of their member receives the best level of care possible. With TopMed their members are their first priority, a happy member is a loyal member.
At TopMed they like to think of themselves as your trusted health partner as such members can look forward to a series of comprehensive benefits.
- Wellness management
- Extended benefits for major medical procedures
- Medical savings account
- Maternity benefits
- Basic and specialised dentistry
- Day to day benefits
- Chronic benefits
- Optical benefits
- Travel cover
- Hospitalisation at private facilities
- Network visits
- Specialised visits
TopMed offers a range of flexible healthcare options to ensure that even the most diverse needs are met.
Healthcare options include:
The Comprehensive option is ideal for the whole family. The option provides maternity benefits, chronic benefits and extended major medical; private hospital cover is provided at 300% of TopMed tariff. Pre authorisation for this option is required.
The Professional option is ideal for persons that require a higher level of healthcare; the option provides maternity benefits, chronic benefits, a medical savings account of 25%, out of hospital cover, extended major medical cover and hospital cover at 200% of TopMed Tariff. Pre authorisation for this option is required.
The Paladin Comprehensive option is ideal for individuals that do not require high level care. The option provides maternity benefits, chronic benefits, extended major medical benefits and hospital benefits at 150% of TopMed tariff. Pre authorisation for this option is required.
The Savings option is ideal for individuals who are starting out and have low healthcare requirements. The option provide maternity benefits, chronic benefits, major medical benefits, medical savings of 20% and hospital benefits at 100% of TopMed tariff. Pre authorisation for this option is required.
The Active Saver option is an affordable healthcare option that provides maternity benefits, chronic benefits, major medical care, a medical savings account of 25% and hospital cover at 100% of TopMed tariff. Pre authorisation for this option is required.
The Hospital option is ideal for individuals with basic healthcare needs. This option provides maternity benefits, limited major medical benefits, chronic benefits and hospital benefits at 150% of TopMed tariff. Out of hospital expenses are for the members account, MRI and CT scans have a co-payment of R1000. Pre authorisation for this option is required.
Member contribution for this option is income based, and hospital benefits are covered at 100% of TopMed tariff. The option has an overall annual limit of one million rand. Healthcare is provided by network service providers. Pre authorisation for this option is required.
TopMed Limited is a traditional design option with specific benefit limits reimbursed on an 80% basis for doctors and health care providers and a sliding scale co-payment for hospital accounts. Other than the hospital account, members must first pay and then submit claims on a claim form.