What is the WELLTH Fund
TFG Medical Aid Scheme is investing in the long-term health of its members by having introduced the WELLTH Fund in 2023. COVID-19 has had an extraordinary impact on the healthcare choices we make, with many people deferring their routine, preventative care during the past few years. At the same time, people have become more conscious of their health and wellness.
For 2023 and up to and including 2024, depending on your first year of registration with TFGMAS, you and your family have access to a once-off, additional risk benefit called the WELLTH Fund, offering up to R10 000 per family to empower you and your family members to understand and address your personal healthcare needs.
What does the WELLTH Fund cover?
The WELLTH Fund covers a comprehensive list of healthcare services to ensure that you are empowered to take specific action according to your individual health needs. This benefit is separate from and additional to the Screening and Prevention Benefit and will be available to all existing and new members of the Scheme.
This benefit can be used for appropriate healthcare services up to your WELLTH Fund limit. Cover is subject to the Scheme's clinical entry criteria; treatment guidelines and protocols and qualifying healthcare services are covered up to a maximum of the Scheme Rate.
Value allocation
The WELLTH Fund is a once-per-lifetime benefit available to every beneficiary on TFG Medical Aid Scheme. The value of the benefit is allocated according to size and make-up of each family on a membership.
R2 500 per adult
(>18 years old)
R1 250 per child
(> 2 years old )
Up to a maximum of R10 000 per membership
The WELLTH FUND is allocated per membership, and therefore once it is activated any person on the membership can make use of any portion of the benefit.
A Health Check is all it takes to unlock your WELLTH Fund
The WELLTH Fund is automatically activated once all members (2 years and older) have completed a Health Check. All Health Checks completed from 1 January 2022 onwards count towards unlocking the WELLTH Fund.
Remember, an annual *Health Check is covered in full for all members by the existing Screening and Prevention Benefit.
What is a Health Check?
A Health Check is a simple but helpful set of basic health screenings and preventive tests which you are covered for annually. These include:
Blood pressure
Blood sugar
Cholesterol or lipogram tests
Weight or body mass index (BMI) assessments
Non-smokers declaration (NSD)
Why should I do Health Check?
- To understand the health status of yourself and your family
- For early detection of any possible health risks, which allows for better treatment and management in the case of more serious conditions
- It is likely to lower your healthcare costs over time
- It helps to inform your doctor and other healthcare providers for more personalized and appropriate care
- It unlocks your WELLTH Fund!
Your Health Check results will show you how healthy you really are, and help you and your family doctor to decide the next best actions to take.
Have a question? Check our FAQs!
Yes, the WELLTH Fund covers the following specific medical devices if they have a registered NAPPI code and are bought from a registered healthcare provider with a valid practice number (such as a pharmacy or doctor):
- Blood pressure monitors
- Glucometers
- Cholesterol monitors
- Peak flow meters
- Spirometers
It depends on which health plan you have.
Plan network rules apply for members on Smart and KeyCare plans:
- Members on TFG Health must use their allocated GP for GP services covered by the WELLTH Fund, they need a GP-to-specialist referral and authorisation to access specialist screening and prevention check-ups covered by the WELLTH Fund.
- Members on TFG Health Plus may use a provider of their choice and do not have to use a network provider to be covered by the WELLTH Fund.
Claims from non-network providers will be reimbursed at 100% of the Scheme Rate. If the provider charges above the Scheme Rate you will be liable for the shortfall.
Claims paid from the WELLTH Fund will accumulate to the WELLTH Fund limit on TFG Health Plus.
On the TFG Health benefit plan the available benefits in your dental and optical benefits will first need to be exhausted before claims will pay from the WELLTH Fund.
Depending on the benefit plan you are registered on, claims paid from the WELLTH Fund may impact your day-to-day benefits. If registered on TFG Health, available benefits in your day-to-day benefits will first need to be exhausted before claims will pay from the WELLTH Fund. For members registered on the TFG Health Plus benefit plan, claims will accumulate to the WELLTH Fund limit first, before paying from your available day-to-day benefits.
No, you cannot claim any medication from the WELLTH Fund.
Your WELLTH Fund is not yet active due to one or more of these reasons:
- You or some of the dependents (aged two and older) on your policy have not completed a Health Check in the last 12 months.
- Your healthcare provider has not yet submitted the Health Check to us.
- To book an appointment for any of the screening and preventative check-ups covered by the WELLTH Fund, use the "Find a Provider" functionality on the TFG Medical Aid Scheme website or app.
Yes, children registered on the TFG Medical Aid Scheme who are younger than two can go for screening and preventative check-ups covered by the Fund, as soon as it has been unlocked.
Yes, if your child turns two before the expiry date of the WELLTH Fund, they will get the child allocation of R1 250 as soon as your WELLTH Fund is unlocked. Children who will still be younger than two at the time when the benefit expires will not get a rand amount allocated. However, you can still use your family's WELLTH Fund on health check-ups for them, if you wish.
Yes, new dependents added to a policy can use the WELLTH Fund, but your policy can only be allocated extra funds once your new dependent completes their Health Check.
If a dependent withdraws from the Scheme during the year, your WELLTH Fund will not decrease, but any member who leaves will lose access to the Fund and any remaining benefits.
Children who turn 18 before the expiry date of your WELLTH Fund will get the adult benefit allocation of R2 500 as soon as your WELLTH Fund is unlocked.
Please allow up to 24 hours for your WELLTH Fund information to update after you have completed your Health Check.
Also make sure that:
- All dependents aged two years and older on your policy have completed their Health Checks.
- All Health Checks for dependents on your policy were completed within the last 12 months.
If you cannot go for an in-person Health Check and you are in South Africa, you can book a Health Check at Home. This service is available if you live in Johannesburg, Pretoria, Cape Town, and Durban. Book a Health Check with one of our nurses at home by clicking here.
If you are outside the borders of South Africa, you can go to a registered healthcare practitioner in that country, who can manually send us your Health Check results. These results will unlock your WELLTH Fund. Download the Health Check form here for your healthcare practitioner to complete.
The Health Check form must include your full name and date of birth, with the following Health Check results:
- Your blood pressure
- Your blood glucose
- Your cholesterol or lipogram
- Your weight assessment or body mass index (BMI)
Your healthcare professional must validate your Health Check by either signing or stamping the form, and confirming their or the clinic's details, where relevant. Please then send your completed form to healthchecks@discovery.co.za.
If you cannot complete your Health Check at one of our accredited healthcare providers, you can go to a registered healthcare practitioner who can manually send us your Health Check results, These results will unlock your WELLTH Fund. Download the Health Check form here for your healthcare practitioner to complete.
The Health Check form must include your full name and date of birth, with the following Health Check results:
- Your blood pressure
- Your blood glucose
- Your cholesterol or lipogram
- Your weight assessment or body mass index (BMI)
Your healthcare professional must validate your Health Check by either signing or stamping the form, and confirming their or the clinic's details, where relevant. Please then send your completed form to healthchecks@discovery.co.za.