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The Anglo American Corporation Medical Aid
Society (A.A.C.M.A.S.) is a closed society to
which only Anglo American group company employees
and pensioners can subscribe and the Society
is administered by Sovereign Health (Pvt) Ltd.
A.A.C.M.A.S. offers a split benefit structure
with high-cost essential medical care funded
from Insured Benefits and day-to-day low-cost
Out-of-Hospital medical care being funded from
an individually or family owned Medical Savings
Account (MSA).
Insured Benefits
These are the main or 'core' benefits that provide
cover for those infrequent but financially catastrophic
medical events such as an in-hospital stay or
a diagnosis of cancer. A.A.C.M.A.S. provides
realistic and comprehensive cover for these
events through a ring-fenced 'Core or Insured
Benefit Fund'.
Insured Benefits have an annual overall limit
per registered beneficiary with internal sub-limits
for benefits such as optical, dental, chronic
medication, special appliances, prosthesis and
rehabilitation. The A.A.C.M.A.S. membership
year is January to December and members who
join during the course of the year have their
benefits pro-rated. Current benefits are detailed
in the A.A.C.M.A.S. Benefit Structure and Guide
available online at the Sovereign Health website.
Claim Reimbursements
A.A.C.M.A.S. processes and pays claims twice
a month, that is mid-month and at the end of
each month. Service provider payments are accompanied
by detailed statements indicating tariff codes
and other information as well as reasons for
any shortfalls.
Members and providers are urged to submit their
claims as frequently as is manageable in order
to ensure speedy reimbursement.
Membership Cards
A.A.C.M.A.S. reissued members with new membership
cards in January 2005. The new membership cards
incorporate the MARS logo and emergency telephone
numbers.
Under normal circumstances, only 2 membership
cards are issued per family. Members are, however,
free to request for additional or replacement
cards at no extra cost to themselves.
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