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THE MAKOTI SCHEME WAS DEVELOPED WITH THE FOLLOWING IN MIND<\/strong><\/p>\n – To provide high quality medical care at affordable costs<\/p>\n – To Introduce measures to make the Scheme sustainable into the future<\/p>\n – To prevent illness wherever possible by dealing with healthcare issues in the community we serve<\/p>\n <\/p>\n MEMBER RELATED INFORMATION<\/strong><\/p>\n Universal Healthcare (Pty) Ltd is responsible for registering the rules and benefits of the Makoti Medical Scheme. The Scheme will apply underwriting as allowed by the Medical Schemes Act to all new entrants.<\/p>\n The following administrative guidelines apply: A spouse or partner, biological children, adopted children and immediate family members that are dependent on the member for family care and support are eligible.<\/p>\n Cover for children as dependants<\/strong><\/span><\/p>\n Your children may remain on the Makoti Medical Scheme as your dependants, until they:<\/p>\n – Become employed, or<\/p>\n – Reach the age of 21 years<\/p>\n – After 21 years of age your children may remain as adult dependants<\/p>\n <\/p>\n Adding adult dependants<\/strong><\/span><\/p>\n If you wish to add adult dependants underwriting will be done according to the Medical Schemes Act.<\/p>\n <\/p>\n How many medical aid schemes can a person belong to?<\/span><\/strong><\/p>\n You may not belong to more than one medical aid.<\/p>\n <\/p>\n Your membership status<\/span><\/strong><\/p>\n – Please report the following changes to your membership status to the human resources department of your company. The birth or legal adoption of a child<\/p>\n – The new ID number of a dependant – Passing away of a dependant<\/p>\n – Removal of a dependant from the Makoti Medical Scheme<\/p>\n – Divorce<\/p>\n – Addition of dependants<\/p>\n – Change of option may only be done once a year in January<\/p>\n – Change of address<\/p>\n Changes in dependant status must be recorded in order for a new card to be issued. You need to check all the details on your membership card to make sure they are correct.<\/p>\n Any mistakes must be reported as soon as possible so that a new card can be issued to you. Change of status forms can be collected from your human resources by 1 November the previous year.<\/p>\n <\/p>\n What medicines and Laboratory tests will be used?<\/span><\/strong><\/p>\n Makoti has carefully chosen quality medicines. These medicines have been chosen to treat and prevent diseases. They need to be used in the correct manner and according to the correct dosage to regain or maintain health. It is very important to use medicines in the correct dosages, because if they are used incorrectly, they can cause a great deal of harm or even death. The majority of these medications are proven quality generics. If a patient insists on a more costly alternative the additional cost will be for the member to pay directly to the pharmacy. Medication commonly requested that is not on the formulary include: Vitamins, laxatives, proton pump inhibitors and over the counter medicines. Clinically appropriate Laboratory tests are accessed subject to protocol and after pre-authorisation only.<\/p>\n <\/p>\n Your membership cards<\/span><\/strong><\/p>\n Each member is issued with a membership card.<\/p>\n <\/p>\n Contributions<\/span><\/strong><\/p>\n Contributions to the Makoti Medical Scheme will be deducted from your wages. These are paid each month in advance by your employer to the scheme.<\/p>\n Accounts<\/span><\/strong><\/p>\n It is the member\u2019s responsibility to ensure that Enablemed receives all accounts immediately. Accounts received four months after the service date will not be paid by the Scheme and become the member\u2019s responsibility.<\/p>\n<\/div>\n <\/p>\n