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Mamoth Health Plan is a medical aid product of Mamoth Employee Benefits. Established in 2003, Mamoth Health Plan is the leading Medical Aid Service Provider in Lesotho that offers health care services locally and regionally.
Mamoth Health Plan is a medical aid product of Mamoth Employee Benefits. Established in 2003, Mamoth Health Plan is the leading Medical Aid Service Provider in Lesotho that offers health care services locally and regionally.

Elite Plan

Elite Plan

Our Elite plan is open to everyone but is preferred by executives, mature individuals and small families. No matter if there is a history of one or more major diseases, organ transplants, multiple chronic conditions, and age-related health conditions, the Elite plan will help you best manage these conditions with excellent hospital cover and generous day to day benefits. As with the Elite Magenta, on this plan, you also have access to free GP consultations (12 per year), unlimited specialist consultations. The more than adequate prescription and over-the-counter medication cover, makes life easy and less stressful knowing you’ll always be covered.
Contributions:
Main Member: 2 807
Spouse: 2 246
Child over 21 (*student dependent): 1 535
Child: 1 072
Adult: 2 719

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HOSPITALISATION, MATERNITY
& PARAMEDICAL BENEFITS
DAY-TO-DAY BENEFITS (CONSULTATION)
MAJOR DISEASE BENEFITS
DAY-TO-DAY & CHRONIC BENEFITS

HOSPITALISATION, MATERNITY & PARAMEDICAL BENEFITS

Overall Annual Limit: 2 500 000
Hospitalisation: Subject to OAL
Hospital Alternatives: 45 694
Paramedic Services: Subject to OAL
Blood Transfusion: 77 028
Maternity: Subject to OAL
Maxilla Facial Surgery (Non-elective): Subject to OAL
Mental Health (In-Hospital): 47 610

DAY-TO-DAY BENEFITS (CONSULTATION)

General Practitioner Consultation -
Number of visits

12

Specialist Consultation

Unlimited No. of visits

*Only by referral from a General Practitioner

Unlimited

 

Prescribed Medication

*All Acute Medication including prescribed supplements

4 000

Supplements

1 000

Over the Counter (OTC)

1 500

Supplements per script

per beneficiary

170

 

OTC Sublimit per script per day per beneficiary

170

MAJOR DISEASE BENEFITS

Major Disease Benefit Limit

894 116

Oncology (includes chemo and pathology)

298 039

Organ Transplant

298 039

Renal Dialysis

298 039

Specialized Radiology

52 900

Prosthesis Benefit, with sub limits

Prosthesis Limit

103 392

Internal Devices

73 768

External/Appliances

29 624

Detox Program

(Non-elective)

Subject to OAL

DAY-TO-DAY & CHRONIC BENEFITS

If you have an illness that requires ongoing medication, make sure your doctor fills in a chronic form and submit it to our Office. And also ensure that your medication updates reach our office.

Chronic

17 986

Immune Deficiency

16 450

Dentistry - P/B

2 921

Advanced Dentistry

6 900

Optometry (Bi-annual Benefit)

3 606

Frame

(Subject to prescribed Lens)

*prescribed lens is up to 100% of optometry benefit

2 254

Prescribed Lens

3 606

Pathology, Physical Therapy

& Radiology (combined)

14 812

 

Mental Health

(Out-of-hospital, Pb/Pa)

3 174

 

VOLUNTARY MONTHLY SAVINGS ACCOUNT (MSA)
A member can contribute voluntary savings from a minimum of M50.00 per month. Savings are used for medical expenses only and can be claimed in the current December benefit year, to be paid out in March the following year.

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