Our premiums may be reviewed and escalated on an annual basis.
Individual
Adult Dependant
Child Dependant
Managed unlimited general practitioner visits at a contracted network provider. Includes certain in-room procedures. All consultations after the 5th visit must be pre-authorised.
2 Consultations per policy per annum, refunded at a maximum of R350.
Up to a maximum of R1 000 per beneficiary per annum. Specialist benefits are available on a pay and claim basis. The member must be referred by a network
Unlimited acute medication either at dispensing network GP or pharmacy. Subject to Wesmart Formulary
R150 per policy per month as per Wesmart formulary. Limited to R600 per policy per annum.
Unlimited. Restricted to 26 chronic diseases on the Chronic Disease List and Wesmart Formulary. All chronic medicine needs to be applied for by the prescribing medical expert.
1 and 2 sided x-rays. Member must be referred by a network GP provider. Services are directly linked and limited to Wesmart Protocols.
Unlimited. Member must be referred by a network GP provider. Services are directly linked and limited to the Wesmart Protocols.
2 visits per beneficiary per annum managed according to the Wesmart Protocols.
Specsavers network only. 1 consultation, 1 frame and single vision lenses per beneficiary every 24 months. The maximum value of these services is R1 249.
R1 000 per policy per annum. Only available after hours and must be pre-authorised by Africa Assist.
Clinically trained Personal Health Advisor available 24/7.
R10 000 principal member and adult dependant R8 000 per child dependant.
For all terms and conditions, benefits, limitations, and exclusions please refer to the
policy wording which forms part of your Schedule of Insurance or consult your broker.
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This is not a medical scheme and the cover is not the same as that of a medical scheme. This policy is not a substitute for a medical scheme membership.
WESMART Financial and Administration Solutions (Pty) Ltd (WESMART), is an authorised Financial Services Provider (FSP: 45769), underwritten by GENRIC Insurance Company Limited (GENRIC), (FSP 43638). GENRIC is an authorised Financial Services Provider and licensed non-life Insurer.
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