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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.

Standard PLAN

Standard Plan

This is a great plan for young adults entering in the work place or starting a family, while the contributions are relatively low, the cover is still comprehensive and will cover you for hospitilisation, major disease and chronic conditions.

With 8 free GP visits and unlimited specialist visits per year, the Standard Plan offers young, adults and their children everything needed to live a healthy life. Over-the-counter and prescription medication has a generous benefit amount. And in the event of planning a family you’ll be covered for maternity and you’ll receive a Mamoth Bambino Welcome Package.
Contributions:
Main Member: 1 900
Spouse: 1 466
Child over 21 (*student dependent): 1 273
Child: 705
Adult: 1 840

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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:

1 500 000

Hospitalisation:

Subject to OAL

Hospital Alternatives:

31 334

Paramedic Services:

Subject to OAL

Blood Transfusion:

61 363

Maternity:

Subject to OAL

Maxilla Facial Surgery
(Non-elective):

Subject to OAL

Mental Health (In-Hospital):

39 675

DAY-TO-DAY BENEFITS (CONSULTATION)

General Practitioner Consultation -
Number of visits

10

 

Specialist Consultation

Unlimited No. of visits

*Only by referral from a General Practitioner

Unlimited

 

Prescribed Medication

*All Acute Medication including prescribed supplements

3 600

Supplements

900

Over the Counter (OTC)

1 250

Supplements per script

per beneficiary

170

 

OTC Sublimit per script per day per beneficiary

170

MAJOR DISEASE BENEFITS

Major Disease Benefit Limit

634 800

Oncology (includes chemo and pathology)

211 600

Organ Transplant

211 600

Renal Dialysis

211 600

Specialized Radiology

31 740

Prosthesis Benefit, with sub limits

Prosthesis Limit

71 944

Internal Devices

57 132

External/Appliances

14 812

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

8 464

Immune Deficiency

11 750

Dentistry - P/B

2 651

Advanced Dentistry

N/A

 

Optometry (Bi-annual Benefit)

3 268

Frame

(Subject to prescribed Lens)

*prescribed lens is up to 100% of optometry benefit

1 803

Prescribed Lens

3 268

Pathology, Physical Therapy

& Radiology (combined)

7 406

Mental Health

(Out-of-hospital, Pb/Pa)

2 645

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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