1. Who is UAP Old Mutual Insurance?
UAP Old Mutual is an international Insurance company with presence in the region and around the world. UAP Old Mutual has products for all types if insurance including Life Insurance, all types of general insurance and Medical Insurance. Any one can buy our insurance products both privately and as a corporate.
2. What is Diaspora Health Connect?
Diaspora Health Connect is a dynamic and revolutionary medical insurance cover that has been designed by UAP Old Mutual in collaboration with The Clinic At The Mall, for those living outside Uganda but who wish to buy medical insurance packages for their loved ones back home.
3. How do I join Diaspora Health Connect?
Simply log on to our link secure.uap-group.com and Follow the self explanatory steps to fill in an application form and you will get an invoice against which you can pay. You will receive a confirmatory email showing that you have been enrolled under Diaspora Health Connect of UAPOM.
4. How do I know what I am covered for on my Medical Cover? / How do I know my Benefit limits?
UAP-OM covers you for both inpatient and Outpatient treatments on credit basis at the approved service providers. You will be required to present you SMART card each time you visit the approved service provider. Each of the benefits will be covered up to a maximum amount of money per person per year. Please visit our website to see the different benefits and limits under each package of Diaspora Health Connect.
Alternatively you can find out your benefit limits by visiting any of our service providers and having them run your card on the SMART machine. The SMART display will show your limits/ Balances as at the time of querying.
5. What is a main benefit? / What is a sublimit?
The main benefit is a financial entitlement that UAP-OM offers you when you join our cover for which a premium needs to be paid. Examples include: Inpatient Benefit, Outpatient Benefit, Dental, and Optical Benefits. On the contrary, a sublimit is an entitlement for which no premium is charged by UAP-OM but any medical treatments that fall within that type of entitlement will be paid up to the specified sublimit amount only in the year. When claims are paid under a sublimit, the amount of money is deducted from both the sublimit balance and from the main benefit balance.
Example: Maternity (2M) is a sublimit of the Inpatient Main Benefit (10M). If you incur treatments worth 900,000/= under the maternity sublimit, your maternity balance will be 1.1M while your Inpatient main benefit balance will be 9.1M. Claims for maternity however will only be paid up to 2M and not up to the overall main benefit limit of 10M.
6. Which medical conditions are covered by Diaspora Health Connect?
You are covered for any medical condition whether it is an emergency or a chronic disease. UAP-OM does however have a list of excluded conditions (mostly cosmetic and self inflicted injuries) and the full list is available on our website or your brochure.
7. How can I minimize the usage of my benefits so that they carry me through the cover period?
UAP-OM has a team of emergency nurses who are available 24 hour a day to advise you on where you can receive the best possible treatment at the most competitive cost. It is advisable that you limit use of your card to only the serious medical conditions and cater for simpler ailments yourself. This will help you preserve your benefit balance in case you end up needing more expensive treatments in the unfortunate even that you are taken severely ill. The emergency Numbers appear at the bottom of each page of this FAQ document.
8. How do I use the SMART card of by child below 5 years?
Children below 5 years do not have developed finger prints. You will therefore be required to register the finger prints of two adults in the care of the child (one finger from each adult). This should be done in advance – when the child is not ill – at any of our accredited service providers. The next time the child actually falls ill, any single one of the two adults who is with the child can take them to hospital and simply present the child’s card and one registered finger print. The child will be offered treatment.
WHAT IF THE two registered adults are not available? Please call UAP-OM immediately for off system authorisation of treatment in such cases. You can also request for a change of the registered adults on the child’s SMART card. The old prints will be cancelled at ago and you will need to take the two new adults at the same time to the hospital with the child for registration of new finger prints.
9. What if I lose my SMART Card?
If you lose your SMART card, please inform UAP-OM at the moment when you realise it is lost (do not wait until you are sick). UAP-OM will require you to pay 20,000/= and a new card will be printed in 3 – 5 days. You can pick up your replacement card at the UAP-OM office on Plot 35 Portbell Road Nakawa Business Park, Block A 6th Floor.
10. Which clinics and hospitals are covered by Diaspora Health Connect?/ In which countries will my SMART card work?
All out patient cover for those in Kampala area will be restricted to The Clinic AT The Mall. The UAP-OM SMART card will be active across the East African region in Kenya, Uganda, Rwanda and South Sudan as long as you present it to an accredited UAP-OM Medical service provider. Please note that your SMART card will not be recognised if you present it at a hospital that is not on the approved list.
11. Will my SMART card work when I am overseas?
The UAP-OM SMART card will not be recognised when you present it to a hospital outside the East African countries mentioned above. We do however have hospitals in India, Kenya and South Africa where you will be covered if you are referred by a specialist in your local country for a condition whose treatment is not available locally. In such cases, you will need written UAP-OM authorisation before flying out for the treatment. Do contact UAP-OM on the emergency lines for assistance.
WHAT IF IT’S AN EMERGENCY? If you experience an emergency medical condition while on other / incidental travel outside East Africa, you will be required to pay for your treatment while overseas but immediately (within 24 -48 hours) inform UAP-OM on our emergency numbers (which appear on your SMART card). UAP-OM will reimburse you 100% of all the medical costs upon return and submission of supporting documentation through your Human resource manager.
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12. What is Outpatient Cover?
Outpatient treatment is what you are given when you go to the clinic or hospital and the doctor either administers the drugs or hands them to you for use at home without having to spend the night in Hospital. Such a hospital bill will be deducted off your Outpatient Benefit.
13. What is Inpatient Cover?
Inpatient treatment is what you are given when you go to the hospital and the doctor administers the drugs by admitting you in hospital for at least one night. Such hospital bills will be deducted off your Inpatient Benefit limit.
14. At what age can an adult join Diaspora Health Connect?
· The official age at which one is recognised as an adult on UAP-OM cover is 18years. All individuals below 18 years are considered as minors and must join the UAP-OM cover as a dependant of at least one adult who is their biological or legally adoptive parent.
· Adults above 65 years are also not allowed on the UAP-OM cover if they are newly joining. However those that have been on cover from before can continue to remain on the cover up to 75years
· Only one legal spouse is allowed on the UAP-OM cover within one family. Any other spouses will have to be covered on their oven independent UAP-OM policies as principal Members.
15. At what age can a child be added to the Diaspora Health Connect?
Any new born child can be enrolled on the UAP-OM cover as a dependant of their parent(s) as long as the following are fulfilled:
i. The child was born at full term (i.e 37 weeks of pregnancy)
ii. The child has been discharged from the hospital Nursery
Newborns who are kept behind in hospital immediately after delivery for medical treatment will be covered under their mother’s maternity benefit if still sufficient.
16. How many dependants can I add to my Diaspora Health Connect cover?
There is no limit to how many dependants one can added to the UAP-OM cover under them as long as they fulfil the requirements of a dependant as mentioned above.
17. Does UAP-OM cover children alone on the scheme? What if I already have my own cover?
UAP-OM does not currently cover minors (below 18 years) on their own. Rather they must Join the cover as a dependant of at least one biological parent. i.e both the parent and the child must be enrolled on the cover.
18. Can I use a SMART card of another person to receive treatment?
This is not allowed and any discovered incidences will be handled as Fraud with the necessary consequences.
19. Can I use my SMART card to get treatment for my child or spouse?
This is not allowed and any discovered incidences will be handled as Fraud with all the necessary consequences. All active members are given their own SMART cards and must presented to hospital when they need treatment.
For more information please email Dr. George Mutema — firstname.lastname@example.org or call +1513.884.5774