Spending time abroad: What if I need to access healthcare overseas?

Whether you are overseas for holidays or for work, it is important to understand if, and how you could get medical expenses reimbursed by AMS.

Value Care Plan: Your benefits are restricted to services provided by Prime Cure providers in South Africa, so you can not claim for healthcare services overseas.

Standard Care Plan and Managed Care Plan: If you incur healthcare costs outside South Africa, you must pay for them in full where they were provided. You then claim from your travel insurance first. If you have no or insufficient insurance, you can submit a claim to the Scheme within four months, including a detailed account for the full service, or for the shortfall, a sworn English translation if the account is in another language, proof of payment and the international claim form which you can find on our website. The account must provide the same details as required for South African claims. Payments are made in Rand to your South African bank account, at the Schemes' sole discretion, based on the average Scheme Reimbursement Rate (SRR) for similar services in South Africa.

As overseas medical expenses might be much higher than our SRR, we urge you to take out travel insurance. For questions on overseas claims contact us on WhatsApp on 011 292 8797 or call us from overseas on: +27 11 529 2888.

Netcare 911 services are also available to you in Namibia, Swaziland, Botswana, Lesotho, Zimbabwe and Mozambique and you need to follow the same process as if you would call them in South Africa. You can call them from abroad on +27 10 209 8288.

Published December 2024