Day 1 Health Day to Day Benefit Plan
December 23, 2016
The day 1 health day to day benefit plan is one of 3 initial option offerings that Day One has. The two others are the hospital plan and the platinum plan that has full cover. The premium for this scheme is R240 for a single principle member, R360 for a single principal and a child and R420 for a couple. There is an age limit of 54 to join this scheme and a once off fee of R200 on entering. This fee is non-refundable.
Day 1 Health Day to Day Benefit Plan Benefits
Benefits of this plan type are: unlimited doctor visits provided that they are on the Day 1 Doctor’s network. After the 5th visit per annum, an R75 co-payment applies. You don’t need to pay cash for a consultation with a network doctor as they claim directly from the scheme. There is a one month waiting period to this benefit on joining the project. Day1 Medical Scheme has a 1Doctor Health formula which covers chronic and acute condition medication . Chronic medication does carry a waiting period of 6 months, while that for pre-existing ailments is 12 months. This same 12
Day1 Medical Scheme has a 1Doctor Health formula which covers chronic and acute condition medication. Chronic medication does carry a waiting period of 6 months, while that for pre-existing ailments is 12 months. This same 12 month applies to new members over 65 years old. Upon diagnosis by a doctor on the network, the physician must register you for the Chronic Management programme, upon authorization, you can collect the medication from a pharmacy. Participating stores are Dischem, Clicks and Medirite. It will not cover over the counter medications. The health formula mention above also applies to
The health formula mention above also goes for the radiological treatment of an essential nature. This treatment has to be from a doctor on the Day 1 Network. X-rays for radiology covers only if they are for diagnosis and are black and white. It includes blood tests on referral by the doctor if this doctor is on the GP network and if they are for diagnosis. It only permits certain tests as shown on pathology schedule. Blood tests are also subject to a waiting period of one month. There are set necessary dentistry treatment procedures that are only for treatment from a network dentist and after a six month waiting period from
More Day 1 Health Day to Day Benefit Plan Benefits
There are set necessary dentistry treatment procedures only for treatment from a network dentist and after a six-month waiting period from the date of joining the scheme. It covers optic care at the rate of an eye test and a set of glasses only from the Spec Savers brand per 24 months. There is also a 12 month waiting period from joining date. The scheme permits three consultations per family per year to a GP who is not your usual network GP either on the Network; this helps when your typical G is unavailable or if you are out of town and need to see a GP. The option plan also has a specialist benefit per family of R500 per year.
So you need to be referred by a network GP and get prior authorization from the scheme. A waiting period of 6 months applies to this benefit from the date of joining the scheme.
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All info was correct at time of publishing