Our premiums may be reviewed and escalated on an annual basis.
Access to all private hospitals accepting health insurance products. Pre-authorisation required.
CASH ASSISTANCE BENEFIT
Stated benefits for a defined list of procedures to a max of R50 000 per policy per annum.
Casualty Benefit of up to R30 000 per event, limited to a max of R1 000 000 with R200 000 per event all costs included. Authorised associated costs for follow up treatments post discharge accumulate to the initial event sub-limit.
EMERGENCY STABILISATION BENEFIT
R15 000 per policy per annum for illness only.
Primary Care Benefits
4 consultations per beneficiary per annum and all visits must be pre-authorised.
PRESCRIBED MEDICATION (ACUTE & OTC)
R1 000 per beneficiary per annum for acute including over-the-counter (OTC) medicine. A maximum of R190 per script. Subject to Wesmart Formulary.
Value Added Benefits
24 HOUR EMERGENCY MEDICAL SERVICES
Unlimited, subject to pre-authorisation.
PERSONAL HEALTH ADVISOR
Clinically trained Personal Health Advisor available 24/7 .
ACCIDENTAL DEATH BENEFIT
R10 000 principal member and adult dependent R8 000 per child dependent