HealthCare Prestige Individual Plan

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HealthCare Prestige Individual Plan
R165 per month
which includes the insurance premium of R110

Up to R22 000 cash back per year and up to R4 400 per hospital admission

You are currently viewing Individual packages
FamilyIndividual
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Cash-back when admitted to hospital

We pay you out R1 100 per day, up to four days per hospital admission. This plan covers up to R22 000 per year.

You need to have been admitted to hospital for 48 hours or more per admission to qualify for the payment.

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Emergency medical response and transportation

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.

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24/7 telephonic nurse assistance on call

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:

  • Pre- and post-test counselling for chronic diseases (including HIV/AIDS).
  • Pre- and post-surgical counselling and advice
  • Symptom assessment and advice
  • Child and baby care

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.

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Trauma counselling

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:

  • Exposure to armed robbery, hijacking, assault and rape
  • Household fires
  • Death of a spouse or child
  • Trauma caused by suicide mental health issues of a loved one
  • Motor vehicle accident
  • Diagnosis of a life-threatening illness

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.

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Access to an online health hub

You get access to a library of helpful health articles, empowering you with information to keep you fit and healthy

Purchase Plan
The HealthCare Prestige Individual Plan covers you at the following plan fees
  • Up to 60 years: R165 (which includes the insurance premium of R110) per month
  • From 61-70 years: R248 (which includes the insurance premium of R166) per month
  • From 71-80 years: R264 (which includes the insurance premium of R176) per month
  • From 81-90 years R281 (which includes the insurance premium of R188) per month
  • From 91 years and above: R297 (which includes the insurance premium of R198) per month
Frequently Asked Questions

How many family members are covered on the plan?

The HealthCare Prestige 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.

What’s not covered?

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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