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WOOLTRU: 2020 BENEFITS AND OPTION SELECTION

Have you reviewed the Fund's benefits and contributions for 2020 and made your option selection for 2020?

The Board has made a number of significant changes and you will find all the details of the changes for the 2020 benefit year in the 2020 benefit brochure - please take the time to look carefully through each option to make an informed choice for 2020.

So what is changing?
We still have three options - but we have renamed them to reflect what they specifically offer and because there have been some significant changes within each option, you need to make an actual selection this year.

Our new options are:
Network Option (previously Core Option)
Saver Option (previously Plus Option)
Comprehensive Option (previously Extended Option)

Network Option
Only network providers may be consulted. The Network Option offers limited benefits, but is sufficient for the average family. The chronic medication benefit covers the 26 prescribed minimum benefit (PMB) conditions with approval for generic medication. The other conditions that are covered are limited.

Saver Option
The Saver Option offers a medical savings account (MSA) for all your day-to-day claims.

If you select this option, you need to manage your MSA carefully to ensure that it lasts. Please note that your MSA is used for ALL day-to-day medical expenses including consultations, medication, dentistry, optometry, etc.

Other non-PMB chronic conditions, including depression and osteoporosis are limited to R14 000 per beneficiary and no longer have separate sub-limits.

Speciality chronic medication benefits (biologicals) will be restricted to PMB conditions only.

Comprehensive Option
The Comprehensive Option will now also offer a medical savings account (MSA) for all your day-to-day claims. Each month 25% of your total contribution will go towards your MSA.

Another significant change to the Comprehensive Option is the introduction of a Professional Services Benefit to help you make your savings go further. The Professional Services Benefit will cover 50% of any out-of-hospital claims from gynaecologists, paediatricians, psychiatrists, psychologists and physiotherapists with the other 50% coming from your MSA.

The Professional Services Benefit covers claims up to three times the Fund's tariff and is limited to the following capping amounts:

Member: R10 000
Adult dependant: R9 700
Child dependant: R3 300

We have also increased the chronic medication benefit for non-PMB conditions to R28 000 per beneficiary per year.

What are the increases for 2020?
After reviewing the benefits and the projected hospital costs, the Trustees have approved the following contribution increases:

Network Option: 6.9%
Saver Option: 7.8%
Comprehensive Option: 10%

New email address for easier communication
We have new email addresses just for our members to make corresponding with the Fund so much simpler:

accounts@wooltruhealthcarefund.co.za
Scan and email your accounts to this address 

enquiries@wooltruhealthcarefund.co.za 
Email your queries and your questions to this email address

 



Please click on the links below to view and print the benefit schedules for 2020.

RETIREES ONLY - If you would like to change your option for 2020, please click on the link below.

    

 

The Wooltru specialist network consists of two types of network service providers:
  • providers where an agreement with the Fund is in place; and
  • providers where no agreement with the Fund is in place.

Where a network provider who has an agreement with the Fund has been consulted for a prescribed minimum benefit (PMB) condition, the Fund will pay up to the agreed rate. Where no agreement exists for providers on the network, the Scheme will pay up to two times the medical fund rate for PMB-related conditions - members will need to negotiate a rate with these providers.

Contact Details

All enquiries (Network Members)
0800 765 432
Fax: 021 413 0512

Client Service Team
(Saver and Comprehensive Members)

021 480 4849
0802 228 922
Fax: 021 480 4759

Links

Clicks direct medicines