Blue Health Insurance Plan

Health Cover Waiting Periods Cover Limits Single Dep(2-3) Dep(4+)
General Practitioner (Doctor) 30 Days Up to R 270 per visit R1 440 R2 585 R3 435
Scripted Medication 30 Days Up to R125 per script. Paid through Mediscor
electronic claim system. No over
counter medication.
R565 R1 020 R1 360
Pathology 30 Days Up to R340 per event. R1 135 R2 270 R3 120
Radiology 30 Days Up to R340 per event. R1 135 R2 270 R3 120
Dentistry 90 Days Up to R455 per visit. Max of 3 visits a year. R1 135 R2 070 R2 835
Specialist Cover 90 Days Not covered on this plan.
Maternity Pre Birth 7 Months applicable to new policies.

Thereafter waiting period of 4 months from date of conception.

Up to R455 per visit. 3 Visits per Pregnancy.
Annual limit of R 1360.
Optometry 12 Months Up to R800 - Limited to claim this every
24 months per dependant.
Maximum overall limits for Health Cover of: Single: R5 950 2 or 3: R10 000 4 plus: R13 280
Hospital Risk Cover Waiting Periods Cover Limits Excess
Emergency Illness 90 Days Up to R4500 for life threatening emergency illness
in casualty units.
Excess:4 months plus - R200
Emergency Accident Immediate Up to R4500 for accident events in casualty units
that does not result in admission.
Excess:0-3 Months - 15 % | 4 months plus -R200
Accident Cover Immediate Up to R153 000 per insured event. Up to R306 000 per family
per event.
Excess: R500 | Contact sport -15% of claim amount
(12 months waiting period)
Illness In Hospital 90 days
Certain conditions are excluded for 12 months.
Up to R34 000 per insured event p/p. Up to R91 000 per insured per year.
Excess:4-6 Months - 15% | 7 months onwards - 5%
Dread Disease 6 Months Up to R210 000 per defined disease per year.
Natural Birth and
Emergency Caesareans
12 Months Up to R34 000 per insured event p/p. Cover forms part
of illness and operations annual limits.
Excess: 10% of claim amount.
Accident Disability Immediate Up to R147 000 for the duration fo the policy.
only principal insured is covered.
Family Death Cover Accidental Death:
Natural Death:
90 Days
Principal Insured: R5 670 | Spouse/Partner:R5 670 | Children 14-21 yrs:R5 670
Children 6-13 yrs R2 835 | Children 1-5 yrs R1 420
Children unborn(28 weeks) ro Oyrs: R850
Trauma,Assault and
Accidental HIV
Immediate Trauma and assault counselling, Accidental HIV protection services.
Accidental HIV infection treatment.
Repatriation Immediate Up to R11 300 per insured person. Repatriation of mortal remains to funeral home.
Ambulance and
Emergency Services
Immediate 24 hr Medical assistance with an emergency dedicated line.
In the event of a justifiable,life-threatening medical emergency,
the insured will be transported by ambulance to the nearest
appropriate medical facility.