What you need to know about the WHO Global Outbreak Benefit
The WHO Global Outbreak Benefit is available to all members of BMW Employees Medical Aid Society during a declared outbreak period, such as the current COVID-19 pandemic. The benefit provides cover for relevant healthcare services, as well as a defined basket of care for out-of-hospital healthcare services related to the pandemic.
This benefit ensures that members have access to screening consultations, testing, and management and appropriate supportive treatment as long as they meet the Society's Benefit entry criteria.
Know your risks
Find out what your risk status is by completing the COVID-19 risk assessment. The questions in the assessment will help you find out if you have symptoms that are linked to COVID-19 or if you may have been exposed to COVID-19 and need a consultation with a doctor. Once you have completed the risk assessment, you get access to additional funding for screening consultations and tests.
How you are covered from the WHO Global Outbreak Benefit
This benefit provides cover for cases of outbreak diseases and out-of-hospital healthcare services related to COVID-19. The cover does not affect your day-to-day benefits.
What you are covered for
This benefit offers cover for out-of-hospital healthcare services related to COVID-19. This means that you have cover for COVID-19 diagnosis and treatment when you are not admitted to hospital. This is in addition to your hospital benefits if you are admitted to hospital for COVID-19 treatment.
The basket of care includes:
- Screening consultations with a nurse or network GP (either virtual consultations, telephone or face-to-face) after you have completed a risk assessment
- Two COVID-19 PCR screening tests, if referred by your doctor or referred by a network GP when you may be at risk of having contracted COVID-19
- Two pre-admission COVID-19 tests required by hospitals before admitting you for treatment not related to COVID-19
- A defined basket of care for COVID-19-positive members, which includes pathology, X-rays and scans, chest physiotherapy, and psychotherapy benefits
- Cover for a list of supportive medicines
- Consultations with a nurse or network GP (virtual consultations, telephone consultations or face-to-face consultations)
- Benefits for the home monitoring of COVID-19-positive members, which includes a pulse oximeter and up to three consultations for each person every year
- COVID-19 vaccinations and booster shots
- Benefits for out-of-hospital treatment and care of long COVID-19 in cases where the symptoms carry on after 21 days of the initial infection
Your cover depends on the following
- You must use the Society's designated service providers (DSPs), where applicable.
- You must meet certain clinical entry criteria.
- Any recommended treatment and healthcare services that are not included in the basket of care are paid from your available day-to-day benefits, or in line with Prescribed Minimum Benefits, where applicable.
- Approved in-hospital treatment related to COVID-19 is covered from the Hospital Benefit in line with Prescribed Minimum Benefits (PMBs), where applicable.
- The cost of COVID-19 vaccines, which includes the cost of administering the vaccine, is covered as Prescribed Minimum Benefits (PMBs).
- You must register on the National Department of Health's Electronic Vaccine Data System (EVDS) to be vaccinated.
Get the facts and follow preventive steps
COVID-19 and the flu season overlap in South Africa, so it is crucial to have the seasonal flu vaccination as protection against flu. Please visit the COVID-19 information hub to understand the facts around COVID-19 and the preventive measures that help protect your health.