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About Us

The Makoti Medical Scheme was developed with the following in mind:

  •  To provide high quality medical care at affordable costs
  •  To Introduce control measures in order to sustain the plan for a long period
  •  To prevent illness wherever possible by dealing with healthcare issues in the community we serve

Service Providers

You will be able to see the following service providers:

Your Accredited General Practitioner

You should carefully consider who you would like to have as your regular doctor. You need to select a general practitioner of your choice who is easily accessible to you. Enablemed will conclude an agreement with him or her to provide you with the services as offered by the fund.

NB: It is important to understand that this will then be the only general practitioner you will be able to see (except in emergencies). We believe that staying with one provider has many advantages. Among others you will build a relationship of trust with your doctor who will get to know you and your particular needs better. Conflicting treatments and medication can also be taken when seeing different doctors. If you wish to change your regular provider you can do so through your HR department by completing a new doctor choice form.

Dental providers are arranged through the Dental call number 0860 033 647.

Managed Healthcare

Managed healthcare has the following aims:
- To provide you and your dependants with high quality healthcare protocols that have been developed by the Scheme which need to be followed to access your benefits
- To keep healthcare affordable to as many people as possible
- This will be done for you through your doctor and the staff of the call centre

NB: All services are subject to pre-authorisation unless an arrangement has been made with your doctor. Please make sure your general practitioner, hospital or other supplier is willing to provide you with the authorised service at the Makoti Medical Scheme tariff.

Please call 0860 00 24 00 for all services.
Ambulance services: Lifemed 0861 086 911

When visiting your doctor

When visiting your doctor please take your Makoti Membership Card and your ID document for positive identification. Also make sure you take your health records such as Baby Clinic or Family Planning Cards.

Making appointments

Some doctors and practices prefer you to make appointments to be seen. This will help to: - Ensure that you will see the doctor that you need to see - Plan your day better - Minimise your waiting time

Chronic Care Programme

Patients are encouraged to join the programme for care of any chronic illness by going to their chosen general practitioner to register their condition. The registration process assists the general practitioner and the patient so that the patient receives optimal care, effectively with minimum administration. The chronic care benefit covers all 27 CDL conditions provided the member is registered on the chronic programme by the treating GP. Medication is covered as per the formulary. HIV/AIDS is also included in the 27 CDL conditions and members can enjoy full cover once registered by their general practitioner on the chronic programme.

What medicines and Laboratory tests will be used?

Makoti has carefully chosen quality medicines. These medicines have been chosen to treat and prevent diseases. They need to be used in the correct manner and according to the correct dosage to regain or maintain health. It is very important to use medicines in the correct dosages, because if they are used incorrectly, they can cause a great deal of harm or even death. The majority of these medications are proven quality generics. If a patient insists on a more costly alternative the additional cost will be for the member to pay directly to the pharmacy. Medication commonly requested that is not on the formulary include: Vitamins, laxatives, proton pump inhibitors and over the counter medicines. Clinically appropriate Laboratory tests are accessed subject to protocol and after pre-authorisation only.



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