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Up to R10 000 cash back per year and up to R2 000 per hospital admission
We pay you out R500 per day, up to four days per hospital admission. This plan covers up to R10 000 per year.
You, your spouse or children under 18 need to have been admitted to hospital for more than 48 hours per admission to qualify for the payment.
Your family plan includes private emergency medical response and transportation to the nearest medical facility. The life saving benefit is unlimited.
Transportation to medical facilities is provided in life-threatening circumstances as assessed by the medical team on call.
Call for an ambulance when your loved one's life is in danger and if you are in need of immediate medical attention.
Services provided by ER24.
Your family plan provides 24/7 access to a nurse on call through the call centre. Your family can use this service for medical advice and to receive medical counselling, support and advice from a qualified nurse throughout their treatment process, including:
Call the nurse whenever you or a family member are feeling sick or experiencing pain. The nurse on call will be available to assist you & your family and give you advice.
Services provided by ER24.
Your family's mental health is just as important as their physical health which is why your family plan includes telephonic support and trauma counselling following traumatic events such as:
When your family experiences problems requiring face-to-face counselling as determined by our counselors we will refer you to specialists for face-to-face counselling. Counselling benefit is limited to R10 000 per family and R5 000 per family member per year.
Services provided by ER24.
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How many family members are covered on the plan?
The HealthCare Gold Family Plan covers you your spouse or life partner, and up to five children under 18. Parents and other extended family members are not covered.
Are there pre-screening requirements?
No. There are no exams or tests required before signing up.
Are pre-existing conditions covered?
Yes, following a 12-month waiting period in which 12 consecutive plan fee payments must have been made.
Is there a waiting period for claims?
There is no waiting period for admissions due to an accident.
For admissions due to an illness, there is a 3-month general waiting period in which 3 consecutive plan fee payments must have been made.
For admissions due to a pre-existing condition, there is a 12-month waiting period in which 12 consecutive plan fee payments must have been made.
How does a member claim?
You can claim by:
Do I have to use the cash back for medical expenses?
No. This cash does not need to be spent on medical requirements unless you wish to do so. Your payout is paid directly into your bank account.
The most common reasons for non-cover include claims directly or indirectly related to any criminal act, substance abuse, mental illnesses, hazardous sports, self-inflicted injuries and suicide, undiagnosed, investigative or routine treatments, pain management treatments, pregnancy, infertility or abortion, claims based on fraudulent, false or non-disclosed information.
Read the full policy document detailing the terms, conditions and exclusions.
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