Pula Medical Aid endures sluggish economy
Isaac Pinielo | Tuesday July 25, 2017 15:42
Addressing the media last week, Pula principal officer, Thato Moumakwa said of late, Botswana’s economy has been under a lot of pressure, experiencing a number of setbacks due to the financial crunch that has resulted in the closure of a number of organisations.
“However as Pula, we want to reassure our valued members, their dependents and our stakeholders that due to our positive solvency margin, we retain a healthy financial standing and are as stable and dependable as ever,” he said. Having been in existence for more than 25 years, Moumakwa said the Fund is still going strong with a healthy financial standing. He said this is due to the fact that they understand the needs of their members and continuously adapt and develop their products to better suit their health care needs.
The Fund also announced developments within their existing products, including the increase of the annual overall limit for the Deluxe benefit option from P800,000 to P1.2 million to ensure that it continues to provide sustainable, affordable and accessible health care services.
In addition to enhancing their existing offering, Pula unveiled two new benefit options, Galaxy and Flexi, effective on July 1, this year.
“The new benefit options have an annual overall limit of P100,000 and P60,000 respectively. The Galaxy benefit option offers inpatient and outpatient medical cover whilst Flexi benefit option provides only outpatient cover,” said Moumakwa.
Associated Fund Administrators (AFA) managing director, Duncan Thela said on average, more than 25,000 beneficiaries were provided access to private health care services from local facilities and outside the country per quarter. AFA are the administrators of Pula Medical Aid.
As Pula Medical Aid Fund, he said their mandate is to take care of the health of the people, adding that the Fund’s board of trustees meets on a quarterly basis to assess the Fund’s performance and provide guidance.
“Furthermore, we are compliant with all our regulatory, financial and operational obligations with the Non Bank Financial Institutions Regulatory Authority (NBFIRA),” he said.
The Fund is also making innovative technical advances to offer speedy claims and payments, as well as integrations with various health service suppliers for the benefit of their customers.
Since 2014, Thela said they introduced EDI (electronic data interchange), which enables the guarantee of payments for services accessed by their customers.
He said currently 66% of their claims are electronic with the balance being paper-based, which he said has also assisted in improving relationships with their service providers and inherently that transfers to the customer.