Is One Plan Insurance Medical Aid or What?

    January 30, 2018

    What is One Plan Insurance?

    • Medical insurance not a medical aid.
    • Affordable premiums for essential healthcare.
    • A company with an innovative claim’s management system.
    • The option to choose different levels of cover.
    • Cover for day-to-day expenses and hospitalisation.

     

    One Plan is a company that offers a range of affordable and innovative products covering healthcare insurance. Their plans starting at R330 per month. They offer a range of different cover options. So this company has taken its mandate of providing affordable healthcare seriously.

    The company has taken a different approach in this field. Most health insurance companies provide cover only within their network of healthcare practitioners. However, One Plan instead pays out a set amount per insurable incident.

    One PlanThe company loads funds onto your card, and you are left to choose where to get medical care. Of course, the cover is subject to annual limits, and One Plan may limit the number of visits you are allowed per annum.

    They pay out the following amounts per insurable incident:

    Doctors Visits

    A maximum of R300 for each visit.

    Medication

    The amount for medication works a little differently. The pharmacy will have to claim it electronically. You get a maximum of R133 for each script, and there is no allowance for over the counter meds.

    Pathology

    A maximum of R390 per visit with annual limits that do apply.

    Radiology

    A maximum of R390 per visit with annual limits that do apply.

    Dentistry

    You get a maximum of R520 per visit with a limit of 3 such visits annually.

    Maternity Check-Ups

    A maximum of R520 per visit with a limit of 3 visits for each pregnancy or annual limit of R1566.

    Optometry

    A maximum of R920 per claim which is paid out once every two years.

    Hospital Cover

    Your One Plan cover will usually include cover for treatments in hospital. Excesses are calculated on the amount of the claim, as a percentage or as a specific number of monthly premiums.

    For example, your excess could equal three month’s premiums.

    Hospital Risk Cover

    One Plan pays up to R4800 for casualty treatment in the event of a life-threatening emergency. A minimum excess of R200 is payable when you make a claim.

    Emergency Accident and Accident Cover

    One Plan pays up to R4800 for casualty treatments when you are in an accident. You must pay an excess of at least R200 or 15% whichever is greater when you make a claim.

    An overall limit for accident cover is R130 000 for each event with a family limit of R260 000 per event with an excess of at least R500 when a claim is paid out.

    Accident Disability

    The primary member receives accidental disability cover of R170 000 total over the lifetime of the policy.

    Family Death Cover

    Cover for the primary member, their partner and children over the age of 14 is R6 500 per person.

    What the company pays for younger children depends on their age, but all cover ends when they are 21.

    Trauma, Assault and Accidental HIV

    The company provides counselling and also access to antiretrovirals for assault victims or those accidentally exposed to HIV.

    Repatriation

    The company pays up to R12 200 for the repatriation of remains.

    Ambulance and Emergency Services

    You have access to a 24-hour medical assistance line. The company pays for transport by ambulance.

    One Plan offers a comprehensive range of insurance at an affordable rate. There are several plan levels that you can choose from. The plan detailed above is one of their Core plans. Other plans have additional benefits.

     

    All info was correct at time of publishing