PG Group Medical Scheme

call 0860 00 50 37 mail [email protected]

PG Group Medical Scheme

account_circle register

Important Contact Details

SCHEME CONTACT DETAILS

Physical address
Parc du Cap, 7 Mispel Road, Bellville 7530

Customer care
call 0860 005 037
0860 005 037
fax 0861 647 775
email [email protected]
Members can dial 0860 005 037 for any Scheme queries
(Monday to Friday, 08:00 to 16:30)

Press
1 for benefits confirmation and claims enquiries
2 for hospital admissions, pre-authorisations, maternity and oncology
3 for dental benefits and authorisation
4 for HIV-related queries
5 for chronic medication

Membership queries
fax 0861 222 664
email [email protected]

Claims and administration
Postal address for claims and correspondence
PG Group Medical Scheme, PO Box 2070, Bellville 7535

Claims submission
email [email protected]

Hospitalisation and pre-authorisation
call 0860 005 037

Chronic medication registration and queries
Medicine Risk Management (MRM) Programme
call 0860 005 037
email [email protected]

Managed healthcare programmes
Integrated care, oncology, renal and maternity programmes
call 0860 005 037

Fraud hotline
call 0800 000 436
email [email protected]

THIRD PARTY SERVICE PROVIDERS

Dental Information Systems (DENIS)
Dental benefits
call 0860 104 939
email [email protected] / [email protected]
web http://www.denis.co.za/

Denis Pharmacy

YourLife Programme
HIV/AIDS treatment and management programme
call 0860 005 037 (option 4)
email [email protected]

YourLife programme

Netcare 911
Emergency assistance and ambulance service
Emergencies/Health-on-Line: 082 911
call 0860 638 2273
email [email protected]
web http://www.netcare911.co.za

Netcare 911

Preferred Provider Negotiators (PPN)
Optical benefits
call 041 065 0650
email [email protected] / [email protected]
web http://www.ppn.co.za

COURIER PHARMACY FOR CHRONIC MEDICATION

Medipost Pharmacy
PO Box 40101, Arcadia 0007
call 012 426 4000
email [email protected]
web http://www.medipost.co.za

Medipost Pharmacy

WELLNESS AND REWARDS

Momentum Multiply
call 0861 886 600
email [email protected]
web http://www.multiply.co.za

Momentum Multiply

MEDICAL ADVICE

Hello Doctor
Dial *120*1019# to request a call back from a doctor, or download the Hello Doctor mobile app
web www.hellodoctor.co.za
Get the Hello Doctor app!

Required information

The Scheme's registered name

PG Group Medical Scheme
The main member and the patient treated

The main member's name and the name of the patient treated (main member or dependant) as registered and indicated on the membership card
Membership number

The Membership number as indicated on the membership card
The doctor's practice number

Doctors registration number on the Health Professions Council of South Africa
ICD-10 code(s)

This is a diagnosis code, eg."J11.1"
Signed Proof of Payment

Proof of payment signed by the member and indicated as 'PAID' (where applicable).

Required information

Your membership number

Your Medical Aid Membership Number on your card
The name and practice details of the admitting doctor

The Doctor who is to performing the procedure should provide this
The date of admission to hospital or clinic

Date at which the patient gets admitted or Procedure Date if it occurs on the same day
The name of hospital or clinic

The Doctor, Hospital or Clinic can provide
The medical condition

The Doctor who is to performing the procedure should provide this
The diagnosis / the ICD-10/ Procedure codes / The type of procedure

The Doctor who is to perform the procedure needs to provide
The expected length of stay

How long the patient is expected to stay in the Hospital / Clinic

1Basic Contributions
2Late Joiner Penalties

person

Main Member

person_add

Dependants

Adult Dependants

Minor Dependants

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Any subsidies paid by the employer in respect of qualifying continuation members will continue. Active principal members who are part of the bargaining sector will continue to receive the employer's subsidy in terms of their current legal employment agreement. Active principal members who have converted to total cost of employment (TCoE) remuneration packages, pay full contribution indicated above.

Pensioners and retirees' income (that is used to determine their income bands and contributions) is based on 50% of their last BPSA pensionable earnings before retirement. This amount is increased by the consumer price index (CPI) every year.

Are you joining the Medical Aid on the same date you are joining the company?

			Years without Medical Aid cover
1	Main Member
{{$index + 2}}	Adult Dependant

Years Without Medical Aid Cover

Up to the age of 21, a dependants cover is regarded as years without cover. Medical Insurances not registered to the Council of Medical Schemes are not regarded as credible cover. Medical cover overseas is also not regarded as credible cover.

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+ Late Joiner Penalties R{{addUpTotal(0,latejoiner_total_member,latejoiner_total_dependant) | number: 2}} CALCULATING...

Total Contributions R{{addUpTotal(total,latejoiner_total_member,latejoiner_total_dependant) | number: 2}} CALCULATING...

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