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Up to R10 000 cash back per year and up to R2 000 per hospital admission
We pay you R500 per day, up to four days per hospital admission. This plan covers up to R10 000 per year.
You need to have been admitted to hospital for more than 48 hours per admission to qualify for the payment.
Your 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 life is in danger and if you are in need of immediate medical attention.
Services provided by ER24.
Your plan provides 24/7 access to a nurse on call through the call centre. You can use this service for medical advice and to receive medical counselling, support and advice from a qualified nurse throughout your treatment process, including:
Call the nurse whenever you are feeling sick or if you are in pain. The nurse on call will be available to assist you and give you advice.
Services provided by ER24.
Mental health is just as important as physical health which is why your plan includes unlimited, telephonic support and trauma counselling following traumatic events such as:
When you experience problems requiring face-to-face counselling as determined by our counselors we will refer you to specialists for face-to-face counselling limited to R5 000 per year.
Services provided by ER24.
You get access to a library of helpful health articles, empowering you with information to keep you fit and healthy
How many family members are covered on the plan?
The HealthCare Gold Individual Plan covers you as the policy holder, but does not include cover for your spouse, life partner, parents or children.
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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