Camaf
Accounting Services in Randburg

We would like to remind you of the following processes relating to the dispensing of chronic medication.
The Chartered Accountants Medical Aid Fund, established in 1951 is a distinctly different scheme from most others in that CAMAF provides a service and support structure which can be classified simply as an “Investment in Health”.

The Chartered Accountants Medical Aid Fund (CAMAF), which was established in 1951, was originally designed for accounting professionals and offers superior benefits to qualifying members. As the fund focuses on a niche market, it is able to provide a range of benefits that significantly surpass those offered by most open schemes. Always ahead of the curve, CAMAF strongly values innovation, and covers many procedures performed with the very latest technology. It also has a distinctly holistic focus, combining excellent healthcare benefits with an actively managed wellness programme. While CAMAF provides cover mainly for companies, it also accepts individual members subject to certain approved qualifications (see Criteria for Individual Membership). To recover these costs, the company is given the patent right to be the sole manufacturer of the specific medication for a number of years, without generic equivalents. Some schemes levy a co-payment on certain procedures or surgery in terms of their rules and cost containment processes. These treatment pairs cover serious and acute medical problems that include the cost of diagnosis, treatment and care of these conditions. They can be produced by the original manufacturer or another manufacturer, once the patent for the branded product has expired. Some insurance products which are labelled as Hospital Plans (not to be confused with a Medical Scheme hospital option) offer a pre-determined monetary pay-out per day of in-patient hospitalisation, not related to the actual cost of the stay. Managed Health Care a programme which manages health care resources and services to ensure that members obtain the most effective, rational and appropriate care for their condition. In some cases it could mean that a member would be required to join the case management programme of the scheme e.g., Oncology for cancer treatment. By testing for these metabolic disorders, parents can be assured that treatment and dietary changes can be implemented sooner rather than later. A completed report is returned to the referring doctor, who would discuss the results with the parents and perform post-test counselling if necessary. It usually consists of chemotherapy or radiation therapy. Members need to register on the Cancer disease management programme and submit a treatment plan in order to obtain the benefits offered. Overall Annual Limit the overall amount that a member and his dependants is allowed over a calendar year, in terms of the option and scheme rules. Any benefit remaining at year end cannot be carried forward. Pre-authorisation A member must obtain prior approval for an intended admission to hospital or requiring other high cost services. Emergency treatment is not subject to Pre-authorisation but members should notify the scheme as soon as possible after the event. The reference price varies per option and where a drug is above the reference price it is indicated that a co payment will apply. Related Account any account/claim, related to an approved in-hospital admission, other than the hospital account. This results in the actual cost of medication being the same no matter where in the country it is purchased; any difference in price is as a result of the dispenser’s mark up. Waiting Periods in terms of the Medical Schemes Act, schemes are allowed to place waiting periods on members joining a scheme, due to risk factors that a member may pose to the scheme.