FAQs
HEALTH
Savings requests can be done from 1st December- 31st January through HR for corporates or send direct email to HealthPremiumAdmin@metropolitan.co.ls. An administration fee of M50 may be incurred per claim.
Refund claims may be sent to Claims@metropolitan.co.ls , detailed invoice and a corresponding receipt
Clients can contact our office on 22222100 and ask for Membership Consultants
Turnaround time for new applications is 48hrs
Full names, date of birth and ID/passport and amendment for which is obtainable at Metropolitan or any of our digital platforms.
Health Risk Management Tel: +266 2222 2180
Cell: +266 6396 7332
Gym is an exclusion; it is paid entirely by the member however as a way of promoting good health we pay an incentive to loyal members of the gym
qualification: 1hr for 14days. 14 days starts from 15th of every month. Incentives differ according to options, access 150, standard 200, advanced 250, comprehensive 300
Submit maternity registration program form, obtainable at our office or on our digital platforms.
It is a contribution from your monthly premiums that is set aside to cater for any medical aid expenses or shortfall that may occur. Medical aid savings maybe carried forward every year or can be claimed at the end of every benefit year if not utilized
Hospital options mainly cover the treatment costs if you are admitted to hospital such as ward costs, theatre fees, and accounts from other in-hospital providers such as anesthetists or radiologists.
This is regarded as a period during which you will be required to pay your normal monthly contributions, but you will not be entitled to any benefits from the scheme.
What are the types of waiting periods?
There are three kinds of waiting periods i.e.:
- General waiting period of up to three months.
- Maternity waiting period of up to 9 months.
- Condition-specific waiting period (usually referred to as “an exclusion”) of up to 24 months
No. Medical aid scheme will usually only allow you to change options once per year, with effect 01 January of that year.
- If you or a member of your family is to be admitted to hospital, you must call your medical aid scheme at least 48 hours before you are admitted in order to obtain authorization from the scheme. In the case of an un-planned, un-scheduled or emergency admission, you must contact your scheme within 24 hours after admission. In order to pre-authorize your hospitalization, you will be asked for the following information:
- your membership number
- the name of the member or dependent who is going to hospital
- the reason for the admission (I.e., the diagnosis and procedure codes)
- the date of admission
- the name, practice number and telephone number of the hospital and the doctor who is admitting you.
RETAIL
Contributions less the expenses provided the policy have acquired the values.
If there was a premium deduction after policy termination
Paid up means that the policy premiums are ceased, and the policy remain in force, however some benefits are forfeited based on policy duration.
Identity document of the new beneficiary\ies and policy holder
The advice is that you go to the nearest branch to discuss the options depending on the policy duration, this will help that the advice be given to avoid policy from being lapse.
Turnaround time is 24 to 48 hrs.
Yes, the claims can be done online except for death claims and maturities
Because there are deadlines between the stop order agencies.
Go to the nearest Client service office and request to be onboarded for Paperless/Tobetsa