DOCSURE INTERMEDIATE

Wesmart Home Page Elements-19
Individual
R1 131
Wesmart Home Page Elements-20
FAMILY MAX 3
R1 576
Wesmart Home Page Elements-21
FAMILY MAX 5
R1 874

WHAT IT COVERS

Comprehensive Advanced page banner_GP consultation
GP CONSULTATION

3 consultations per beneficiary per annum. Dispensing GP reimbursement paid at R330 per consultation and non-dispensing GP reimbursement paid at R300 per consultation.

Comprehensive Advanced page banner_Dentistry
DENTISTRY

R600 as a combined benefit for consultations, Fillings, X-Rays and Extractions, including Scale and Polish, 2 Emergency Root Canal at R400 each, 2 Crowns at R500 each and In Chair Wisdom Teeth at R750, per beneficiary per annum.

Comprehensive Advanced page banner_Optometry
OPTOMETRY

All activities for Optometry services including (Eye Test, 1 Consultation, Frames and Lenses up to R750) or Contact Lenses up to R750 every 24 months per beneficiary.

Comprehensive Advanced page banner_Specialist consultations
SPECIALIST
CONSULTATIONS

Individual Option: 1 consultation refunded at R650. Family Option 3: 2 consultations refunded at R650. Family Option 5: 3 consultations refunded at R650 provides the policyholder and or Insured with access to Specialist consultations.

Comprehensive Advanced page banner_Network providers
OUT OF NETWORK
CONSULTATIONS

2 consultations refunded at R250 per policy.

Comprehensive Advanced page banner_Chronic medication
CHRONIC
MEDICATION (PER CDL)

Individual option: R1 500, Family option 3, R2 000, Family option 5, limited to R3 000 per policy per annum. Up to a max of R300 per script.

Comprehensive Advanced page banner_Hospital booster
HOSPITAL
BOOSTER

Max of R15 000 per event. Paid out at R1 750 per day. Limited to 2 events per annum.

Comprehensive Advanced page banner_Hospital Footprint
HOSPITAL
FOOTPRINT

National Private / State facilitated by Africa Assist.

Comprehensive Advanced page banner_Personal health advisor
PERSONAL
HEALTH ADVISOR

Clinically trained consultant available 24 / 7.

Comprehensive Advanced page banner_Maternity Benefit
MATERNITY
BENEFIT

A sub-limit of R18 000 per policy per annum for confinement, includes 3 Pre-natal consultations refunded at R750.

Comprehensive Advanced page banner_Casualty benefit
CASUALTY BENEFIT
(ACCIDENT ONLY)

R3 000 per policy per annum as a result of Trauma and Accident only.

Comprehensive Advanced page banner_Anaesthetic benefit
ANAESTHETIC
BENEFIT

Max of R4 000 per event for anaesthetic practitioners.

Comprehensive Advanced page banner_Accidental death benefit
ACCIDENTAL
DEATH BENEFIT

R15 000 (principal and spouse).

Comprehensive Advanced page banner_Acute medication
ACUTE
MEDICATION

Individual Option: R900. Family Option 3: R1 500. Family Option 5: Limited to R2 200 per policy per annum. Up to a max of R200 per script.

Comprehensive Advanced page banner_Shortfall benefit
24 HOUR EMERGENCY
MEDICAL SERVICES

Pre-authorised by Africa Assist. Limited to R50 000 per policy per annum

Comprehensive Advanced page banner_Premium waiver
PREMIUM
WAIVER

Actual premium held as a credit for 6 months.

Comprehensive Advanced page banner_Daily illness Benefit
ILLNESS BENEFIT
INCLUDES ALL WARD FEE STRUCTURES

Day 1: R6 000 | Day 2: R5 000 | Day 3 – 6: R3 000 | Day 7 onwards: R1 500 per day to a limit of R37 000 per event.

Comprehensive Advanced page banner_Treatment
TREATING AND
ADMITTING PRACTITIONERS

Max of R6 500 per event for treating and admitting practitioners.

Comprehensive Advanced page banner_Total permanent disability
TOTAL PERMANENT
DISABILITY

R15 000 (Principal only).

Comprehensive Advanced page banner_Radiology & Pathology
RADIOLOGY AND PATHOLOGY
(IN & OUT HOSPITAL)

R6 000 per policy per annum. R1 000 excess per scan and R500 excess for blood tests.

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Call Me Back!

Wesmart is a medical insurance product and therefore may review the premium on an annual basis. In the event of this occurring, we will notify you 30 days in advance of any changes to benefits or premiums. The benefits mentioned are a summary and not the full terms, conditions and limitations. The word “Formulary” refers to an approved list agreed to by Wesmart relating to the specific benefit.

Waiting periods, limitations and exclusions