BPOMAS - Botswana Public Officers Medical Aid Scheme

What BPOMAS - Botswana Public Officers Medical Aid Scheme does

BPOMAS (Botswana Public Officers' Medical Aid Scheme) is a closed, mutual medical aid scheme registered as a society in Botswana in 1990 under a Presidential Directive, serving Botswana Government employees, pensioners, and qualifying parastatal staff. The scheme offers three benefit tiers — Standard (P18,500–P30,000 annual cover), High (P300,000) and Premium (P500,000) — alongside optional add-ons including Critical Illness, Funeral Top Up, Extended Premium Waiver, Parent and Adult Child dependent cover, the Value Add Partnership Programme (VAPP), and a Managed Care Programme covering HIV/AIDS, chronic disease, and Pharmaceutical Benefit Management with generic reference pricing introduced in 2009.

Operations are built on an Electronic Data Interchange (EDI) system enabling real-time claims submission and processing from healthcare providers, supplemented by web-based member and provider portals and a Family Doctor Registration programme for primary-care gatekeeping. BPOMAS holds an 80% interest in the Bokamoso Private Hospital Trust, the first COHSASA-accredited private hospital in Botswana, and works with a network of citizen-owned providers including Sidilega Private Hospital, Gaborone Private Hospital (Life Healthcare), Emergency Assist 991, and the Botswana Dental Association.

The scheme is funded through monthly member contributions split 50/50 with the Botswana Government as employer subsidy, with co-payments capped at P1,000 per financial year on the High and Premium tiers and zero co-payment on the Standard tier. Scheme administration is outsourced — currently to Health Risk Management Botswana (HRMB), a citizen-owned health services company, following the transition from AFA Botswana effective 1 July 2023. As of May 2023 the scheme covered 85,961 principal members and is accepted by 99% of private healthcare facilities in Botswana.

Name

BPOMAS - Botswana Public Officers Medical Aid Scheme

Legal name

Botswana Public Officers' Medical Aid Scheme

Website

https://bpomas.co.bw

Company type

Private

Founded year

1990

Operating status

Operating

Short description

BPOMAS is a closed, mutual medical aid scheme established in 1990 under a Presidential Directive, providing tiered health coverage to 85,961 Botswana Government employees, pensioners, and qualifying parastatal staff with a 50% government contribution subsidy.

Ownership category

akta.pro rank

Product category

Medical Aid Scheme

NAICS

Health and Welfare Funds (52512)

SIC

Hospital & Medical Service Plans (6324), Accident & Health Insurance (6321)

akta.pro primary industry

MA PPO Plans (Local/Regional PPO) (HLAEACAB)

akta.pro secondary industry

Reference-Based Pricing (RBP) / PPO Alternative Networks (HLAEANAL)

Keywords

• Medical aid scheme
• Health insurance
• Government employee benefits
• Managed healthcare
• Medical aid benefits

Headquarters

HQ city

Gaborone

HQ country

Botswana

HQ region

Africa

Offices3 records

Markets served

GTM type

B2B

Offering type

Services

Cost components

Operations, Personnel, Technology or R&D, Marketing or Sales, Infrastructure

Revenue model

1. Monthly Member Contributions: BPOMAS generates revenue through monthly contributions from members and their employers (Botswana Government). Members pay 50% of contributions while the government subsidizes the remaining 50%. Contributions are based on basic salary, selected benefit option, and number of dependants.
2. Government Employer Subsidy: The Botswana Government provides a 50% subsidy on all member contributions, making this a partially government-funded healthcare scheme for public officers.

Pricing tiers

Go-to-market motion2 records

Distribution channels2 records

Marketing channels5 records

Core offering

BPOMAS is a closed medical aid scheme providing healthcare coverage to Botswana Government employees, pensioners, and dependants. The core offering consists of three benefit options (Standard, High, Premium) with annual family coverage from P18,500 up to P500,000, supplemented by emergency medical evacuation, critical illness, funeral cover, dread disease benefits, and managed care programmes for chronic conditions and HIV/AIDS. Contributions are split 50/50 between the member and the Botswana Government, and the scheme is administered by Health Risk Management Botswana (HRMB).

Product overview

BPOMAS is a closed medical aid scheme providing healthcare coverage to Botswana Government employees and pensioners. The core offering consists of three benefit options: Standard, High, and Premium, ranging from P18,500 to P500,000 annual coverage. The scheme is administered by Health Risk Management Botswana (HRMB) and includes supplementary benefits such as emergency medical evacuation, funeral cover, critical illness benefit, and managed care programmes for HIV/AIDS and chronic diseases. Additional optional add-ons include extended family funeral cover, premium waiver extensions, and parent/adult child dependent coverage.

Differentiator

Problem solved

Functional benefit

Products and services

• Standard Benefit Option Basic medical aid benefit option offering P18,500 to P30,000 in benefits per family per financial year (depending on family size), with members exempt from the 10% co-payment. Targeted at Botswana Government employees seeking entry-level cover.
• High Benefit Option Mid-tier medical aid option providing comprehensive cover of P300,000 per family per financial year, including P150,000 Annual Basic Limit and P165,000 Dread Disease Cover. 10% co-payment applies, capped at P1,000 per financial year.
• Premium Benefit Option Top-tier medical aid option providing maximum cover of P500,000 per family per financial year, split into Annual Basic Limit of P200,000 and Dread Disease Benefit of P300,000. Co-payment capped at P1,000 per financial year.
• Emergency Medical Evacuation 24/7 emergency medical assistance delivered via Emergency Assist 991 (EA991), including pre-hospital care, road and air evacuation, inter-hospital transfers, and repatriation of mortal remains. Included for BPOMAS members at no additional cost.
• Critical Illness Benefit Optional cash benefit priced from P2.10 per month (Principal Member P2.80/month; Principal and Spouse P5.60/month), paid out once upon diagnosis of specified critical illnesses including Cancer, Heart Attack, Kidney Failure, and Major Organ Transplant. 6-month waiting period applies.
• Funeral Benefit Top Up Optional funeral benefit top-up with three premium options (P1.05, P2.10, or P5.25 per month) increasing funeral cover up to P50,000 for members/spouse and P30,000 for children.
• Extended Premium Waiver Optional add-on extending free dependant coverage for 12, 24, or 36 months after the principal member's death. Pricing varies by benefit option (e.g., 36-month Standard P8.50, High P21.10, Premium P32.40).
• Extended Family Funeral Cover Optional coverage for parents and parents-in-law under Standard or High Benefit Options, with up to four parent dependents per principal member. Monthly contributions are Standard P386 or High P1,524, with the member paying 100% (no government subsidy).
• Parents and Parents-in-Law Cover Optional medical aid coverage for parents and parents-in-law at P386/month (Standard) or P1,524/month (High), not available under Premium. Limited to principal members under 65 years of age.
• Adult Child Dependent Cover Optional coverage for adult children aged 21-35 not in school and earning at or below minimum wage. Contributions: age 21-30 Standard P450 / High P707 / Premium P1,105; age 31-35 Standard P464 / High P896 / Premium P1,581. Member pays 100%.
• Family Doctor Registration Primary care programme requiring members to register a family doctor for primary care. Specialist visits require GP referral, with exceptions for gynaecologists, paediatricians (children under 5), and ophthalmologists.
• Managed Care Programme Healthcare management programme covering HIV/AIDS Disease Management, Chronic Illness Management, and Pharmaceutical Benefit Management with Generic Reference Pricing and differential mark-up structures to control medicine costs while ensuring quality care.
• Value Add Partnership Programme (VAPP) Discount programme offering members savings through partnerships with selected merchants offering discounts on purchases.

Quantifiable outcome

• 85,961 principal members served as of May 2023
• +3 more outcomes

Named customers3 records

Segments3 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature3 records

Partnerships

Seven partnerships are on record, tiered core and minor.

• Health Risk Management Botswana (HRMB)coreImplementation/ SI/ Consulting PartnerHRMB is the current administrator of BPOMAS, appointed by the Management Committee. HRMB is a majority citizen-owned health services company established in January 2013, specializing in healthcare risk management and health scheme administration. Administration changed to HRMB effective July 1st, 2023.
• Emergency Assist 991 (EA991)coreStrategic or Co-development PartnerEA991 provides 24/7 emergency medical evacuation services to BPOMAS members at no additional cost. Services include pre-hospital care, road and air evacuation, inter-hospital transfers, and repatriation of mortal remains. EA991 is 100% citizen-owned company.
• Sidilega Private HospitalcoreOthersFirst citizen-owned private hospital in Botswana, launched October 17, 2019. Located in Gaborone's Block Seven area. Provides comprehensive private healthcare services to BPOMAS members.
• Bokamoso Private HospitalcoreOthersBPOMAS holds 80% interest in Bokamoso Private Hospital Trust which operates this facility. First private hospital in Botswana to attain COHSASA accreditation.
• Gaborone Private Hospital (Life Healthcare)coreOthers132-bed hospital operated by Life Healthcare, serving Gaborone and surrounding areas with quality private healthcare to BPOMAS members.
• Board of Healthcare Funders of Southern Africa (BHF)minorStrategic or Co-development PartnerBPOMAS is a member of BHF, providing access to expertise and knowledge from within the health insurance industry worldwide.
• Botswana Dental Association (BODEA)minorStrategic or Co-development PartnerPartnership with dental professionals allowing BPOMAS members to access dental services without upfront cash payment effective November 2019.

Scale indicators5 records

Recent moves6 records

Expansion highlights4 records

Direct peers

• Botswana Medical Aid Society (Bomaid): Bomaid is the other principal open medical aid scheme in Botswana, offering comparable benefit tiers and managed-care programmes. It competes with BPOMAS for healthcare-provider contracts and represents the most direct comparable for product structure, pricing, and claims operations within the Botswana market.
• Government Employees Medical Scheme (GEMS): GEMS is a closed medical scheme for South African public-sector employees with a government subsidy structure analogous to BPOMAS. It is the closest functional analogue — same target population (civil servants), same subsidy model, and similar benefit-tier design — making it a key reference point for governance and growth comparisons.
• Pula Medical Aid Fund: Pula is a Botswana-based medical aid fund that competes for the same provider network and serves an overlapping (predominantly parastatal and corporate) member base. Comparable in scale and product structure to BPOMAS's non-government-eligible population.

Regional players

• Lesotho Medical Aid Fund: A medical aid scheme operating in neighbouring Lesotho with a similar pooled-contribution model for public- and private-sector employees. Useful as a Southern African regional reference for scale, contribution rates, and benefit-tier design.
• Swaziland Medical Aid Fund: Eswatini's main medical aid fund, structured similarly to BPOMAS as a pooled health-benefit fund for employees. Provides a regional benchmark for claims management, provider contracting, and contribution rate-setting in small Southern African markets.

Broad incumbents

• Discovery Health: South Africa's largest private medical scheme administrator with a managed-care platform and scale-driven provider negotiations. Comparable to BPOMAS on managed-care philosophy and PBM-style cost control, but operating at much larger scale across an open market.
• Medscheme: A major South African medical scheme administrator and managed-care provider. Comparable to the role that HRMB plays for BPOMAS, providing third-party administration, claims processing, and managed-care services to multiple closed and open schemes.
• Metropolitan Health Corporate: One of South Africa's largest medical scheme administrators, offering administration and managed-care services to a range of restricted-membership schemes. Relevant peer for benchmarking administration cost structures and managed-care programme design.
• Old Mutual Healthcare: A broad South African financial-services group with a healthcare division offering medical scheme administration and health-insurance products. Provides a broader-market comparable for benefit design, distribution, and provider-network management.

Others

• Board of Healthcare Funders of Southern Africa (BHF): Industry body representing healthcare funders across Southern Africa, of which BPOMAS is a member. Not a competitor but a direct ecosystem enabler — relevant for industry benchmarking, advocacy, and access to actuarial and managed-care expertise.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat4 records

Key risks6 records

Key highlights7 records

Customer concentration

• Facebookfacebook.com/bpomas
• Instagraminstagram.com/bpomas_officialbw/?hl=en

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

Subsidiaries1 record

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about BPOMAS - Botswana Public Officers Medical Aid Scheme