Day One Health Hospital Plan Benefits

    December 21, 2016

    The Day One Health Hospital Plan Benefits offers either an initial Hospital plan, essential day to day benefit option or comprehensive cover with a plan that provides both. The premium for the Day One Health Hospital Plan currently starts at R352 per month for a single principal member. A single head with one child dependant pays R396 per month, while a couple would pay R704 monthly premiums. This plan is therefore very cost efficient and especially appealing to single parents. The age cap for this scheme is 54, and a once off fee of R200 is for joining. This fee is non-refundable.

    Day One Health Hospital Plan Benefits

    Day One Health Hospital Plan BenefitsBenefits of this plan type are all in-hospital. There are accident and illness benefits that are only for the principal member to a limit of R10000. Related to this is the R250 000 benefit for permanent disability due to an accident. This benefit is also for the principal member, and only one event can be claimed for. The cover kicks in immediately. The accident cover on this plan has a limit of R150, 000 for a single member, where the family cap is R300, 000. This is also referred immediately.

    There is also the Family funeral benefit which offers different amounts of cover depending on the member of the family’s age. All members over 14 years old are included at R10000; between 6 and 13 at R5000, from 0 to 5 years at R2500, except babies less than 28 weeks old, for which cover is R1250. A waiting period of 90 days applies for this benefit to kick in.

    From day four up to 21 days in a hospital, the cover is R1500 per day. There is no cover after day 21. Any dread diseases are included per family. Only one incident is covered per year for cover up to R250000 if they undergo a medical examination paid for by themselves. Without such examination, the cover limits at R50000. There is 24hour emergency assistance available from ER24. They will also provide the Pre-Authorisation and guarantee hospital admission. A waiting period of 3 months applies broadly to all policy benefits upon commencing membership.

    Day One Health Hospital Plan Benefits Claims

    Submit Applications within 90 days of the admission, to ensure that the plan covers it from Day 1. The cover is to most private and government hospitals. One does need to obtain pre-authorisation from ER24 though. Maternity benefits are subject to a 12 month waiting period. Also if a policyholder would like to upgrade to a higher option plan, the same waiting period applies. Visits to the casualty ward are only for accidents out of the accident benefit. It will not cover any hospitalisation for less than 24 hours. That is procedures like grommets, tonsillectomy, scopes and scans.

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    All info was correct at time of publishing