Eswatinimed offers nine benefit options and each individual should choose an option according to his/her health care needs. For all the options, benefits are paid at Eswatinimed scale of benefit (SPL) with adequate annual limits.

NO/ LOW CLAIM BONUS

Members who have completed a twelvemonth membership (calendar year; January-December) are entitled to a percentage of their contributions which is claimed before the end of March of the following year. Only High benefit, Standard benefit, Medium benefit and Savings plan members are entitled to these claims. Members are encouraged to write claims letters to Eswatinimed for tax purposes thus there is no automatic payments of bonuses.

Members on High, Standard and Medium option from January to December will be allowed to write a letter to claim a 30% incentive bonus for the previous year before the end of March in the following year. To qualify for the bonus members should have cleared all contribution arrears by March of the following year.
Payment will be between June and October.

SAVINGS OPTIONS

Swazisave members can claim a 20% savings balance only if the member has 12 months membership from the beginning of the year. If the member on the savings option leaves the fund the balance of the savings will remain with the fund and the member may claim the 20% yearly. The current year balance will be paid only if the member leaves by the end of December.

100% CASH BACK CLAIMS

Members who have terminated their membership may claim 100% savings balance and payment will be processed after the lapse of the stale period (4 months) from the date of termination. Members may use their savings for future medical expenses/contributions if preferred not to claim back as cash.

WHAT HAPPENS TO MY SAVINGS WHEN I CHANGE OPTIONS?

Member’s savings will be transferred to the newly selected option and members may claim 20% of the savings balance on annual basis. Applications can be sent before the end of March the following year.

WHAT HAPPENS TO MY SAVINGS WHEN I TERMINATE MEMBERSHIP DURING THE YEAR?

Members on high benefit, standard benefit, medium benefit and savings plan forfeit their savings or claims for the incomplete current financial period (January-December). Members may only claim for a full financial period. Members who join at the beginning of the year and terminate membership during the course of the year will not claim savings for that year. The balance from the previous years may only be claimed annually (20% balance every year)

EX-GRATIA ASSISTANCE
Ex-gratia is a conditional assistance which is granted to a member who has exhausted the normal benefit and there is a clinical indication that if the treatment is not received the members life will be in danger.
Terms and conditions apply.