Unlimited Managed Doctor Visits

Via a registered 1Doctor Health Network Provider. A co-payment of R75.00 will apply for all additional visits after the 5th visit. 1 Month Waiting period applies.

Specialist Benefit

Specialist Benefit of up to R500 per family per annum. Subject to pre-authorisation and referral from a 1Doctor Health Network GP. 3 Month Waiting period applies.

Acute & Chronic Medication

Both acute and chronic medication are covered according to the 1Doctor Health formulary. A 3 month waiting period applies on chronic medication for unknown conditions and 12 months waiting period on pre-existing conditions.

Basic radiology according to the 1Doctor Health formulary via a 1Doctor Health Network GP. Black and white diagnostic x-rays only. 1 Month Waiting period applies.

Pathology

Basic diagnostic blood tests on referral by a 1Doctor Health Network GP and subject to a list of basic pathology tests approved by Day1 Health. 1 Month Waiting period applies.

Optometry (Spec-Savers)

One eye test and one set of glasses every 24 months per the specific Spec-Savers agreed protocol range. 12 month waiting period applies.

Out-of-Area Visits

In the event that you cannot see your Network GP, the Plan will allow 3 “out of area” visits per family per annum to an alternative Network GP or GP of your choice, subject to pre-authorisation. 1 Month Waiting period applies.

To get more information, click here to see a list of benefits.

In-hospital Illness Benefit

Covers up to R10,000 for the first day in hospital, up to R10,000 for the second day in hospital, up to R10,000 for the third day in hospital. Thereafter R1,500 per day up to a maximum of 21 days. A 12 month pre-existing condition exclusion applies. (Authorised admissions subject to a min 24 hour hospital stay.)

Accident / Trauma Benefit

Up to R150,000 per single member per incident and up to R300,000 per family per incident. Immediate cover

Dread Disease Benefit

Accidental Permanent Disability Benefit

R250 000 for the Principal Member only. Single event only. Immediate cover.

Death Benefit

R10 000 for the Principal Member only.

Family Funeral Benefit

Principal, Spouse & Child > 14 years R10,000. Child > 6 years R5,000. Child > 0 years > R2,500. Child > 28 weeks R1,250.

24 Hour Emergency Services & Pre-Authorisation (0861 144 144)

24 Hour Emergency Services, Medical Assistance and Pre-Authorisation provided by Africa Assist. Guaranteed hospital admission.

To get more information click here to see a list of benefits

The comprehensive plan is a combination of day to day cover with hospital cover as well. To see a complete list of benefits, click here.