MASM MALAWI

You are here: Home » FAQs
Thursday, 24 Jan 2019

FAQs

Who can Join?

  • Anyone can join if their employer has agreed and registered to be part of the scheme.  
  • An individual may also join in their own right.  
  • The maximum joining age is 55 years unless the member is transferring from another medical aid scheme affiliated to the International Federation of Health Fund (FHF).  In which case a certificate must be produced.

How do I change Schemes?

The Society does not encourage its members to change schemes. It is essential that applicants understand the benefits under the different medical schemes before choosing a scheme.  

Change of scheme shall not be allowed in the first three months of registration.  

A member may change schemes under the following conditions:

Changing from lower to higher scheme:

  • A processing fee of K100.00 applies
  • Normal waiting periods shall be effective
  • One months notice in writing must be given.

Changing from higher to lower scheme:

  • A processing fee of K100.00 applies
  • One months notice in writing must be given.

What about ID?

A membership card will be issued to you reflecting:

  • the scheme you have registered for
  • your membership numberyour name
  • the names of your registered dependants
  • the date from which you are entitled to benefits.

Always show your Card and suitable identification to the GP or any registered provider of healthcare services. A member will not be treated without producing the Card.

Do not lend your card to anyone other than your registered dependants. Use of the card by or on behalf of any other party is illegal and may result in criminal prosecution.  

A lost or defaced card will be replaced upon payment of an appropriate fee.

What about Doctors and Specialists?

Each member must chose a doctor (GP) from the MASM list of panel doctors. For a list of panel doctors, see Service Providers.  

Any emergencies occurring outside of your doctor's practice hours should be treated at a registered hospital or clinic.

If you see a doctor outside the list for non-emergency treatment, you will have to pay for the visit and treatment yourself.

If you need to see a Specialist:

  • Your doctor must give you a referral letter.
  • The Specialist will only be paid if he has this letter.
  • Otherwise you will be liable for this cost.
  • A member is limited to three visits to a Specialist in a month.  

You can change doctors:

  • At any time by completing the "advice of change of doctor" form.
  • The member must advise the Society of the change of doctor before the tenth of each month for the change to be effected on the first day of the following month.

What if my Address or Dependants change?

Complete the appropriate form promptly to advise the Society of: 

  • a change to your marital status
  • the birth or adoption of a child
  • any dependant who is no longer entitled to dependant membership
  • a change to your postal address.

Do I need to undergo a medical examination?

  • The Society may require that a prospective member undergo medical test before membership is approved.  
  • Similarly where the health of a member is deteriorating the Society can arrange to have the member undergo medical examination for decision making.

Is there a waiting period?

  • There is no waiting period. You are entitled to most of your benefits from the first day of membership.
  • There are however, specific benefit waiting periods:
      Benefit
      Waiting Period
      Hospitalization
      3 months
      Maternity
      12 months
      Foreign Treatment
      12 months
      Foreign Visiting Specialist
      12 months
      Chronic Medication
      12 months

When does my scheme expire?

If you joined through your employer, membership ceases if:

  • You leave the service of your employer.
  • The employer withdraws from the scheme     

In all cases a person stops being a member if:

  • He/she dies and the society is informed.
  • He/she is expelled by the Society.

Two months notice of termination is given by the firm, the member, or the Society in writing.

If a Member fails to pay contributions by due date in a given month, the Society may opt to suspend the benefits only.

If a Member fails to pay contributions in three consecutive months, their membership expires.   

Important:   When you leave, you must give your membership card to your employer. If an individual, send it to MASM directly.

Who can be registered as my dependants?

  • Your spouse and children. 
    Note: a newborn or adopted child must be registered within 30 days of birth or adoption.  
  • You or your spouse's dependant parents.
  • You or your spouse's brother, sister or adopted brother or sister.  
  • Any other dependants of you, the member.

Which medicines are covered?

Medicines on the Essentials Drug List.

Dispensed by Panel Doctor 100%
Prescription
  • Participating Pharmacy
  • 100%
  • Other Pharmacy
  • According to tariff

    Medicines not on the Essential Drug List
    Partially covered according to tariff if:

  • they are a required part of your treatment;
  • prescribed by your doctor.
  • How do I pay Contributions?

    1. You can pay at any NBS Bank Branch or Agency near you 
    2. It is important for a member to choose a scheme that he/she can afford to pay for.  
    3. Contributions are payable to the Society in advance monthly, quarterly, half-yearly, or annually. 
    4. Contributions must reach the Society before the twentieth of each month.