Wesmart Medical Insurance

    September 7, 2020

    Wesmart deals with healthcare underwriting with the aim of bringing quality healthcare closer to all South Africans. Healthcare can prove very costly in South Africa.Wesmart hopes to enable thousands of citizens who have been locked out of healthcare to get treatment. Below are the healthcare plans Wesmart has to offer along with an overview of their benefits:

    Wesmart Docsure Advanced

    This is Wesmart’s day-to-day benefits plan. You can take up this cover for yourself as an individual or if you have a family of up to five. For a fair premium, you will have access to the below:

    Consultations

    Up to five consultations per beneficiary every year. You will have a per-visit limit of either R300 or R330.  The former is for visits to non-dispensing GPs while the latter is for dispensing GP visits.

    Wesmart Medical Insurance for South Africans Explained

    If you visit a specialist and pay for consultation from your pocket, you will be refunded up to R850. Note that compensation for specialist consultations only applies for one visit per year for individuals.

    Those with families of three will be compensated for two visits. Families of five will be compensated for three visits per year.

    Consultation sessions with dentists will be covered for up to R700. This cover includes any x-rays, tooth extractions or fillings you may require. You are also entitled to one optometry session per year.

    Procedures

    When it comes to dental procedures, you will be entitled to cover of R400 each for a maximum of two emergency root canals every year. Each beneficiary under your policy can get up to two crowns of up to R500 each annually.

    Every beneficiary under your policy can have up to one eye test every two years. This, together with optometric consultation and any lenses or contact lenses prescribed, should not cost more than R900.

    Medication

    For families with of to five, you will be covered for chronic medication for up t R3,000 every year. those with families of three will be covered up to three can use R2,000 annually.

    Maternity

    With Wesmart You can be refunded up to R900 if you attend pre-natal counseling and pay for it out of your own pocket. But tis is limited to just three pre-natal visits every year. If you are confined to a hospital, the policy will reward you with a maximum of R20,000 per policy per year.

    Added extras from Wesmart

    Over and above your hospital or day-today benefits plans, Wesmart will still cover you. The Wesmart Hospital Booster product will pay out up to R40,000 or up to R500 per day if you are hospitalized for a maximum of two events per year.

    You will have a clinically trained consultant ready to assist you whenever you have an issue. You will also have access to 24-hour emergency medical services.

    Docsure Intermediate

    This is the Wesmart plan to opt for if you wish to have both day-to-day benefits and in-patient treatment covered.

    Ward fees are covered depending on how long you stay.

    Limits for each day of treatment reduce as the days go along.

    There is also an accidental death benefit of R15,000 that covers both the principal and their spouse.

    Complete and submit the form on this page to request your hospital plan quote. Act now!

    All info was correct at time of publishing