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The following plans are network bound:

Get In Touch

Have a question, call the PAMC team today!

087 943 9612

For WhatsApp Nurse / Virtual Nurse consultations or GP benefits confirmation, please contact Africa Assist at 010 211 6111.

    • WhatsApp Nurse Chat - WhatsApp functionality for medical advice from qualified nurses available within the 30-day waiting period and thereafter
      • Nurse hours: This service will be available 24 hours a day, 7 days a week
      • WhatsApp: 060 550 4337
    • Virtual Nurse Consultation - Members can make use of the PAMC virtual Nurse Network. To consult with the GP, the member must obtain a referral / authorisation from the nurse. Benefits include unlimited consultations, when referred by the WhatsApp nurse. A 30-day waiting period applies.
    • GP consultations: Unlimited GP Consultations with PAMC Network GP’s. Member must obtain a referral / authorisation from the nurse before the GP consultation. No referral / authorisation no payment.

For benefits confirmation, please contact our PAMC call centre at 087 943 9612.

    • Pathology: Basic blood tests as requested by a PAMC Network provider subject to PAMC’s protocols and pathology formulary. A 30-day waiting period applies.
    • Radiology: Basic Black and White X-Rays as requested by a PAMC Network provider, subject to PAMC’s protocols and pathology formulary. A 30-day waiting period applies.
    • Out of Network consultation: 3 Consultations per annum at R450 per consultation. Claims or refunds can be submitted to claims@pamc.co.za. A 30-day waiting period applies.
    • Acute medication: Unlimited, subject to PAMC’s protocols and medicine formulary. A 30-day waiting period applies
    • Chronic medication: Unlimited, subject to PAMC’s protocols and medicine formulary. 3 months waiting period applies.
    • Over the counter Medication:
      • Individuals - R100 per event subject to an overall limit of R350 per annum.
      • Families - R100 per event subject to an overall limit of R825 per annum.
    • HIV Screening: HIV ELISA blood test. One per member per annum.
    • Claim submission:
      • Day to day claims - submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing.

Please note that the claim period for claim submissions is 4 months. Claims submissions submitted after the 4 months, will be rejected as stale.

PAMC contact details:

Nurse Whatsapp Line: 060 550 4337
Virtual Nurse Consultation : 010 211 6111
PAMC Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za
Hospital/Emergency : 010 211 6111
Provider Portal : https://www.pamc.co.za/PamcPortal/login

For WhatsApp Nurse / Virtual Nurse consultations or GP benefits confirmation, please contact Africa Assist at 010 211 6111.

  •  WhatsApp Nurse Chat - WhatsApp functionality for medical advice from qualified nurses available.
      • Nurse hours: This service will be available 24 hours a day, 7 days a week
      • WhatsApp: 060 550 4337
  • Virtual Nurse Consultation - Members can make use of the PAMC virtual Nurse Network. To consult with the GP, the member must obtain a referral / authorisation from the nurse from the 3rd visit onwards. Benefits include unlimited consultations, when referred by the WhatsApp nurse. A 30-day waiting period applies.
  • GP consultations: Unlimited GP Consultations with PAMC Network GP’s. Members have a maximum of 2 GP visits without the nurse authorisation. Authorisation from the nurse must be obtained from the 3rd GP visit onwards. No referral / authorisation no payment. A 30-day waiting period applies.

For benefits confirmation, please contact our PAMC call centre at 087 943 9612.

  • Pathology: Basic blood tests as requested by a PAMC Network provider subject to PAMC’s protocols and pathology formulary. A 30-day waiting period applies.
  • Radiology: Basic Black and White X-Rays as requested by a PAMC Network provider, subject to PAMC’s protocols and pathology formulary. A 30-day waiting period applies
  • Out of Network consultation: 3 Consultations per annum at R450 per consultation. Claims or refunds can be submitted to claims@pamc.co.za. A 30-day waiting period applies.
  • Acute medication: Unlimited, subject to PAMC’s protocols and medicine formulary. A 30-day waiting period applies.
  • Chronic medication: Unlimited, subject to PAMC’s protocols and medicine formulary. 3 months waiting period applies.
  • Over the counter Medication: A 30-day waiting period applies
    • Individuals - R100 per event subject to an overall limit of R350 per annum.
    • Families - R100 per event subject to an overall limit of R825 per annum.
  • HIV Screening: HIV ELISA blood test. One per member per annum. A 30-day waiting period applies.
  • Flu Vaccination: One per member per annum. A 30-day waiting period applies
  • Health Assessment: One test per member per annum. A 30-day waiting period applies
  • The following benefits are assessed and administered by African Assist (010 211 6111)
    • Accidental Hospitalisation
    • Accidental Death
    • Emergency Casualty Cover
    • Emergency Transportation
  • Claim submission:
    • Day to day claims - submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing.
    • All Hospital and related claims - Submitted to African Assist.

Please note that the claim period for claim submissions is 4 months. Claims submissions submitted after the 4 months, will be rejected as stale.

PAMC contact details:

Nurse Whatsapp Line: 060 550 4337
Virtual Nurse Consultation : 010 211 6111
PAMC Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za
Hospital/Emergency : 010 211 6111
Provider Portal : https://www.pamc.co.za/PamcPortal/login

For WhatsApp Nurse / Virtual Nurse consultations or GP benefits confirmation, please contact Africa Assist at 010 211 6111.

    • WhatsApp Nurse Chat - WhatsApp functionality for medical advice from qualified nurses available.
      • Nurse hours: This service will be available 24 hours a day, 7 days a week
      • WhatsApp: 060 550 4337
    • Virtual Nurse Consultation - Members can make use of the PAMC virtual Nurse Network. To consult with the GP, the member must obtain a referral / authorisation from the nurse from the 4th visit onwards. Benefits include unlimited consultations, when referred by the WhatsApp nurse. A 30-day waiting period applies.
    •  GP consultations: Unlimited GP Consultations with PAMC Network GP’s. Members have a maximum of 3 GP visits without the nurse authorisation. Authorisation from the nurse must be obtained from the 4th GP visit onwards. No referral / authorisation no payment. A 30-day waiting period applies.

For benefits confirmation, please contact our PAMC call centre at 087 943 9612.

    • Pathology: Basic blood tests as requested by a PAMC Network provider subject to PAMC’s protocols and pathology formulary. A 30-day waiting period applies.
    • Radiology: Basic Black and White X-Rays as requested by a PAMC Network provider, subject to PAMC’s protocols and pathology formulary. A 30-day waiting period applies
    • Out of Network consultation: 3 Consultations per annum at R450 per consultation. Claims or refunds can be submitted to claims@pamc.co.za. A 30-day waiting period applies.
    • Acute medication: Unlimited, subject to PAMC’s protocols and medicine formulary. A 30-day waiting period applies
    • Chronic medication: Unlimited, subject to PAMC’s protocols and medicine formulary. 3 months waiting period applies.
    • Over the counter Medication: A 30-day waiting period applies
      • Individuals - R100 per event subject to an overall limit of R350 per annum.
      • Families - R100 per event subject to an overall limit of R825 per annum.
    • HIV Screening: HIV ELISA blood test. One per member per annum. A 30-day waiting period applies.
    • Flu Vaccination: One per member per annum. A 30-day waiting period applies
    • Health Assessment: One test per member per annum. A 30-day waiting period applies
    • The following benefits are assessed and administered by African Assist (010 211 6111)
      • Accidental Hospitalisation
      • Accidental Death
      • Emergency Casualty Cover
      • Emergency Transportation
      •  On-site wellness days
      • Maternity benefit
    • Claim submission:
      • Day to day claims - submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing.
      • All Hospital and related claims - Submitted to African Assist.

Please note that the claim period for claim submissions is 4 months. Claims submissions submitted after the 4 months, will be rejected as stale.

PAMC contact details:

Nurse Whatsapp Line: 060 550 4337
Virtual Nurse Consultation : 010 211 6111
PAMC Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za
Hospital/Emergency : 010 211 6111
Provider Portal : https://www.pamc.co.za/PamcPortal/login

For benefits confirmation, please contact our PAMC call centre at 087 943 9612.

  • GP consultations: Four visits per annum. One month waiting period is applicable on this benefit.
  • Consulting room benefits (consumables): Three consulting room benefits per annum, one month waiting period is applicable on this benefit.
  • Radiology: Maximum of R800 per annum. One month waiting period is applicable on this benefit.
  • Pathology: Maximum of R1 200 per annum. One month waiting period is applicable on this benefit.
  • Specialist visits: Two visits per annum. Three months waiting period is applicable on this benefit.
  • Medication: Limited to R450 per event. One month waiting period is applicable on this benefit.
  • Consulting room procedure: Limited to one procedure @ R950 per annum. Six months waiting period is applicable on this benefit.

All claims may be submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing. Please note that the claim period for claim submissions is 60 days. Claims submissions submitted after the 60 days, will be rejected as stale.

PAMC contact details:

Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za

For benefits confirmation, please contact our PAMC call centre at 087 943 9612.

  • GP consultations: Four visits per annum. One month waiting period is applicable on this benefit.
  • Consulting room benefits (consumables): Three consulting room benefits per annum, one month waiting period is applicable on this benefit.
  • Radiology: Maximum of R800 per annum. One month waiting period is applicable on this benefit.
  • Pathology: One event per annum. Maximum of R1 200 per annum. One month waiting period is applicable on this benefit.
  • Specialist visits: Two visits per annum. Three months waiting period is applicable on this benefit.
  • Medication: Limited to R450 per event. One month waiting period is applicable on this benefit.
  • Consulting room procedure: Limited to one procedure @ R950 per annum. Six months waiting period is applicable on this benefit.

All claims may be submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing. Please note that the claim period for claim submissions is 60 days. Claims submissions submitted after the 60 days, will be rejected as stale.

PAMC contact details:

Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za

For benefits confirmation, please contact our PAMC call centre at 087 943 9612.

  • GP consultations: Eight visits per annum. One month waiting period is applicable on this benefit.
  • Consulting room benefits (consumables): Three consulting room benefits per annum, one month waiting period is applicable on this benefit.
  • Radiology: Maximum of R1 000 per annum. One month waiting period is applicable on this benefit.
  • Pathology: Maximum of R1 300 per annum. One month waiting period is applicable on this benefit
  • Specialist visits: Two visits per consultation per annum. Three months waiting period is applicable on this benefit.
  • Pregnancy screening: Two events per annum. Four months waiting period is applicable on this benefit.
  • Medication: Limited to R500 per event. One month waiting period is applicable on this benefit.
  • Consulting room procedure: Limited to one procedure @ R1 200 per annum. Six months waiting period is applicable on this benefit.

All claims may be submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing. Please note that the claim period for claim submissions is 60 days. Claims submissions submitted after the 60 days, will be rejected as stale.

PAMC contact details:

Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za

For benefits confirmation, please contact our PAMC call centre at 087 943 9612.

  • GP consultations: Eight visits per annum. One month waiting period is applicable on this benefit.
  • Consulting room benefits (consumables): Three consulting room benefits per annum, one month waiting period is applicable on this benefit.
  • Radiology: Maximum of R1 000 per annum. One month waiting period is applicable on this benefit
  • Pathology: Maximum of R1 300 per annum. One month waiting period is applicable on this benefit
  • Specialist visits: Two visits per annum. Three months waiting period is applicable on this benefit.
  • Pregnancy screening: Two events per annum. Four months waiting period is applicable on this benefit.
  • Medication: Limited to R500 per event. One month waiting period is applicable on this benefit.
  • Consulting room procedure: Limited to one procedure @ R1 200 per annum. Six months waiting period is applicable on this benefit.

All claims may be submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing. Please note that the claim period for claim submissions is 60 days. Claims submissions submitted after the 60 days, will be rejected as stale.

PAMC contact details:

Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za

For benefits confirmation, please contact our PAMC call centre at 087 943 9612.

  • GP consultations: Twelve visits per annum. One month waiting period is applicable on this benefit.
  • Consulting room benefits (consumables): Three consulting room benefits per annum, one month waiting period is applicable on this benefit.
  • Radiology: Maximum of R1 050 per annum. One month waiting period is applicable on this benefit.
  • Pathology: Maximum of R1 400 per annum. One month waiting period is applicable on this benefit
  • Specialist visits: Four visits per annum. Three months waiting period is applicable on this benefit.
  • Pregnancy screening: Three events per annum. Four months waiting period is applicable on this benefit.
  • Medication: Limited to R550 per event. One month waiting period is applicable on this benefit.
  • Consulting room procedure: Limited to one procedure @ R1 450 per annum. Six months waiting period is applicable on this benefit.

All claims may be submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing. Please note that the claim period for claim submissions is 60 days. Claims submissions submitted after the 60 days, will be rejected as stale.

PAMC contact details:

Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za

For benefits confirmation, please contact our PAMC call centre at 087 943 9612.

  • GP consultations: Twelve visits per annum. One month waiting period is applicable on this benefit.
  • Consulting room benefits (consumables): Three consulting room benefits per annum, one month waiting period is applicable on this benefit.
  • Radiology: Maximum of R1 050 per annum. One month waiting period is applicable on this benefit.
  • Pathology: Maximum of R1 400 per annum. One month waiting period is applicable on this benefit.
  • Specialist visits: Four visits per annum. Three months waiting period is applicable on this benefit.
  • Pregnancy screening: Three events per annum. Four months waiting period is applicable on this benefit.
  • Medication: Limited to R550 per event. One month waiting period is applicable on this benefit.
  • Consulting room procedure: Limited to one procedure @ R1 450 per annum. Six months waiting period is applicable on this benefit.

Claims may be submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing. Please note that the claim period for claim submissions is 60 days. Claims submissions submitted after the 60 days, will be rejected as stale.

PAMC contact details:

Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za

For benefits confirmation, please contact our PAMC call centre at 087 943 9612.

  • GP consultations: Four visits per annum. One month waiting period is applicable on this benefit.
  • Consulting room benefits (consumables): Three consulting room benefits per annum, one month waiting period is applicable on this benefit.
  • Radiology: Maximum of R800 per annum. One month waiting period is applicable on this benefit.
  • Pathology: Maximum of R1 200 per annum. One month waiting period is applicable on this benefit.
  • Specialist visits: Two visits per annum. Three months waiting period is applicable on this benefit.
  • Medication: Limited to R450 per event. One month waiting period is applicable on this benefit.

All claims may be submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing. Please note that the claim period for claim submissions is 60 days. Claims submissions submitted after the 60 days, will be rejected as stale.

PAMC contact details:

Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za

Sudden, unexpected occurrence of illness, dread disease, or the unforeseen need for an operation. All cases must be pre-authorised, pre-authorisation requests can be submitted to auths@agshealth.co.za or contact 010 140 1516.

  • Illness and Operations:
    • R150 000 per member per annum. Family limit of R300 000.
    • 3 Months general waiting period.
    • Six months waiting period on specific illnesses, refer to policy wording.
    • Twelve months waiting period on pre-existing conditions.
    • Dreaded diseases: Included in the Illness and Operation benefit R120 000 per annum.
  • Accidental/Trauma room:
    • R15 000 per member per event.
  • EMS, Ambulance:
    • R35 000 limit per member per annum. Emergency calls only.
    • Twelve months waiting period on pre-existing conditions.
  • Pregnancy cover for birth:
    • R45 000 limit per member per annum.
    • Nine months waiting period.

Must be an accident event and the member must be admitted in hospital as an inpatient. All cases must be pre-authorised, pre-authorisation requests can be submitted to auths@agshealth.co.za or contact 010 140 1516.

  • Accidental Hospitalisation:
    • R150 000 per member per annum. Family limit of R300 000.
    • Twelve months waiting period if the life threating event relates to a pre-existing condition.
  • Accidental/Trauma room:
    • R15 000 per member per event.
  • EMS, Ambulance:
    • R35 000 limit per member per annum. Emergency calls only.
    • Twelve months waiting period on pre-existing conditions.

Must be an accident event and the member must be admitted in hospital as an inpatient. All cases must be pre-authorised, pre-authorisation requests can be submitted to auths@agshealth.co.za or contact 010 140 1516.

  • Accidental Hospitalisation:
    • R150 000 per member per annum. Family limit of R300 000.
    • Twelve months waiting period if the life threating event relates to a pre-existing condition.
  • Accidental/Trauma room:
    • Accidents /Major Medical R15 000 per member per event.
    • Minor Incidents R2 000 per member per annum.
  • EMS, Ambulance:
    • R35 000 limit per member per annum. Emergency calls only.
    • Twelve months waiting period on pre-existing conditions.
  • Illness and Operations:
    • R90 000 per member per annum.
    • 3 Months general waiting period.
    • Six months waiting period on specific illnesses, refer to policy wording.
    • Twelve months waiting period on pre-existing conditions.
    • Dreaded diseases – Included in the Illness and Operation benefit. R120 000 per annum
  • Pregnancy cover for birth:
    • R45 000 limit per member per annum.
    • Nine months waiting period.

For benefits confirmation, please contact our PAMC call centre at 087 943 9612.

  • GP consultations: Pre-authorisation is required after the fourth consultation for a single member and after the eleventh consultation for a family.
  • Specialist visit: Subject to annual rand limit. Contact PAMC for benefit confirmation.
  • Pathology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Radiology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Out of Network consultation: Contact PAMC for benefit confirmation.
  • Acute medication: Unlimited, according to specified formulary.
  • Chronic medication: Unlimited, according to specified formulary.

All claims may be submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing. Please note that the claim period for claim submissions is 4 months. Claims submissions submitted after the 4 months, will be rejected as stale.

PAMC contact details:

Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za

For benefits confirmation, please contact our PAMC call centre at 087 943 9612.

 

  • GP consultations: Pre-authorisation is required after the fourth consultation for a single member and after the eleventh consultation for a family.
  • Specialist visit: Subject to annual rand limit. Contact PAMC for benefit confirmation.
  • Pathology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Radiology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Out of Network consultation: Contact PAMC for benefit confirmation.
  • Acute medication: Unlimited, according to specified formulary.
  • Chronic medication: Unlimited, according to specified formulary.

All claims may be submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing. Please note that the claim period for claim submissions is 4 months. Claims submissions submitted after the 4 months, will be rejected as stale.

PAMC contact details:

Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za

For benefits confirmation, please contact our PAMC call centre at 087 943 9612.

 

  • GP consultations: Pre-authorisation is required after the fourth consultation for a single member and after the eleventh consultation for a family.
  • Specialist visit: Subject to annual rand limit. Contact PAMC for benefit confirmation.
  • Pathology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Radiology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Out of Network consultation: Contact PAMC for benefit confirmation.
  • Acute medication: Unlimited, according to specified formulary.
  • Chronic medication: Unlimited, according to specified formulary.

All claims may be submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing. Please note that the claim period for claim submissions is 4 months. Claims submissions submitted after the 4 months, will be rejected as stale.

PAMC contact details:

Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za

For benefits confirmation, please contact our PAMC call centre at 087 943 9612.

 

  • GP consultations: Subject to three consultations for single member annually, and six consultations for a family annually.
  • Pathology: PAMC protocol rules apply, referred by Network Provider.
  • Radiology: PAMC protocol rules apply, referred by Network Provider.
  • Out of Network consultation: Contact PAMC for benefit confirmation.
  • Acute medication: Subject to annual limit, according to specified formulary.
  • Chronic medication: Unlimited, according to specified formulary.

All claims may be submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing. Please note that the claim period for claim submissions is 4 months. Claims submissions submitted after the 4 months, will be rejected as stale.

PAMC contact details:

Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za

For benefits confirmation, please contact our PAMC call centre at 087 943 9612.

 

  • GP consultations: Pre-authorisation is required after the fourth consultation for a single member and after the eleventh consultation for a family.
  • Specialist visit: Subject to annual rand limit. Contact PAMC for benefit confirmation.
  • Pathology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Radiology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Out of Network consultation: Contact PAMC for benefit confirmation.
  • Acute medication: Unlimited, according to specified formulary.
  • Chronic medication: Unlimited, according to specified formulary.

All claims may be submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing. Please note that the claim period for claim submissions is 4 months. Claims submissions submitted after the 4 months, will be rejected as stale.

PAMC contact details:

Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za

For benefits confirmation, please contact our PAMC call centre at 087 943 9612.

  • GP consultations: Pre-authorisation is required after the fourth consultation for a single member and after the eleventh consultation for a family.
  • Specialist visit: Subject to annual rand limit. Contact PAMC for benefit confirmation.
  • Pathology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Radiology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Out of Network consultation: Contact PAMC for benefit confirmation.
  • Acute medication: Unlimited, according to specified formulary.
  • Chronic medication: Unlimited, according to specified formulary.

All claims may be submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing. Please note that the claim period for claim submissions is 4 months. Claims submissions submitted after the 4 months, will be rejected as stale.

PAMC contact details:

Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za

For benefits confirmation, please contact our PAMC call centre at 087 943 9612.

 

  • GP consultations: Pre-authorisation is required after the fourth consultation for a single member and after the eleventh consultation for a family.
  • Specialist visit: Subject to annual rand limit. Contact PAMC for benefit confirmation.
  • Pathology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Radiology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Out of Network consultation: Contact PAMC for benefit confirmation.
  • Acute medication: Unlimited, according to specified formulary.
  • Chronic medication: Unlimited, according to specified formulary.

All claims may be submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing. Please note that the claim period for claim submissions is 4 months. Claims submissions submitted after the 4 months, will be rejected as stale.

PAMC contact details:

Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za

For benefits confirmation, please contact our PAMC call centre at 087 943 9612.

 

  • GP consultations: Pre-authorisation is required after the fourth consultation for a single member and after the eleventh consultation for a family.
  • Specialist visit: Subject to annual rand limit. Contact PAMC for benefit confirmation.
  • Pathology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Radiology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Out of Network consultation: Contact PAMC for benefit confirmation.
  • Acute medication: Unlimited, according to specified formulary.
  • Chronic medication: Unlimited, according to specified formulary.

All claims may be submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing. Please note that the claim period for claim submissions is 4 months. Claims submissions submitted after the 4 months, will be rejected as stale.

PAMC contact details:

Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za

For benefits confirmation, please contact our PAMC call centre at 087 943 9612.

 

  • GP consultations: Pre-authorisation is required after the fourth consultation for a single member and after the eleventh consultation for a family.
  • Specialist visit: No Benefit.
  • Pathology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Radiology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Out of Network consultation: Contact PAMC for benefit confirmation.
  • Acute medication: Unlimited, according to specified formulary.
  • Chronic medication: Unlimited, according to specified formulary.

All claims may be submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing. Please note that the claim period for claim submissions is 4 months. Claims submissions submitted after the 4 months, will be rejected as stale.

PAMC contact details:

Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za

For benefits confirmation, please contact our PAMC call centre at 087 943 9612.

 

  • GP consultations: Pre-authorisation is required after the fourth consultation for a single member and after the eleventh consultation for a family.
  • Specialist visit: Subject to annual rand limit. Contact PAMC for benefit confirmation.
  • Pathology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Radiology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Out of Network consultation: Contact PAMC for benefit confirmation.
  • Acute medication: Unlimited, according to specified formulary.
  • Chronic medication: Unlimited, according to specified formulary.

All claims may be submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing. Please note that the claim period for claim submissions is 4 months. Claims submissions submitted after the 4 months, will be rejected as stale.

PAMC contact details:

Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za

For benefits confirmation, please contact our PAMC call centre at 087 943 9612.

 

  • GP consultations: Pre-authorisation is required after the fourth consultation for a single member and after the eleventh consultation for a family.
  • Specialist visit: Subject to annual rand limit. Contact PAMC for benefit confirmation.
  • Pathology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Radiology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Out of Network consultation: Contact PAMC for benefit confirmation.
  • Acute medication: Unlimited, according to specified formulary.
  • Chronic medication: Unlimited, according to specified formulary.

All claims may be submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing. Please note that the claim period for claim submissions is 4 months. Claims submissions submitted after the 4 months, will be rejected as stale.

PAMC contact details:

Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za

For benefits confirmation, please contact our PAMC call centre at 087 943 9612.

 

  • GP consultations: Pre-authorisation is required after the fourth consultation for a single member and after the eleventh consultation for a family.
  • Specialist visit: Subject to annual rand limit. Contact PAMC for benefit confirmation.
  • Pathology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Radiology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Out of Network consultation: Contact PAMC for benefit confirmation.
  • Acute medication: Unlimited, according to specified formulary.
  • Chronic medication: Unlimited, according to specified formulary.

All claims may be submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing. Please note that the claim period for claim submissions is 4 months. Claims submissions submitted after the 4 months, will be rejected as stale.

PAMC contact details:

Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za

For benefits confirmation, please contact our PAMC call centre at 087 943 9612.

 

  • GP consultations: Pre-authorisation is required after the fourth consultation for a single member and after the eleventh consultation for a family.
  • Specialist visit: No benefit
  • Pathology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Radiology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Out of Network consultation: Contact PAMC for benefit confirmation.
  • Acute medication: Unlimited, according to specified formulary.
  • Chronic medication: Unlimited, according to specified formulary.

All claims may be submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing. Please note that the claim period for claim submissions is 4 months. Claims submissions submitted after the 4 months, will be rejected as stale.

PAMC contact details:

Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za

For benefits confirmation, please contact our PAMC call centre at 087 943 9612.

 

  • GP consultations: Pre-authorisation is required after the fourth consultation for a single member and after the eleventh consultation for a family.
  • Specialist visit: Subject to annual rand limit. Contact PAMC for benefit confirmation.
  • Pathology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Radiology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Out of Network consultation: Contact PAMC for benefit confirmation.
  • Acute medication: Unlimited, according to specified formulary.
  • Chronic medication: Unlimited, according to specified formulary.

All claims may be submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing. Please note that the claim period for claim submissions is 4 months. Claims submissions submitted after the 4 months, will be rejected as stale.

PAMC contact details:

Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za

For benefits confirmation, please contact our PAMC call centre at 087 943 9612.

 

  • GP consultations: Pre-authorisation is required after the fourth consultation for a single member and after the eleventh consultation for a family.
  • Specialist visit: Subject to annual rand limit. Contact PAMC for benefit confirmation.
  • Pathology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Radiology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Out of Network consultation: Contact PAMC for benefit confirmation.
  • Acute medication: Unlimited, according to specified formulary.
  • Chronic medication: Unlimited, according to specified formulary.

All claims may be submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing. Please note that the claim period for claim submissions is 4 months. Claims submissions submitted after the 4 months, will be rejected as stale.

PAMC contact details:

Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za

For benefits confirmation, please contact our PAMC call centre at 087 943 9612.

 

  • GP consultations: Pre-authorisation is required after the fourth consultation for a single member and after the eleventh consultation for a family.
  • Specialist visit: Subject to annual rand limit. Contact PAMC for benefit confirmation.
  • Pathology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Radiology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Out of Network consultation: Contact PAMC for benefit confirmation.
  • Acute medication: Unlimited, according to specified formulary.
  • Chronic medication: Unlimited, according to specified formulary.

All claims may be submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing. Please note that the claim period for claim submissions is 4 months. Claims submissions submitted after the 4 months, will be rejected as stale.

PAMC contact details:

Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za

For benefits confirmation, please contact our PAMC call centre at 087 943 9612.

 

  • GP consultations: Pre-authorisation is required after the fourth consultation for a single member and after the eleventh consultation for a family.
  • Specialist visit: No benefit
  • Pathology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Radiology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Out of Network consultation: Contact PAMC for benefit confirmation.
  • Acute medication: Unlimited, according to specified formulary.
  • Chronic medication: Unlimited, according to specified formulary.

All claims may be submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing. Please note that the claim period for claim submissions is 4 months. Claims submissions submitted after the 4 months, will be rejected as stale.

PAMC contact details:

Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za

For benefits confirmation, please contact our PAMC call centre at 087 943 9612.

 

  • GP consultations: Pre-authorisation is required after the fourth consultation for a single member and after the eleventh consultation for a family.
  • Specialist visit: Subject to annual rand limit. Contact PAMC for benefit confirmation.
  • Pathology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Radiology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Out of Network consultation: Contact PAMC for benefit confirmation.
  • Acute medication: Unlimited, according to specified formulary.
  • Chronic medication: Unlimited, according to specified formulary.

All claims may be submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing. Please note that the claim period for claim submissions is 4 months. Claims submissions submitted after the 4 months, will be rejected as stale.

PAMC contact details:

Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za

For benefits confirmation, please contact our PAMC call centre at 087 943 9612.

 

  • GP consultations: Pre-authorisation is required after the fourth consultation for a single member and after the eleventh consultation for a family.
  • Specialist visit: Subject to annual rand limit. Contact PAMC for benefit confirmation.
  • Pathology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Radiology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Out of Network consultation: Contact PAMC for benefit confirmation.
  • Acute medication: Unlimited, according to specified formulary.
  • Chronic medication: Unlimited, according to specified formulary.

All claims may be submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing. Please note that the claim period for claim submissions is 4 months. Claims submissions submitted after the 4 months, will be rejected as stale.

PAMC contact details:

Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za

For benefits confirmation, please contact our PAMC call centre at 087 943 9612.

 

  • GP consultations: Pre-authorisation is required after the fourth consultation for a single member and after the eleventh consultation for a family.
  • Specialist visit: Subject to annual rand limit. Contact PAMC for benefit confirmation.
  • Pathology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Radiology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Out of Network consultation: Contact PAMC for benefit confirmation.
  • Acute medication: Unlimited, according to specified formulary.
  • Chronic medication: Unlimited, according to specified formulary.

All claims may be submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing. Please note that the claim period for claim submissions is 4 months. Claims submissions submitted after the 4 months, will be rejected as stale.

PAMC contact details:

Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za

For benefits confirmation, please contact our PAMC call centre at 087 943 9612.

 

  • GP consultations: Pre-authorisation is required after the fourth consultation for a single member and after the eleventh consultation for a family.
  • Specialist visit: No benefit
  • Pathology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Radiology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Out of Network consultation: Contact PAMC for benefit confirmation.
  • Acute medication: Unlimited, according to specified formulary.
  • Chronic medication: Unlimited, according to specified formulary.

All claims may be submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing. Please note that the claim period for claim submissions is 4 months. Claims submissions submitted after the 4 months, will be rejected as stale.

PAMC contact details:

Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za

For benefits confirmation, please contact our PAMC call centre at 087 943 9612.

 

  • GP consultations: Pre-authorisation is required after the fourth consultation for a single member and after the eleventh consultation for a family.
  • Specialist visit: Subject to annual rand limit. Contact PAMC for benefit confirmation.
  • Pathology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Radiology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Out of Network consultation: Contact PAMC for benefit confirmation.
  • Acute medication: Unlimited, according to specified formulary.
  • Chronic medication: Unlimited, according to specified formulary.

All claims may be submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing. Please note that the claim period for claim submissions is 4 months. Claims submissions submitted after the 4 months, will be rejected as stale.

PAMC contact details:

Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za

For benefits confirmation, please contact our PAMC call centre at 087 943 9612.

 

  • GP consultations: Pre-authorisation is required after the fourth consultation for a single member and after the eleventh consultation for a family.
  • Specialist visit: Subject to annual rand limit. Contact PAMC for benefit confirmation.
  • Pathology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Radiology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Out of Network consultation: Contact PAMC for benefit confirmation.
  • Acute medication: Unlimited, according to specified formulary.
  • Chronic medication: Unlimited, according to specified formulary.

All claims may be submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing. Please note that the claim period for claim submissions is 4 months. Claims submissions submitted after the 4 months, will be rejected as stale.

PAMC contact details:

Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za

For benefits confirmation, please contact our PAMC call centre at 087 943 9612.

 

  • GP consultations: Pre-authorisation is required after the fourth consultation for a single member and after the eleventh consultation for a family.
  • Specialist visit: Subject to annual rand limit. Contact PAMC for benefit confirmation.
  • Pathology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Radiology: Unlimited - PAMC protocol rules apply, referred by Network Provider.
  • Out of Network consultation: Contact PAMC for benefit confirmation.
  • Acute medication: Unlimited, according to specified formulary.
  • Chronic medication: Unlimited, according to specified formulary.

All claims may be submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing. Please note that the claim period for claim submissions is 4 months. Claims submissions submitted after the 4 months, will be rejected as stale.

PAMC contact details:

Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za

For benefits confirmations, please contact our PAMC call centre at 087 943 9612.

 

  • GP consultations: Unlimited managed visits per person per annum (limited to a designated provider on the Getsavvi Doctors Network. Three month waiting period is applicable on this benefit. Pre -authorisation after the 6th consultation.
  • Pathology: Unlimited According to protocol and requested by a contracted network service provider. Three month waiting period is applicable on this benefit.
  • Radiology: Unlimited According to protocol and requested by a contracted network service provider. Three month waiting period is applicable on this benefit.
  • Maternity benefits: Maternity benefits will include gynaecologists’ visits and ultrasound scans as well as the costs related to the birth. Twelve month waiting period is applicable on this benefit.
  • Acute medication: Medication for the treatment of acute conditions according to a fixed formulary. (Prescribed by non-dispensing GetSavvi Network doctors only). Three month waiting period is applicable on this benefit.
  • Chronic medication: Unlimited According to formulary. Twelve month waiting period is applicable on this benefit.
  • Preventative Benefits: Three month waiting period is applicable on this benefit.
  • Hospital Benefit: Subject to scheme rules and pre-authorisation.
  • Emergency Hospital Cover (per insured person per annum): Subject to scheme rules and pre-authorisation.

All claims may be submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing. Please note that the claim period for claim submissions is 4 months. Claims submissions submitted after the 4 months, will be rejected as stale.
PAMC contact details:

Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za

For benefits confirmations, please contact our PAMC call centre at 087 943 9612

 

  • GP consultations: Unlimited managed visits per person per annum (limited to a designated provider on the Getsavvi Doctors Network. Three month waiting period is applicable on this benefit. Pre -authorisation after the 6th consultation.
  • Pathology: Unlimited According to protocol and requested by a contracted network service provider . Three month waiting period is applicable on this
  • Radiology: Unlimited According to protocol and requested by a contracted network service provider . Three month waiting period is applicable on this benefit.
  • Maternity benefits: Maternity benefits will include gynaecologists’ visits and ultrasound scans as well as the costs related to the birth. Twelve month waiting period is applicable on this benefit.
  • Acute medication: Medication for the treatment of acute conditions according to a fixed formulary. (Prescribed by non-dispensing GetSavvi Network doctors only). Three month waiting period is applicable on this benefit.
  • Chronic medication: Unlimited According to formulary. Twelve month waiting period is applicable on this benefit.
  • Preventative Benefits: Three month waiting period is applicable on this benefit.
  • Hospital Benefit: Subject to scheme rules and pre-authorisation.
  • Emergency Hospital Cover (per insured person per annum): Subject to scheme rules and pre-authorisation.

All claims may be submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing. Please note that the claim period for claim submissions is 4 months. Claims submissions submitted after the 4 months, will be rejected as stale.
PAMC contact details:

Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za

For benefits confirmations, please contact our PAMC call centre at 087 943 9612.

 

  • GP consultations: Unlimited managed visits per person per annum (limited to a designated provider on the Getsavvi Doctors Network. Pre -authorisation after the 6th consultation. Three month waiting period is applicable on this benefit.
  • Pathology: Unlimited According to protocol and requested by a contracted network service provider. Three month waiting period is applicable on this benefit.
  • Radiology: Unlimited According to protocol and requested by a contracted network service provider. Three month waiting period is applicable on this benefit.
  • Maternity benefits: Maternity benefits will include gynaecologists’ visits and ultrasound scans as well as the costs related to the birth. Twelve month waiting period is applicable on this benefit.
  • Acute medication: Medication for the treatment of acute conditions according to a fixed formulary. (Prescribed by non-dispensing GetSavvi Network doctors only). Three month waiting period is applicable on this benefit.
  • Chronic medication: Unlimited According to formulary. Twelve month waiting period is applicable on this benefit.
  • Preventative Benefits: Three month waiting period is applicable on this benefit.
  • Hospital Benefit: Subject to scheme rules and pre-authorisation.
  • Emergency Hospital Cover (per insured person per annum): Subject to scheme rules and pre-authorisation.

All claims may be submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing. Please note that the claim period for claim submissions is 4 months. Claims submissions submitted after the 4 months, will be rejected as stale.
PAMC contact details:

Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za

For WhatsApp Nurse / Virtual Nurse consultations or GP benefits confirmation, please contact Africa Assist at 010 211 6111. For benefits confirmation, please contact our PAMC call centre at 087 943 9612

  • Virtual Consultation - Members can make use of the PAMC virtual Nurse Network. Services will be available 24 hours a day, 7 days a week
    • Nurse line: Africa Assist - 010 211 6111
  • GP consultations: Unlimited GP Consultations with PAMC Network GP’s. Pre-authorisation required after the 3rd visit. Member must contact the nurse line for authorisation from the 4th consultation. No authorisation no payment.
  • Pathology: Basic blood tests as requested by a PAMC Network provider subject to PAMC’s protocols and pathology formulary.
  • Radiology: Basic Black and White X-Rays as requested by a PAMC Network provider, subject to PAMC’s protocols and pathology formulary.
  • Acute and OTC medication: Overall limit of R1 300 per policy per annum and R150 per OTC event.
  • Chronic medication: As prescribed by a PAMC Network provider subject to PAMC protocols and medicine formulary. 3 months waiting period applies.
  • Specialist benefits: Specialist visits are limited to a maximum of R2 000 per member. Maximum of R4 000 per policy per annum. Specialist visits will only be covered if a PAMC Network provider has referred the insured to a specialist. 3 months waiting period applies.
  • Maternity: 2 Growth scans and antenatal medication of R100 per month for 9 months according to Mediscor formulary. 10 months waiting period applies.
  • Covid: Test and Vaccine as referred by a Network Provider.
  • The following benefits are assessed and administered by African Assist and need pre-authorisation (010 211 6111)
    • Emergency Casualty Cover: R5 000 per policy per annum – Treatment of patients with acute and life-threatening traumatic events.
    • Emergency Transportation: Transportation to Hospital as authorised by Africa Assist.
  • Claim submission:
    • Day to day claims - submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing.
    • All Hospital and related claims - Submitted to African Assist.

Please note that the claim period for claim submissions is 4 months. Claims submissions submitted after the 4 months, will be rejected as stale.

PAMC contact details:

Virtual Nurse Consultation : 010 211 6111
PAMC Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za
Hospital/Emergency : 010 211 6111
Provider Portal : https://www.pamc.co.za/PamcPortal/login

PAMC contact details:

Nurse Whatsapp Line: 060 550 4337
Virtual Nurse Consultation : 010 211 6111
PAMC Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za
Hospital/Emergency : 010 211 6111
Provider Portal : https://www.pamc.co.za/PamcPortal/login

For WhatsApp Nurse / Virtual Nurse consultations or GP benefits confirmation, please contact Africa Assist at 010 211 6111. For benefits confirmation, please contact our PAMC call centre at 087 943 9612

 

  • Virtual Consultation - Members can make use of the PAMC virtual Nurse Network. Services will be available 24 hours a day, 7 days a week
    • Nurse line: Africa Assist - 010 211 6111
  • GP Consultations: Unlimited GP Consultations with PAMC Network GP’s. Pre-authorisation required after the 3rd visit. Member must contact the nurse line for authorisation from the 4th consultation. No authorisation no payment.
  • Pathology: Basic blood tests as requested by a PAMC Network provider subject to PAMC’s protocols and pathology formulary.
  • Radiology: Basic Black and White X-Rays as requested by a PAMC Network provider, subject to PAMC’s protocols and pathology formulary.
  • Acute and OTC medication: Overall limit of R1 300 per policy per annum and R150 per OTC event.
  • Chronic medication: As prescribed by a PAMC Network provider subject to PAMC protocols and medicine formulary. 3 months waiting period applies.
  • Specialist benefits: Specialist visits are limited to a maximum of R2 000 per member. Maximum of R4 000 per policy per annum. Specialist visits will only be covered if a PAMC Network provider has referred the insured to a specialist. 3 months waiting period applies.
  • Maternity: 2 Growth scans and antenatal medication of R100 per month for 9 months according to Mediscor formulary. 10 months waiting period applies.
  • Covid: Test and Vaccine as referred by a Network Provider.
  • The following benefits are assessed and administered by African Assist and need pre-authorisation (010 211 6111)
    • Emergency Casualty Cover: R12 000 per policy per annum – Treatment of patients with acute and life-threatening traumatic events.
    • General Admission: Maximum of R53 000 per Illness Admission according to stated benefits. 3 Months waiting period applies. Pre-existing Illness 12 months waiting period.
  • ICU Admission: Up to R15 000 per day (Maximum of 5 days). 3 Months waiting period applies. Pre-existing Illness 12 months waiting period.
    • Accident: R300 000 per individual to a maximum of R450 000 per family.
  • Dreaded Disease Admission: Pay out as per disease stage up to R250 000. 6 Months waiting period applies. 12 Months waiting period for pre-existing illness.
  • Maternity: 10 Months waiting period applies.
    • R35 000 Natural delivery
    • R45 000 C-Section delivery
  • Surgery: As per stated benefits and authorised by Africa Assist. 3 Months waiting period applies. 12 Months waiting period on pre-existing conditions.
    • Emergency Transportation: Transportation to Hospital as authorised by Africa Assist.
  • Claim submission:
    • Day to day claims - submitted electronically to PAMC or alternatively to claims@pamc.co.za for capturing and processing.
    • All Hospital and related claims - Submitted to African Assist.

Please note that the claim period for claim submissions is 4 months. Claims submissions submitted after the 4 months, will be rejected as stale.

PAMC contact details:

Virtual Nurse Consultation : 010 211 6111
PAMC Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za
Hospital/Emergency : 010 211 6111
Provider Portal : https://www.pamc.co.za/PamcPortal/login

 

The following benefits are assessed and administered by African Assist and need pre-authorisation (010 211 6111)

    • Emergency Casualty Cover: R12 000 per policy per annum – Treatment of patients with acute and life-threatening traumatic events.
    • General Admission: Maximum of R53 000 per Illness Admission according to stated benefits. 3 Months waiting period applies. Pre-existing Illness 12 months waiting period.
  • ICU Admission: Up to R15 000 per day (Maximum of 5 days). 3 Months waiting period applies. Pre-existing Illness 12 months waiting period.
    • Accident: R300 000 per individual to a maximum of R450 000 per family.
  • Dreaded Disease Admission: Pay out as per disease stage up to R250 000. 6 Months waiting period applies. 12 Months waiting period for pre-existing illness.
  • Maternity: 10 Months waiting period applies.
    • R35 000 Natural delivery
    • R45 000 C-Section delivery

 

  • Surgery: As per stated benefits and authorised by Africa Assist. 3 Months waiting period applies. 12 Months waiting period on pre-existing conditions.
    • Emergency Transportation: Transportation to Hospital as authorised by Africa Assist.
  • Claim submission:
    • All Hospital and related claims - Submitted to African Assist.

Please note that the claim period for claim submissions is 4 months. Claims submissions submitted after the 4 months, will be rejected as stale.

PAMC contact details:

PAMC Call centre: 087 943 9612
Client services – enquiries@pamc.co.za
Claim submissions – claims@pamc.co.za
Hospital/Emergency : 010 211 6111
Provider Portal : https://www.pamc.co.za/PamcPortal/login

 

 

 
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