Day 1 Hospital Plan Frequently Asked Questions

    To help prospective clients understand more clearly we offer. Day 1 Medical Aid scheme will answer some common questions. Below are some answers to some frequently asked question about the day 1 hospital plan.

    Will you cover an appendectomy – Day 1 hospital plan

    We do include this in our cover plan. Although appendectomy cover is only on the platinum health plan for in-hospital cover. It will pay for in hospital costs up to a limit of R20, 000.

    Do you cover day procedures

    We will not cover any day procedures, or if your hospital stay is less than 24  hours. This means that for any tonsillectomy, scopes, scans and grommets or similar procedures the member will have to pay out of their pocket.

    Does my cover include a trip to the casualty ward – Day 1 hospital plan

    Day 1 Hospital Plan Frequently Asked QuestionsThere are only certain specific casualty ward cases that we will cover. Those will be from an accident, and we will cover it from the accident benefit

    How does the hospital admission work?

    Hospital admissions are subject to prior authorization being issued by ER24.

    Which hospitals fall under your cover?

    We cover most private and government hospitals on the hospital plan.

    Where can I find the ER24 number?

    You can locate the contact number for the ER24 on your member card.

    Will you cover a hysterectomy procedure?

    Yes. We will cover the hysterectomy procedure on the platinum plan to a total of R 20 000.

    Do you provide any maternity benefits?

    We do include maternity benefits cover on the platinum option. Benefits of this plan will include R 11 000 for hospital bills for a natural birth. Or for C-Section’s we cover three days of hospital stay up to a total of R 15 000.

    How do the waiting periods work? – Day 1 hospital plan

     

    Waiting periods are there by regulation to protect the scheme from the risk of taking on members who only want financial gain as opposed to health cover. The Scheme falls under the governance of the Medical Scheme Act of 1998. It is not constituted for profit and owes its existence to its members.

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