HEALTH CARE PLAN* BY LEGAL&TAX
HEALTHCARE PLAN BY LEGAL&TAX IS NOT A MEDICAL AID SCHEME AND THE COVER IS NOT A SUBSTITUTE FOR A MEDICAL SCHEME.
CASH-BACK WHEN ADMITTED TO HOSPITAL:
Payout of R2000 per day up to 10 days, per family, per year. The member needs to have been admitted to hospital for 48 hours or more to qualify for the payment.
24/7 TELEPHONIC NURSE ASSISTANCE ON CALL:
Unlimited access to a nurse on call through the call centre. Members can make use of the unlimited, 24/7 call centre to get medical advice and receive nurse counselling. The call centre provides support and advice throughout the treatment process.
- Pre- and post-test counselling for chronic diseases (including, but not limited to, HIV).
- Symptom assessment and advice
- Pre-surgical counselling and advice
- Child and baby care
Call the nurse whenever you are feeling sick and/or if you are in pain. The nurse on call will be available to assist you and give you advice.
EMERGENCY ASSISTANCE AND EVACUATION
Unlimited access to emergency assistance and/or evacuation.
- If a member requires emergency assistance and/or evacuation, a private emergency ambulance will be dispatched. The member is taken to a medical facility. This service is only provided in life-threatening circumstances as assessed by the medical team on call.
Call for an ambulance when you or a loved one’s life is in danger and if you/they are in need of immediate medical help.
Unlimited, telephonic support and trauma counselling following a traumatic event.
- This includes, but is not limited to: exposure to armed robbery; household fire; death of a spouse or child; trauma from suicide and/or mental health issues; hijacking; serious assault; rape; serious motor vehicle accident; diagnosis of a life-threatening illness.
Members who experience family related problems requiring counselling will be referred to specialist agencies
How many family members are covered on the plan?
The main member, their legal spouse, plus up to five dependants under the age of 18 can be covered on one HealthCare plan.
Are there pre-screening requirements?
No. There are no exams or tests required before signing up.
Are pre-existing conditions covered?
Yes. There is a twelve month waiting period for pre-existing conditions.
Is there a waiting period for claims?
For admissions due to an accident, there is one-day waiting period.
For admissions due to an illness, there is a three-month general waiting period and a twelve-month waiting period for pre-existing conditions.
How does a member claim?
A member can claim by calling 0860 587 587 or by SMSing “claims” to 31690.
Does a member have to use the cash back for medical use?
No. This cash does not need to be spent on medical requirements unless the member wishes to do so. The cash back funds are paid directly into the beneficiary’s bank account.