Frequently Asked Questions

Frequently Asked Questions

You are assured of a financially sound and secure health plan. The products administered by MedHealth offer both financial stability and sustainability to ensure continued access to healthcare cover at an affordable cost.

  • 1st step will be MedHealth representative presenting the product
  • 2nd step will be signing the Service Level Agreement
  • 3rd step please send a fully filled member application form
  • 4th step will be MedHealth sending a pro forma billing, once it has been confirmed we will send an invoice.
  • 5th Membership to commence as at 1st day of following month, member will receive a membership welcome pack

The product on offer is a local product which covers members within Malawi (Country Wide) with all registered Service Providers. On the higher options one can access foreign treatment in the event of the following:

  • Foreign referrals
  • Emergency evacuation

Please contact us on the hotline number +265 111 738 388, toll free number 9797 or info@medhealth.mw and we will direct you to the right personnel.

When one joins the scheme, they will be provided with a membership card. This card enables you to access services from hospitals, clinics and pharmacies.

The change is a result of a management buyout. MedHealth bought the shares of Metropolitan. The change of name does not signify a change of service delivery, Management, operations and procedures are still the same. Members can be sure that the services will not change, if anything MedHealth will strive to deliver better.

The name and the shares are what have changed. The services and the quality of the services rendered by the company have not changed, if anything they will get better.

No it is not, students studying in South Africa can still access health care service if they register with us for student cover in South Africa.

Yes, it has a future because the services will be the same. Please note that the team that was previously with Metropolitan Malawi is the team now working with MedHealth.

Yes, there is. MedHealth has introduced a toll free line which can be accessed by members to verify membership during odd hours, get assistance with preauthorization, case management, and advise from our esteemed and qualified personnel. The toll free line is 9797.

MedHealth has six products, each designed to cater for different socio-economical needs. If you would like to learn more about the products we have to offer, feel free to download the brochure on the MedHealth website or get in touch with us through +2651771977, or drop us an email at info@medhealth.mw, or pay us a visit at any one of our offices.

MedHealth currently has one company with two offices, one in Blantyre and one in Lilongwe.

We have been operating as MedHealth since February 2017. However, our experience dates back to 2009 with Momentum health, then Metropolitan Health following the merger between Metropolitan and Momentum.

We are experienced in both the local and global markets.

MedHealth will now give every member a membership card, regardless of whether you are the main member or a dependent.

Yes, you are more than welcome to get another card if you have lost the current one. Please note that a replacement card will incur a fee of MWK 3,000 only.

Yes, you are. By informing us, you help widen the network of service providers and improve our services.

No. MedHealth is not obliged to provide transportation to members if they are ill. However, in extreme cases or emergencies MedHealth does offer an ambulance service to its members.

Physiotherapy sessions are subject to your auxiliary limit and depended on your doctor’s recommendation. If your doctor recommends you for physiotherapy, please contact MedHealth to get pre-authorization. You may do so by dialling 9797 or sending an email to info@medhealth.mw.

No. MedHealth prides itself in being the first and only scheme in Malawi that guarantees 100% no shortfalls as long as you do not exceed your limit. We are known for being a trend setter in the market leading the way for health insurers all over Malawi.

Yes. So long as your plan allows for that option and you inform MedHealth beforehand that you will be leaving the country.

For more information concerning foreign emergency treatment please contact us on +2651771977 or drop us an email at info@medhealth.mw.

Yes. We do cover any disclosed critical condition.

This is largely due to the fact that Malawi has only one MRI machine located at Queen Elizabeth Central Hospital, under the Blantyre Malaria Project. No patient ever walks in without booking. Your doctor will request for the scan and makes a booking on behalf of the patient if it is an emergency. However, if the situation does not require immediate medical attention or pose any immediate threat the doctor may request for the MRI and the patient will have to make the booking. Please note that this does not only apply to MedHealth but to all schemes as well as cash paying patients.

For all in-patient procedures hospital/ clinics have to obtain the pre-authorization. However, for dental, optical and minor out-patient procedures, members get the pre-authorization. Members must present a quotation and motivation letter from a doctor to MedHealth for assessment.

Members may send the documents via email: preauth@medhealth.mw or hand them in person to either of the MedHealth offices in Lilongwe or Blantyre. Members may also call the toll free number 9797 for clarification or assistance.

SERVICES THAT REQUIRE PRE AUTHORISATIONS/ PRE NOTIFICATION

NO

SERVICE

EXAMPLE

1

Hospital admission

 

2

Short  Stay Admissions

 

3

All Specialist Consultations (Written Referral from GP then approval)

 

4

Specialized Lab Tests

Includes but not limited to:

Hormonal Tests

  • LFTs

  • CD4 Count

  • Viral Load

  • Cardiac Enzyme

  • Lipid Profile

  • Clotting Profile

  • Tumour markers

5

Procedures in doctors rooms

Major and minor procedures

6

Specialized dentistry

  • Braces

  • Root canals

  • Crowns

  • Bridges

  • Surgical extraction

  • Orthodontic treatment

7

Dental surgery

 

8

Elective Surgical and Obstetrical procedures

  • Caesarean Section etc.

  • Endoscopies (gastroscopy, colonoscopy etc.)

  • Hernia repair and other surgical procedures.

9

Specialized radiology

  • MRI

  • CT scans

  • Mammogram

10

Auxiliary services

  • Physiotherapy

  • Psychotherapy

  • Diet sessions

  • Counselling sessions

11

Confinements

Maternity

12

Appliances

  • External i.e. hearing aids,

  • Wheelchairs.

  • Internal appliances.

13

Personal Health assessment (Limited to the listed investigations)

Cholesterol, blood sugar, HIV rapid test, pap smear, PSA, TB screen, chest x-rays, urinalysis

14

Evacuations and Foreign country treatment (Referral from Specialist required)

  • In country

  • Cross border

15

Rehabilitation

 

16

Ambulance services

 

17

Optometry

  • Lenses

  • Frames

The disease management program allows members with chronic illnesses to maintain health and to prolong life. Members with chronic illnesses register to ensure that their benefits are not exhausted prematurely due to the illness.

Chronic illnesses include but are not limited to: hypertension; HIV/AIDS; cancer; epilepsy; coronary Disease; and asthma.

MedHealth health personnel would give you advice on how best to manage your condition, help monitor your condition, and see how you are responding to various medications; this is known as case management and drug compliance.

In addition, the program allows you to have access to chronic benefits, which entails that all your medication and treatments associated with the illness will be charged on account of the disease management program ensuring that your benefits are not exhausted quickly.

You are welcome to call the toll free number 9797 or send an email to info@medhealth.mw and we help you register onto the program.

New born babies are covered under their mother during the first 30 days of their lives. Parents are encouraged to register their new born baby within this period. The baby’s benefits are then activated on the first of the following month after registration.

No, that is not true. Pregnant women can get supplements and vitamins under the scheme if these have been prescribed by a doctor.

This is because many clinics and hospitals inflate the bill to make more money for example by including costs of conditions they did not treat you for. This has a negative impact on the member, as his auxiliary limit is being depleted.

Claim forms are in triplicates. One copy is for MedHealth, one is for you, and one is for the hospital/clinic/health centre.

You are encouraged to collect your copy of the claim form when checking out of the health facility in order to prevent fraud and for your personal records.

The yellow copy is meant for you. Ask the cashier to hand you your copy after signing the form.

If the healthcare provider is refusing to let you sign the claim form after receiving treatment and/or to collect your copy of the claim form report this to MedHealth immediately by calling the Toll Free Hotline 9797.

Know that members have a right to know their benefits and a responsibility to make sure that they are not participating in fraud.

You may start accessing your outpatient benefits from the first of the next month after joining. However, you will have to wait 3 months to access your in-patient benefits.

No. Every member is entitled to his/her own benefits. It would be unfair to have a member give up his/her benefits because another member has exhausted them, even if that member is a relation.

No. Members cannot transfer benefits from one line to another.

Yes. You can continue to be part of the MedHealth family, even you leave the company that initiated the relationship. We now welcome individuals into our dynamic family.

A child dependent is an individual under the age of 21, or under the age of 26 and a full time student, or a child due to physical or mental disability, is dependent upon the Member.

The age limit for a new member to join the scheme is 60 years. However, if you already were a member and have surpassed the age of 60, MedHealth continues to offer its services to you and your dependents.